Form REV184b, Business Power of Attorney
Read instructions before completing this form.
To grant authority for an individual or sole proprietor, complete Form REV184i, Individual or Sole Proprietor Power of Attorney.
Business Taxpayer Name Minnesota or Federal Employer Identification Number (FEIN)
Street Address or PO Box Phone Number Fax Number
Apt. or Suite Combined Business Returns: Filing entity name (if different)
City State ZIP Code Filing Entity FEIN or Taxpayer Identification Number
Business Taxpayer
Name of Appointee Attorney Number, Accountant Number, or PTIN
Street Address or PO Box Phone Number
Apt. or Suite Fax Number
City State ZIP Code Email Address
Primary Appointee
If appointing more than one person, enter on page 2 of this form.
The person named above, and anyone included on the attached list, is appointed to access the taxpayer’s information and represent it be-
fore the Minnesota Department of Revenue.Check the box for Limited Authority or Full Authority. (This authority does not cover powers
listed in the Additional Powers section below, unless indicated.)
Limited Authority Full Authority
The appointee is authorized to act on behalf of the taxpayer, but only for the following: The appointee is
Type of Tax (Such as Business Income, Tax Form Name or Number Years or Periods authorized to act on
Sales, Withholding) or Debt Issue (If applicable) (If left blank, applies to all) behalf of the taxpayer
for all tax and debt
issues for all years or
periods.
Authority Granted
Authority Expiration Date:
Add the following powers to the appointee’s limited or full authority (check any that apply):
Communicate with the department by email Add additional appointees (Primary Appointee only)
Sign returns and other tax forms Receive all mail except refunds (see instructions) (Primary Appointee only)
Powers
Additional Extend statute of limitations to assess tax Authorize the department to release return information to third parties
Execute agreements
This Power of Attorney is not valid until it is signed and dated by someone with legal authority to sign agreements on behalf of the business taxpayer.
I certify that I have the legal authority to sign this form.
Signature Date Address, If Different from Taxpayer
Signature Print Name and Title Phone Number City State ZIP Code
Send a signed copy of this form to the department:
Mail: Minnesota Department of Revenue, Mail Station 4123, 600 N. Robert St., St. Paul, MN 55146
Fax: 651-556-5210
Email: MNDOR.POA@state.mn.us
(Rev. 11/19)