Check Form for Common Errors & Reminders

                                                                                                                            OMB No. 1545-0150 
                                                       Power of Attorney 
Form   2848                                                                                                                 For IRS Use Only 
(Rev. January 2021)                      and Declaration of Representative                                                Received by: 
Internal Revenue Service           Go to 
Department of the Treasury       ▶       www.irs.gov/Form2848 for instructions and the latest information.                Name 
 Part I Power of Attorney                                                                                                 Telephone 
        Caution: A separate Form 2848 must be completed for each taxpayer. Form 2848 will not be honored                  Function 
        for any purpose other than representation before the IRS.                                                         Date              /      / 
 1     Taxpayer information. Taxpayer must sign and date this form on page 2, line 7. 
Taxpayer name and address                                                     Taxpayer identification number(s) 

                                                                              Daytime telephone number                Plan number (if applicable) 

hereby appoints the following representative(s) as attorney(s)-in-fact: 
 2     Representative(s) must sign and date this form on page 2, Part II. 
Name and address                                                              CAF No. 
                                                                              PTIN
                                                                              Telephone No. 
                                                                              Fax No. 
Check if to be sent copies of notices and communications                   Check if new:  Address    Telephone No.             Fax No. 
Name and address                                                              CAF No. 
                                                                              PTIN
                                                                              Telephone No. 
                                                                              Fax No. 
Check if to be sent copies of notices and communications                   Check if new:  Address    Telephone No.             Fax No. 
Name and address                                                              CAF No. 
                                                                              PTIN
                                                                              Telephone No. 
                                                                              Fax No. 
(Note: IRS sends notices and communications to only two representatives.)  Check if new:  Address    Telephone No.             Fax No. 
Name and address                                                              CAF No. 
                                                                              PTIN
                                                                              Telephone No. 
                                                                              Fax No. 
(Note: IRS sends notices and communications to only two representatives.)  Check if new:  Address    Telephone No.             Fax No. 
to represent the taxpayer before the Internal Revenue Service and perform the following acts:
 3     Acts authorized (you are required to complete line 3). Except for the acts described in line 5b, I authorize my representative(s) to receive and 
       inspect my confidential tax information and to perform acts I can perform with respect to the tax matters described below. For example, my 
       representative(s) shall have the authority to sign any agreements, consents, or similar documents (see instructions for line 5a for authorizing a 
       representative to sign a return).
 Description of Matter (Income, Employment, Payroll, Excise, Estate, Gift,    Tax Form Number                       Year(s) or Period(s) (if applicable) 
 Whistleblower, Practitioner Discipline, PLR, FOIA, Civil Penalty, Sec.    (1040, 941, 720, etc.) (if applicable)       (see instructions) 
       4980H Shared Responsibility Payment, etc.) (see instructions) 

 4     Specific use not recorded on the Centralized Authorization File (CAF). If the power of attorney is for a specific use not recorded on 
       CAF,  check this box. See Line 4. Specific Use Not Recorded on CAF in the instructions  . . . .       .    . . . . . .  .   .        .  ▶
 5 a  Additional acts authorized. In addition to the acts listed on line 3 above, I authorize my representative(s) to perform the following acts (see 
       instructions for line 5a for more information): Access my IRS records via an Intermediate Service Provider;
        Authorize disclosure to third parties;         Substitute or add representative(s);      Sign a return;

        Other acts authorized:

For Privacy Act and Paperwork Reduction Act Notice, see the instructions.                    Cat. No. 11980J              Form 2848 (Rev. 1-2021) 

Form 2848 (Rev. 1-2021)                                                                                                                           Page 2 
 b  Specific acts not authorized. My representative(s) is (are) not authorized to endorse or otherwise negotiate any check (including directing or 
      accepting payment by any means, electronic or otherwise, into an account owned or controlled by the representative(s) or any firm or other 
      entity with whom the representative(s) is (are) associated) issued by the government in respect of a federal tax liability.
      List any other specific deletions to the acts otherwise authorized in this power of attorney (see instructions for line 5b): 

