Fill - Free fillable Form PAR 101: Virginia Power of Attorney and (Virginia Department of Motor Vehicles) PDF form

Form PAR 101

Virginia Power of Attorney and

Declaration of Representative

Virginia Tax

P. O. Box 1115

Richmond, VA 23218-1115

Individual fax: (804) 254-6113

Business fax: (804) 254-6111

This is a legal document.

If this Form PAR 101, Power of Attorney and Declaration of Representative is not signed and dated, lacks complete

information, or is illegible, it will be denied.

Asterisks denote required elds. Read the instructions carefully before completing this form.

1. Taxpayer Information

Taxpayer Name (Individual, Business, or Fiduciary)* SSN, ITIN, or FEIN*

Spouse Name (For joint representation only. See instructions.) Spouse SSN or ITIN

Address* Daytime Telephone Number

( )

Address Alternative Telephone Number

( )

City* State* ZIP Code* Email Address

2. Maintain or Revoke Prior Authorization

Maintain authorization for the agent listed below. This form automatically revokes all earlier powers of attorney on le with Virginia

Tax for the same tax matters covered by this form.

(Specify agent name, address, ZIP Code, and date granted. Attach copy of the power of attorney form.)

Revoke prior authorization(s). To revoke a prior power of attorney without naming another representative, send a copy of the power

of attorney form to Virginia Tax at the address above and write “REVOKE” across the top. If you do not have a copy of the power of attorney

form, provide the agent’s name, address, ZIP Code, and date granted:

3. Tax Matters – Taxable years or periods may not extend more than 3 years into the future. You must

designate at least one tax type and taxable year period.*

Annual Income Taxes Only – Individual, Corporate, Pass-through Entity, Fiduciary, or Estate Tax Type

Tax Type Taxable Years

Do Not Enter “All Years” – Must be Specic

Business, Excise, Commodity, and Other Taxes

Tax Type 15-Character Virginia Tax Account

Number

REQUIRED: See Instructions

Do Not Enter “All Periods” – Must be Specic

Beginning Period

(MM/YYYY)

Ending Period

(MM/YYYY)

4. Authorized Agent /Representative Information. Additional representatives should be listed on an

attached list and may not receive copies of correspondence.

Primary Representative – Must be a person; cannot be a business

Automatic Correspondence

An Authorized Agent will automatically be mailed

copies of correspondence regarding the tax

matters.

Authorized Agent Number

A -

_________________________

Do NOT mail copies of any correspondence

to agent.

Mail copies of email communications to

agent.

First Name* Last Name*

Address

City State ZIP Code

Daytime Telephone Number

( )

Fax Number

( )

Email Address

Additional Representative – Must be a person; cannot be a business

Automatic Correspondence

An Authorized Agent will automatically be mailed

copies of correspondence regarding the tax

matters.

Authorized Agent Number

A -

_________________________

Do NOT mail copies of any correspondence

to agent.

Mail copies of email communications to

agent.

First Name Last Name

Address

City State ZIP Code

Daytime Telephone Number

( )

Fax Number

( )

Email Address

5. Signature of Taxpayer(s) and Acknowledgment of Authorized Acts

By signing this form, I am granting the representative(s) listed in Section 4 the authority to:

• Receive and inspect my condential tax information for the tax matters listed in Section 3,

• Perform all acts that I can perform with respect to the specied tax matters, and

• Represent me before Virginia Tax, including consenting to extend the time to assess tax and executing consents that

agree to a tax adjustment.

• In addition, I understand that the acts of my Authorized Agent may increase or decrease my tax liabilities and legal rights.

The authority does not, however, include the power to receive refund checks, substitute another representative, request a

copy of a tax return, sign certain returns, or consent to a disclosure of tax information.

For joint representation, both the taxpayer and the spouse listed in Section 1 must sign and date this form. If this form is

signed by a corporate ofcer, partner, guardian, tax matters partner, executor, receiver, administrator, or trustee on behalf of

the taxpayer, they certify that they have the authority to execute this form on behalf of the taxpayer. This power of attorney will

remain in effect until it is revoked by either the taxpayer or the agent.

Print Name* Signature* Title Date*

Print Name Signature Title Date

6. Representative Signature: Under penalties of perjury, I declare I am authorized to represent the taxpayer(s)

listed in Section 1.

