Fillable POA-1 Power of Attorney Read instructions on the (New York State)

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POA-1 Power of Attorney Read instructions on the (New York State)

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02900106170094
New York State Department of Taxation and Finance
New York City Department of Finance
Power of Attorney
POA-1
(6/17)
Read instructions on the back before completing this form. For estate tax matters, use Form ET-14, Estate Tax Power of Attorney.
Filing Form POA-1 does not automatically revoke any previously led powers of attorney (POAs), but may affect who receives mailings.
1. Taxpayer information (taxpayers must sign and date this form in section 5)
2. Representative information (special conditions may apply; see instructions)
4. Authority granted
The taxpayers named in section 1 appoint the individuals named in section 2 to act as their representatives with full authority to receive condential
information and to perform any and all acts the taxpayers can perform, unless limited below, in connection with the following matters. Your appointed
representatives will not have the authority to sign tax returns or delegate their authority to another individual unless specically authorized below.
Mark an X in all boxes that apply. If this section is left blank, this POA will cover all tax types for all tax periods.
Taxpayer’s name Taxpayer’s identication number
Spouse’s name
(if you led a joint tax return and both spouses are appointing the same representative) Spouse’s SSN
Mailing address
(number and street with apartment or suite number, or PO Box) City State ZIP code
Country
(if not United States)
Primary individual representative name Firm name (if any) Telephone number
Mailing address
(number and street with apartment or suite number, or PO Box) City State ZIP code
Country
(if not United States) Email address
Title or profession
(see instructions) PTIN, SSN, or EIN NYTPRIN (if applicable)
Additional individual representative name Firm name (if any) Telephone number
Mailing address
(number and street with apartment or suite number, or PO Box) City State ZIP code
Country
(if not United States) Email address
Title or profession
(see instructions) PTIN, SSN, or EIN NYTPRIN (if applicable)
Tax type Years, periods, or transaction
All
Corporation
Partnership/LLP/LLC
Personal Income
Tax type Years, periods, or transaction
Sales and Use
Withholding
Other (explain):
Mark an X in the box if this POA is for: An offer in compromise (OIC) case
A conciliation conference or Tax Appeals hearing
I want to limit the authority granted by this POA as follows (explain):
I have other POAs on le for the specic matters identied above and want to revoke all of these other POAs ...............................................................
I authorize the representatives in section 2 to do the following:
Sign tax returns (including refund/credit applications) on my behalf Delegate his/her/their authority to another individual
5. Taxpayer signature
I certify, under penalty of perjury, that I am the taxpayer named in section 1, or a corporate ofcer, partner (except a limited partner), member or
manager of a limited liability company, or duciary acting on behalf of the taxpayer, and that I have the authority to execute this POA.
Signature Print or type name (and title, if applicable) Date Telephone number
Spouse’s signature
(required if spouse listed in section 1) Print or type name Date Telephone number
►  IF NOT SIGNED AND DATED, THIS POA WILL NOT BE PROCESSED.   See instructions on back for Where to send Form POA-1.
3. Mailings
We will send copies of notices and other communications related to the matters authorized in section 4 to the primary individual representative
listed above. If you want them sent to a different representative who has a POA on le for the same matters, enter that individual’s name below.
Name of representative to receive copies of notices and other communications:
You must sign by hand
Spouse must sign by hand
02900206170094
POA-1 (6/17) (back)
General information
Use Form POA-1, Power of Attorney, when you want to give one or
more individuals the authority to obligate or bind you, or appear on your
behalf. You may only appoint individuals (not a rm) to represent you.
Note: Authorizing someone to represent you does not relieve you of your
tax obligations.
Use this form for all matters (except estate tax) imposed by the Tax
Law or another statute administered by the New York State (NYS)
Department of Taxation and Finance (Tax Department) and the New
York City (NYC) Department of Finance. If you and your spouse led a
joint tax return but have different representatives, you must each le a
separate Form POA-1.
Unless you limit the authority you grant (see section 4), your appointed
representative will be authorized to perform any and all acts you can
perform, including but not limited to: receiving condential information
concerning your taxes, agreeing to extend the time to assess tax, and
agreeing to a tax adjustment.
You do not need Form POA-1 to authorize someone to appear with you
or with someone who is already authorized to act for you or to authorize
someone to provide information, or prepare a report or return for you.
Only certain types of professionals may act on your behalf before the
NYS Bureau of Conciliation and Mediation Services (BCMS), the NYC
Department of Finance Conciliation Bureau or at Tax Appeals. Visit the
Tax Department’s POA webpage (at www.tax.ny.gov/poa) for more
information.
Revocation and withdrawal – New: This POA will remain active until
you (the taxpayer) revoke it or your representative withdraws from
representing you. Representatives may not revoke a POA.
