Form REV184i, Individual or Sole Proprietor Power of Attorney 
Read instructions before completing this form. To grant authority for a business, complete Form REV184b, Business Power of Attorney.
                                                                             Taxpayer Name                                                          Social Security Number or ITIN 

                                                                             Street Address or PO Box                                               Minnesota or Federal Employer Identification Number (FEIN)(Sole Proprietors) 

                                                                             Apt. or Suite                                                          Phone Number                                             Fax Number 
                                         Taxpayer 
                                                                             City                                   State       ZIP Code            Email Address 

                                                                             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. 
                                                                             I appoint the person above, and anyone included on the attached list, to access my information and represent me before the Minnesota 
                                                                             Department of Revenue. This authority does not cover powers listed in the Additional Powers section below, unless indicated. 
                                                                             Check the box for Limited Authority or Full Authority. 
                                                                                 Limited Authority                                                                                                             Full Authority  
                                                                             The appointee is authorized to act on my behalf, but only for the following:                                                    The appointee is 
                                                                             Type of Tax (Such as Income, Estate,                                                           Years or Periods                 authorized to act on 
                                                                             Property Tax Refund, Withholding)    or Debt Issue                               (If left blank, applies to all)                my behalf for all of my 
                                                                                                                                                                                                             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 my return information to third parties 
                                                                                 Execute agreements                                                   Act on my behalf if I become incapacitated or incompetent (Durable POA)  
                                                                             This Power of Attorney is not valid until it is signed and dated by the taxpayer. 
                                                                             Parent, Guardian, Conservator: I certify that I have the legal authority to sign this form. 
                                                                             Signature                                          Date                                     Address, If Different from Taxpayer 

                                                            Signature        Print Name and Title, If Applicable                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) 

Form REV184i, Page 2 — Additional Appointees 
Name of Taxpayer                                                          SSN, ITIN, MN ID, or FEIN 

Include any additional appointees below. Additional appointees only have authority over matters chosen in the Authority Granted 
and    Additional Powers sections on page 1. 
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 

  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 

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 

  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 

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 

Attach additional copies of this page, as needed. 

Form REV184i Instructions 

What is a Power of Attorney (POA)?
A power of attorney (POA) is a legal document that grants an attorney, accountant, agent, tax return preparer, or other person authority to 
access your account information and represent you before the Minnesota Department of Revenue. 

Use of Information 
The information you enter on this form may be private or nonpublic under state law. We use it to allow your appointee to access your ac-
count and take actions on your behalf. We may share it with other government entities for tax administration if allowed by law. You are not 
required to provide the information requested, however, we are unable to process the appointment unless the form is complete. 

How do I complete this form? 
Taxpayer 
Step 1  
Enter the individual taxpayer’s name and contact information. Submit two separate forms if authorizing the same person for you (REV184i) 
and your business (REV184b). Submit only one form for you and your spouse. 
Step 2  
Enter the appropriate identification number: Social Security number (SSN), Individual Taxpayer ID number (ITIN), Federal Employer ID 
number (FEIN), or Minnesota Tax ID number. 
Deceased Individuals and Estates: Enter the decedent’s name and SSN or ITIN in the Taxpayer section. Include the contact information for 
the decedent’s executor or personal representative. 
Sole Proprietors: If you are authorizing an appointee for both individual and business tax issues, enter your SSN or ITIN 
and your FEIN or Minnesota Tax ID number. 

Primary Appointee 
Eligibility: Your appointee must be eligible to represent you with the department. 
You may not appoint: 
  •  A person barred or suspended from practice as an attorney or accountant 
   • A person barred or suspended from practice before the Internal Revenue Service (IRS) 
  •  A current employee of the department 
  •  A former department employee within one year of leaving the department 
For details, go to www.revenue.state.mn.us and enter Preparer Enforcement in the Search box. 
Step 3  
An appointee is a person selected to represent you before the department. Enter the appointee’s name and contact information. You may 
have more than one appointee, but only the primary appointee can be selected to receive mailed correspondence from the department. 
For additional appointees, complete page 2 of Form REV184i. Include additional pages, if needed. 
Note:  You are responsible for keeping your appointees informed of changes to your account. 

