Form REV187, Email Authorization
Read instructions before completing this form. 
                            Taxpayer Name                                       Social Security Number or ITIN

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

                            Apt. or Suite                                       Phone Number                                       Fax Number 
         Taxpayer 
                            City                            State   ZIP Code    Email Address                                                                               Copy me on 
                                                                                                                                                                            all email

                            Name of Person to Receive Email                     Attorney Number, Accountant Number, or PTIN

                            Email Address                                       Expiration Date                                       
                  Recipient                                                                                                                 

                            This authorization is not valid until it is signed and dated by the taxpayer, or someone with legal authority to sign on behalf of the taxpayer.
                            Parent, Guardian, Conservator, or Officer: I certify that I have the legal authority to sign this form.
                            Signature                                           Print Name and Title, If Applicable                           Date 
                  Signature

                            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 

Form REV187 Instructions

Purpose of This Form
By signing this form, you authorize the Minnesota Department of Revenue to exchange private or nonpublic data using unencrypted email 
with the person above. Unencrypted email is not secure.
You accept the risk in the unencrypted email that data may be intercepted by someone other than the intended recipient and understand that 
the department is not liable for any damages caused by such interception.
This form does not authorize the department to release private or nonpublic data to anyone other than the recipient unless there is a valid 
power of attorney on file. 
Copy Me on All Email
You can receive a copy of the email sent to your recipient by checking the box next to your email address.
Your Signature
This authorization 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 information 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 the taxpayer, we require documents and a photo 
ID to confirm your legal authority. 
We reserve the right to request additional information as needed. 
Expiration
This authorization remains in effect until it expires, if indicated above, or is removed in writing. You may remove this authorization at any time.
Questions?
Website: www.revenue.state.mn.us
Email:  MNDOR.POA@state.mn.us
Phone:  651-556-3003 or 1-800-657-3909

(Rev. 9/22)