Important -- to ensure this form works properly,                                                       Save         Print     Clear
save it to your computer before completing the form. Power of Attorney
                                                     (Please print or type)
                                                                                                         Form
Wisconsin Department
     of Revenue                                                                                                   A-222

Part 1 – Taxpayer Information

Last name or business name                                 First name                                  ID number

Spouse’s last name                                         Spouse’s first name                         Spouse’s ID number

Current address                                                                                        Daytime phone number 
                                                                                                       (        )   -
City                                                 State Zip code            Email address (optional)

Part 2 – Representative(s)

Describe action (check one)
Appointing a new or additional representative                       Revoking authority of the representative named below
                                                                    (Complete Parts 3A or 3B)

Part 3 – Representative is an Entity or Individual (check one)

Check here if you want to grant authority to an entire entity or firm and complete Part 3A ONLY.
Check here if you want to grant authority to a specific individual(s) and complete Part 3B ONLY.

Part 3A – Entity or Firm

Entity’s legal name                                                                                    Phone number
                                                                                                       (        )   -
Contact’s last name                                        Contact’s first name

Email address                                                                                          Fax number 
                                                                                                       (        )   -
Mailing address                                                                                        Apt. no. 

City                                                                              State                Zip code

Part 3B – Individual

Individual’s last name                                     Individual’s first name

Email address                                                                                          Phone number 
                                                                                                       (        )   -
Mailing address                                                                                        Apt. no. 

City                                                                              State                Zip code

A-222 (R. 10-21)
                                                                                                                  Go to Page 2

                                              Power of Attorney
Form A-222                                           (Please print or type)                                        Page 2 of 2
 Taxpayer Name                                                                              ID Number

Part 3B – Continued
Individual’s last name                                  Individual’s first name

Email address                                                                                       Phone number 
                                                                                                    (       )     -
Mailing address                                                                                     Apt. no.

City                                                                                  State         Zip code

If revoking a representative’s authority, skip Part 4 and sign and date the form.

Part 4 – Full or Limited Authority (check one)

     I grant full authority to the representative(s) - The representative(s) named above has full authority to perform any act with 
     respect to matters before the department that the taxpayer(s) can and may perform, including receiving confidential Wisconsin 
     tax information. Note:  If granting full authority, do not check any boxes below.

     I grant limited authority to the representative(s) -  (check  only  items  below  for  which  you  are  granting  authority.)  The 
     representative(s) named above has authority to perform any act, with respect to the items checked below, that the taxpayer(s) 
     can and may perform, including the authority to receive confidential Wisconsin tax information.

Authority                          Period(s) (optional)               Authority                            Period(s) (optional)
     Income or Franchise Taxes                                        Employer Withholding Taxes
     Sales and Use Taxes                                              Pass-Through Withholding
     Excise Taxes                                                     Taxes
                                                                      Nontax Debt
     Property Taxes
                                                                      Other (describe below)

Part 5 – Signature of Taxpayer(s)

I understand that the execution of this Power of Attorney does not relieve me of personal responsibility for reporting and paying taxes 
correctly and timely, or from the penalties, fees, or interest for failure to do so, all as provided for under Wisconsin tax law. I understand 
a photocopy, faxed copy, and/or electronic copy of this form has the same authority as the signed original.

If signed by a corporate officer, general partner, managing member, or fiduciary on behalf of the taxpayer, I certify that I have the 
authority to execute this Power of Attorney on behalf of the taxpayer.
Signature                                               Title                                                 Date

Signature                                               Title                                                 Date

Note:  All notices that are automatically generated by the department’s computer system (e.g. Notice of Amount Due or Notice of 
Refund/Offset) will be sent only to the taxpayer. Representatives may access copies of most notices through My Tax Account, if the 
taxpayer authorizes online access to the representative. If the representative does not have access through My Tax Account, they must 
request copies from the department employee they are working with, or request copies of taxpayer records at https://www.revenue.
wi.gov/Pages/FAQS/ise-request.aspx.