IL-2848 (R-08/20) Front
Illinois Department of Revenue
Form IL-2848
Power of Attorney
*65204201W*
This form is authorized by various acts found in Illinois Compiled Statutes. Disclosure of
this information is REQUIRED. Failure to provide information could result in a penalty.
Check one box (See instructions) Add: New POA Add: Additional POA Change: Existing POA Remove: Existing POA
:
Step 3 - Authority Granted
I grant the above person, and anyone included in the attachment,
full authority, authorizing them to act on my behalf in all tax matters with IDOR.
limited authority (check only the boxes that apply). By checking boxes, the appointee(s) will be authorized to act on my behalf only
for the indicated tax matters. If I do not indicate a specific year or period for a selected tax type, I am granting authority for all years
or periods.
Tax Type Years/Periods Tax Type Years/Periods
I
ndivid
ual Income Tax Sales and Use Tax
Withholding Income Tax
Vehicle Use Tax (RUTs)
Excise Tax
NPL/1002D
Business Income Tax
Specific Authority Granted. Attach Form IL-2848-B.
Check this box if the appointee(s) is not authorized to sign tax return.
Check this box if your authorized agent (corporate officer, partner, or individual on behalf of the taxpayer) or fiduciary is executing this
form and complete Step 4 in addition to Steps 1, 2, 3, 5, and 6.
Step 1 - Taxpayer Information
Taxpayer’s name (person or business) FEIN, SSN, or Illinois Account ID
Spouse’s name (if joint income tax return) Spouse’s SSN (if joint income tax return)
Taxpayer’s Street Address City State ZIP
Taxpayer Phone Number Taxpayer’s Email address
Power of Attorney Signature Date
Power of Attorney Printed Name Jurisdiction
Step 2 - Power of Attorney Information Form IL-2848-A attached _______ How many Forms IL-2848-A are attached?
Check one box: Attorney Certified Public Accountant Enrolled Agent Other (Complete Step 6)
Power of Attorney’s name Firm Name
Identification Number (Attorney License, PTIN, FEIN, SSN) Email Address
Power of Attorney’s Street Address City State ZIP
( ) ( )
Daytime Phone Number Fax Number
Check this box to authorize IDOR to send duplicate copies of notices to the Power of Attorney listed here.
If your Power of Attorney is an attorney, certified public accountant, or enrolled agent, the Power of Attorney must complete this
section:
I declare that I am not currently under suspension or disbarment, and that I am
a member in good standing of the highest court of the jurisdiction indicated;
or
duly qualified to practice as a certified public accountant in the
jurisdiction indicated;
or
enrolled as an agent pursuant to the requirements of United
States Treasury Circular #230.
Use your 'Mouse' or the 'Tab' key to move through the fields. Use your 'Mouse' or 'Space Bar' to activate Check Boxes.
IL-2848 (R-08/20) Back
*65205202W*
Step 4 - Authorized Agent/Fiduciary
If you checked the box in Step 1 indicating that your authorized agent (corporate officer, partner, or individual on behalf of the taxpayer) or
fiduciary is executing this form, complete this Step in addition to Steps 1, 2, 3, 5, and 6.
Corporate Officer, Partner, Individual, or Fiduciary Name Title (Corporate Officer, Partner, Individual, or Fiduciary)
( )
Email Address Daytime Phone Number
Street Address City State ZIP
Step 5 - Signature
This form must be signed by the taxpayer(s) listed in Step 1 unless it is being signed by an authorized agent (corporate officer, partner, or
individual on behalf of the taxpayer) or fiduciary who certifies: That I have the authority to execute this power of attorney on behalf of the
taxpayer.Note: If the Other box in Step 2 of this form or in any section of Form IL-2848-A, is checked, this section must be signed in front of
the witnesses or notary as documented in Step 6.
Taxpayer (Authorized Agent/Fiduciary) Signature Printed Name Title (if applicable) Date
Spouse’s Signature (required if listed in Step 1) Printed Name Date
Step 6 - Witness (if applicable)
If you checked the Other box in Step 2 of this form or in any section of Form IL-2848-A, this section must be completed. This section must be
signed by two witnesses or notarized for the form to be considered complete.
Any person, signing in Step 5, as or for the taxpayer,
is known by (and this document is signed in the presence of)
two disinterested witnesses whose printed names and signatures appear here
Signature of Witness
Date
Signature of Witness Date
Printed Name of Witness Printed Name of Witness
OR
appeared this day before a notary public and acknowledged, by signing in
my presence, this power of attorney as his or her voluntary act and deed
Signature of Notary Public Date Notary Seal
Printed by the authority of the State of Illinois. Web only, 1 copy.
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