Form REV187, Email Authorizaon
Taxpayer Name Social Security Number or ITIN
Street Address or PO Box Minnesota or Federal Employer Idencaon Number (FEIN)
Apt. or Suite Phone Number Fax Number
City State ZIP Code Email Address
Taxpayer
Name of Person to Receive Email Aorney Number, Accountant Number, or PTIN
Email Address Expiraon Date
Recipient
Signature
This authorizaon is not valid unl it is signed and dated by the taxpayer, or someone with legal authority to sign on behalf of the taxpayer.
Parent, Guardian, Conservator, or Ocer: I cerfy that I have the legal authority to sign this form.
Signature Print Name and Title, If Applicable Date
Send a signed copy of this form to the department:
Mail: Minnesota Department of Revenue, Mail Staon 7703, 600 N. Robert St., St. Paul, MN 55146
Fax: 651-556-5210
Email: MNDOR.POA@state.mn.us
(Rev. 11/19)
Form REV187 Instrucons
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 le.
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 conrm your legal authority.
We reserve the right to request additional information as needed.
Expiraon
This authorization remains in eect until it expires, if indicated above, or is removed in writing. You may remove this authorization at any time.
Quesons?
Website: www.revenue.state.mn.us
Email: MNDOR.POA@state.mn.us
Phone: 651-556-3003 or 1-800-657-3909
Read instrucons before compleng this form.
Copy me on
all email