A.) Attorney B.) Certied Public Accountant C.) Enrolled Agent D.) Family member or Other (provide relationship below):

Relationship:

____________________________________________________________________________________

Representative

Designation

Letter from

Above List

Print Name * Representative Signature* Date*

Primary

Additional

INSTRUCTIONS FOR VIRGINIA FORM PAR 101

POWER OF ATTORNEY AND DECLARATION OF REPRESENTATIVE

Form Purpose

Use Form PAR 101 to:

• Authorize a person to represent you before Virginia Tax

with respect to the tax matters you specify, or

• Revoke a prior power of attorney authorization.

THIS IS A LEGAL DOCUMENT: When you submit Form

PAR 101, you are authorizing the person you name in

Section 4 to be your representative. For the tax matters

you specify in Section 3, your representative will be able

to receive and inspect your condential tax information

and perform any and all acts you can perform, including

consenting to extend the time to assess tax or executing

consents that agree to a tax adjustment. The acts of your

representative may increase or decrease your tax liabilities

and legal rights. Certain exceptions apply. See below.

When to submit Form PAR 101:

The following are examples of when you need to complete

and submit Form PAR 101:

1. You are disputing an assessment of tax and a third party

is representing you before Virginia Tax,

2. You have been notied that we will be conducting

an audit of your account and you have engaged the

services of a third party to assist with the audit, or

3. You are the administrator of a deceased individual’s

estate and you need to grant access to the decedent’s

condential tax information to a third party in order to

perform your duties.

The above list is not all-inclusive. There are other similar

situations that may require you to grant a person the

authority to act on your behalf, including the authority to

obligate and bind you to agreements and to receive and

inspect your condential tax information.

When a Form PAR 101 is NOT required:

Form PAR 101 is not required when a person merely

furnishes information or prepares a report or return for you

or your business. For example, you do not need to submit

Form PAR 101 to:

1. Authorize a tax professional (CPA, Enrolled Agent, tax

preparer, or payroll service provider) to discuss routine

issues regarding return lings and payments the tax

professional submitted on your behalf,

2. Authorize an employee or ofcer of your business to

discuss routine issues regarding return lings and

payments submitted by your business, or

3. Authorize a duciary (trustee, receiver, or guardian) to

act as Authorized Agent, because a duciary already

stands in the position of the taxpayer.

Virginia Tax will discuss routine issues regarding return

lings and payments and related assessments and

adjustments with your designated tax professionals and the

employees and ofcers of a business, provided we are able

to verify the person and the person’s relationship to you or

your business.

Exceptions - The power of attorney you grant to your

representative using Form PAR 101 does not include the

power to receive refund checks, the power to substitute

another representative, the authority to execute a request

for a tax return, the power to sign certain returns for you, or

the power to consent to a disclosure of tax information.

Section 1 - Taxpayer Information

Individual - If the tax matter involves a joint return and you

and your spouse are designating the same representative,

provide your spouse’s name and social security number.

Sole Proprietor - For business tax matters, enter your

name and the federal employer identication number for

your business.

Corporations, Partnerships, or Associations - Enter the

legal name of the organization and the organization’s federal

employer identication number. If the tax matter involves a

consolidated or a combined tax return led for a corporation,

do not attach a list of subsidiaries or afliated corporations

to this form. Only the parent corporation‘s information is

required in Section 1. A subsidiary or afliate must le its

own PAR 101 for returns that it les separately.

Fiduciary/Trust - Enter the name and federal employer

identication number of the trust, and the telephone number

and email address of the trustee. The trustee must sign the

form.

Estate or Inheritance Tax - Applicable only for decedents

whose date of death was prior to July 1, 2007. Enter the

name and the social security number of the deceased

taxpayer and provide the address, telephone number, and

email address of the decedent’s personal representative.

The taxpayer’s personal representative must sign and date

the form.

Section 2 - Revoking or Maintaining Prior

Authorization

Check the box that applies. If you are naming a

representative, any prior power of attorney on le with

Virginia Tax for the same tax matters covered by the Form

PAR 101 you are submitting will be automatically revoked

unless you attach a copy of any power of attorney you want

to remain in effect.

Either the taxpayer or their representative may revoke the

power of attorney. This must be done in writing by submitting

a copy of Form PAR 101 with “REVOKE” written on the top

of the form or by sending a written request. If you wish to

revoke the power of attorney for only one spouse on a joint

power of attorney, this should be done by a submitting a

letter to indicate which spouse is no longer represented.