Authority Granted 
Step 4      
Choose whether to grant the appointee full authority or to limit authority to specific issues. 
Limited Authority allows the appointee to act on specific tax or debt issues. 
  •  By tax type or issue 
   • By year or filing period is optional. If no year is provided, authority applies to all periods. 
Full Authority allows your appointee to act on your behalf for your tax and debt issues. 
Choose an expiration date for the POA if applicable. To have the POA end on a specific date, enter the month, day, and year (enter as MM/ 
DD/YY). If no date is provided, the POA and additional powers will remain in effect until removed. 

                                                                                                                              Continued 

Form REV184i Instructions, cont. 

Additional Powers 
Step 5  
Choose additional powers to give the appointee. 
  •  Communicate by email: Allows your appointee to communicate with the department by email. 
 Note: Transmit return information via email at your own risk. Email is not secure; the department is not liable for damages caused by inter-
    ception of emails. 
  •  Sign returns and other forms: This does not authorize the appointee to endorse or negotiate any checks or other payments issued by the 
    department. 
  •  Add additional appointees: Allows a primary appointee to authorize additional appointees. 
 Note: The appointee may only grant authority over tax types or issues you authorized in the Authority Granted section. 
  •  Execute agreements: Allows the appointee to enter into contracts and other binding agreements on behalf of the taxpayer. 
  •  Authorize disclosure to third parties: Allows your appointee to authorize the department to share return information with people outside 
    the department. Appointees may discuss your account with people they employ or supervise, even if this box is not checked. 
  • Receive all mail except refunds: Authorizes the department to mail letters, legal notices, and tax information directly to the primary ap-
    pointee only. Any refunds or letters relating to refunds will be sent directly to you. If you are only granting authority for specific years or 
    periods, this option is not available. All mail will go directly to you. 
 Note:  You may still receive copies of some mail from the department in certain circumstances. 
  This power is effective only for the tax types or issues granted to the primary  appointee. 
  Mail will go to the most recently designated person, replacing designations from a prior POA. 
  •  Durable POA: Allows this POA to remain in effect if you become incapacitated or incompetent. Consult an attorney if you need more 
    information about this authority. 

Signature 
Step 6  
Sign, print your name, and date the form. 
This POA is not valid until it is signed and dated by someone with legal authority to sign it. For most people, this is the taxpayer whose infor-
mation is being shared. 
If granting authority for a joint return, only one spouse needs to sign. Parents or legal guardians must sign for minors. For legal guardians, 
conservators, personal representatives, and others signing on behalf of a taxpayer, we require documents and a photo ID to confirm your legal 
authority. 
We reserve the right to request additional information as needed. 
Deceased Individuals and Estates: The decedent’s executor or personal representative must sign, date, and enter their title in the Signature 
section. 
Step 7  
Send the form to the department using only one of the following: 
  • Mail: Minnesota Department of Revenue, Mail Station 4123, 600 N. Robert St., St. Paul, MN 55146 
  • Fax: to 651-556-5210 
  • Email: MNDOR.POA@state.mn.us 

How do I revoke an appointee?
To revoke an appointee, you or the appointee must send the department a signed and dated statement terminating the appointee’s authority or 
a completed Form REV184r, Revocation of Power of Attorney. 

E-Services Account 
No POA form is necessary to access a taxpayer’s e-Services account, but the appointee must request Third-Party access through e-Services. 
Go to our website and enter Third Party Access in the Search box. 

Questions? 
Website:  www.revenue.state.mn.us 
Email:  MNDOR.POA@state.mn.us          
Phone:   651-556-3003 or 1-800-657-3909