6     Retention/revocation of prior power(s) of attorney.      The filing of this power of attorney automatically revokes all earlier power(s) of 
      attorney on file with the Internal Revenue Service for the same matters and years or periods covered by this form. If you         do not want to 
      revoke a prior power of attorney, check here  . .      . .   . . . .  . .    . .    .   .         . . .     . . .    .   .   .    . . .   .  ▶
      YOU MUST ATTACH A COPY OF ANY POWER OF ATTORNEY YOU WANT TO REMAIN IN EFFECT. 
7     Taxpayer declaration and signature. If a tax matter concerns a year in which a joint return was filed, each spouse must file a separate power 
      of attorney even if they are appointing the same representative(s). If signed by a corporate officer, partner, guardian, tax matters partner, 
      partnership representative (or designated individual, if applicable), executor, receiver, administrator, trustee, or individual other than the 
      taxpayer, I certify I have the legal authority to execute this form on behalf of the taxpayer. 
      ▶ IF NOT COMPLETED, SIGNED, AND DATED, THE IRS WILL RETURN THIS POWER OF ATTORNEY TO THE TAXPAYER. 

                           Signature                                   Date                                       Title (if applicable) 

                        Print name                                          Print name of taxpayer from line 1 if other than individual 
Part II Declaration of Representative 
 Under penalties of perjury, by my signature below I declare that: 
• I am not currently suspended or disbarred from practice, or ineligible for practice, before the Internal Revenue Service;
• I am subject to regulations in Circular 230 (31 CFR, Subtitle A, Part 10), as amended, governing practice before the Internal Revenue Service;
• I am authorized to represent the taxpayer identified in Part I for the matter(s) specified there; and 
• I am one of the following: 
a  Attorney—a member in good standing of the bar of the highest court of the jurisdiction shown below. 
b  Certified Public Accountant—a holder of an active license to practice as a certified public accountant in the jurisdiction shown below. 
c  Enrolled Agent—enrolled as an agent by the IRS per the requirements of Circular 230. 
d  Officer—a bona fide officer of the taxpayer organization. 
e  Full-Time Employee—a full-time employee of the taxpayer. 
f   Family Member—a member of the taxpayer’s immediate family (spouse, parent, child, grandparent, grandchild, step-parent, step-child, brother, or sister).
g  Enrolled Actuary—enrolled as an actuary by the Joint Board for the Enrollment of Actuaries under 29 U.S.C. 1242 (the authority to practice before 
    the IRS is limited by section 10.3(d) of Circular 230). 
h  Unenrolled Return Preparer—Authority to practice before the IRS is limited. An unenrolled return preparer may represent, provided the preparer (1) 
    prepared and signed the return or claim for refund (or prepared if there is no signature space on the form); (2) was eligible to sign the return or 
    claim for refund; (3) has a valid PTIN; and (4) possesses the required Annual Filing Season Program Record of Completion(s). See Special Rules 
    and Requirements for Unenrolled Return Preparers in the instructions for additional information.
k  QualifyingStudent    or Law Graduate—receives permission to represent taxpayers before the IRS by virtue of his/her status as a law, business, or 
    accounting student, or law graduate working in a LITC or STCP. See instructions for Part II for additional information and requirements.
r  Enrolled Retirement Plan Agent—enrolled as a retirement plan agent under the requirements of Circular 230 (the authority to practice before the 
    Internal Revenue Service is limited by section 10.3(e)). 
    ▶ IF THIS DECLARATION OF REPRESENTATIVE IS NOT COMPLETED, SIGNED, AND DATED, THE IRS WILL RETURN THE 
    POWER OF ATTORNEY. REPRESENTATIVES MUST SIGN IN THE ORDER LISTED IN PART I, LINE 2. 
Note: For designations d–f, enter your title, position, or relationship to the taxpayer in the “Licensing jurisdiction” column.
Designation—   Licensing jurisdiction  Bar, license, certification, 
Insert above   (State) or other        registration, or enrollment                                      Signature                               Date 
 letter (a–r). licensing authority     number (if applicable)
                        (if applicable)

                                                                                                                                   Form 2848 (Rev. 1-2021)