Section 3 - Tax Matters

Be specic. You should only grant a person your power

of attorney for taxable periods for which you have a tax

matter.

You may specify taxable periods no more than 3 years

into the future. Future periods are determined starting after

Dec. 31 of the year in which we receive Form PAR 101. You

may list the current taxable year or period and any taxable

years or periods that have already ended as of the date you

sign Form PAR 101.

Annual Income Taxes - If the tax matter involves individual,

corporate, pass-through entity, or duciary income tax, enter

the name of the tax under “Tax Type.” Also use this section

for composite/unied ling tax matters. If the tax matter

involves estate tax or inheritance tax for a taxpayer whose

date of death was prior to July 1, 2007, enter the date of

death of the taxpayer in the taxable year eld.

Business, Excise, Commodity, and Other Taxes - You

must enter the tax type and the beginning and ending

periods covered by this form. For each tax type, you must

also provide your assigned 15-character Virginia Tax

Account Number. If you have multiple locations, be sure to

list the account number for each location. If you do not enter

your account number(s), the form will be returned.

Exceptions - For the following tax types, leave the Virginia

Tax Account Number eld blank: Apple Excise Tax, Bank

Franchise Tax, and Rolling Stock Tax on Railroads and

Freight Car Companies.

Section 4 - Authorized Agent/Representative

Information

You must provide complete information for each

representative listed on the form. You cannot name a

business as your representative. Your representative must

be a person. In addition, each representative must sign and

date the form. The signature must be an actual signature

and cannot be an electronic signature or rubber stamp.

Virginia Tax will automatically mail copies of all outgoing

correspondence sent to you regarding the tax matters listed

in Section 3 to your Authorized Agent provided that:

• Your Authorized Agent is registered with Virginia Tax,

and

• You provide the Authorized Agent’s number, a unique

9-character identication number assigned by us that

begins with “A.”

Virginia Tax will not automatically mail correspondence to

your Authorized Agent in the following situations:

• You do not provide your Authorized Agent’s number, or

• You check the box indicating that you do not want

correspondence automatically mailed to your Authorized

Agent.

We will automatically mail copies of secure email to your

Authorized Agent if you have opted to have copies of email

communications sent to your agent.

Taxpayers may use secure email to discuss specic

questions related to their account. The authorized

representative(s) will receive copies of this secure email

communication through the U.S mail. To use secure email

on Virginia Tax’s website at www.tax.virginia.gov, log in to

iFile (business or individual) or iReg, select Secure Message

to send and receive secure email.

To register as an Authorized Agent, your representative

must submit Virginia Form R-7. If Form R-7 is submitted

with Form PAR 101, enter “Applied For” in the Registered

Authorized Agent Number eld. Form R-7 is available at

www.tax.virginia.gov.

Sections 5 and 6 - Signature of Taxpayer(s),

Acknowledgment of Authorized Acts, and

Representative Signature

Individuals - You must sign and date the form. If the tax

matter involves a joint return and you and your spouse are

designating the same Authorized Agent(s), your spouse

must also sign and date the form.

Corporations or Associations - An ofcer having authority

to bind the taxpayer must sign and date the form.

Partnerships - All partners should sign unless only one

partner is authorized to act in the name of the partnership.

A partner is authorized to act in the name of the partnership

if, under state law, the partner has authority to bind

the partnership. A copy of such authorization should

be attached. For dissolved partnerships, see 26 CFR

601.503(c)(6).

All others - If the taxpayer is a dissolved corporation,

decedent, insolvent, or a person for whom or by whom

a duciary (a trustee, guarantor, receiver, executor, or

administrator) has been appointed, see 26 CFR 601.503(d).

The representative(s) must sign and date the form.

Note - Generally, the taxpayer signs rst, granting the

authority and then the Authorized Agent signs, accepting

the authority granted. The date for both the taxpayer and

the representative must be within 45 days for domestic

authorizations and within 60 days for authorization from

taxpayers residing abroad. If the taxpayer signs last, then

there is no timeframe requirement.

All signatures on the form must be actual and cannot be

electronic or rubber stamps.

* * * * *

Mail or fax the completed form and enclosures to:

Virginia Tax

P.O. Box 1115

Richmond, Virginia 23218-1115

Business fax: (804) 254-6111

Individual fax: (804) 254-6113

For individual assistance call: (804) 367-8031

For business assistance call: (804) 367-8037

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