For information on ways to revoke a POA, or how a representative
can withdraw, see the Tax Department’s POA webpage (at
www.tax.ny.gov/poa).
Specic instructions
For additional information on how to complete Form POA-1, including
who must sign as the taxpayer, visit the Tax Department’s POA webpage
(at www.tax.ny.gov/poa).
Section 1 – Taxpayer information
The taxpayer identication number may be a social security number
(SSN), employer identication number (EIN), individual taxpayer
identication number (ITIN) issued by the Internal Revenue Service, or a
tax identication number issued by the NYS Tax Department.
Section 2 – Representative information
You may use Form POA-1 to appoint one or more representatives.
Your
Primary individual representative will be mailed copies of notices and
other communications unless you direct otherwise in section 3. If you are
appointing more than two representatives, attach a sheet that provides
all of the information requested in section 2. The attached sheet must be
signed and dated by each taxpayer named in section 1.
Caution: This POA cannot be partially revoked or withdrawn. If you
appoint more than one representative on this POA and later choose
to revoke one representative or one representative withdraws, the
revocation or withdrawal will apply to all representatives, and none will
have ongoing authority to represent you. You must le a new POA to
appoint the representatives that you want to continue representing you.
All representatives are deemed as authorized to act separately unless
you explain that all representatives are required to act jointly on the line
in section 4 that allows you to limit the authority granted by this POA.
For each appointed representative, enter the title or profession or, if
your representative is not a professional, enter the representative’s
relationship to you. If the representative is not licensed in NYS, also
include the state where licensed (for example, Florida attorney). Enter
each representative’s federal preparer tax identication number (PTIN),
SSN, or EIN. If applicable, also enter each representative’s New York tax
preparer registration identication number (NYTPRIN).
Section 3 – Mailings
If you want copies of notices and other communications sent to someone
other than the primary individual representative listed in section 2 of this
POA, enter the name of that representative on the line provided. This
representative must be someone who is listed as a representative for the
matters covered by this POA on this or another valid POA on le.
If you do not want copies of notices and other communications sent to
any representative, enter None.
Example: On 2/1/2016 you appoint Mr. Smith as your representative
for all tax matters for 2015. Mr. Smith will receive copies of mailings
for these matters. On 8/15/2016, you appoint Ms. Jones as your
representative for all tax matters for 2015. Ms. Jones will now receive
copies of mailings for these matters. However, if you want Mr. Smith to
continue to receive mailings, you must list Mr. Smith’s name in section 3
of the POA appointing Ms. Jones. Ms. Jones will not receive mailings.
Section 4 – Authority granted
Use this section to specify the matters covered by this POA. By default,
this POA will cover all tax types for all tax periods. If you select a tax
type, but do not enter a tax period, this POA will cover the tax type
selected for all tax periods. If you enter a tax period, but do not select a
tax type, this POA will cover the tax period entered for all tax types. For
tax periods other than calendar years, enter the beginning and ending
dates for the periods. For taxes based on a specic transaction, enter
the transaction date.
If your tax type is not listed, or if you are granting authority for a special
assessment or fee administered by an agency, mark an X in the Other
box and explain. To identify a specic audit case or assessment, mark
the Other box and enter a case or assessment ID number.
If you want to limit your representative’s authority, explain the limitation.
For example, you can limit your representative’s authority to only receive
condential information, but make no binding decisions for you. If you
need more space to explain the limitation, attach a sheet. The attached
sheet must be signed and dated by each taxpayer named in section 1.
Section 5 – Taxpayer signature
You or someone who is authorized to act for you must sign and date
Form POA-1. The authorized person who signs Form POA-1 may need
to provide identication and evidence of authority to sign this POA.
If a joint tax return was led and both spouses will be represented by the
same representatives, both spouses must sign and date Form POA-1
unless one spouse authorizes the other, in writing, to sign for both. In
that case, attach a copy of the authorization.
Where to send Form POA-1
For matters administered by the NYS Tax Department:
FAX to: (518) 435-8617 (the easiest and fastest method)
Mail to: NYS TAX DEPARTMENT
POA CENTRAL
W A HARRIMAN CAMPUS
ALBANY NY 12227-0864
See Publication 55, Designated Private Delivery Services, if not
using U.S. Mail.
For matters administered by NYC Department of Finance, send to the
ofce in which the matter is pending.
Privacy notication
New York State Law requires all government agencies that maintain a
system of records to provide notication of the legal authority for any
request for personal information, the principal purpose(s) for which the
information is to be collected, and where it will be maintained. To view
this information, visit our website at www.tax.ny.gov, or, if you do not
have Internet access, call (518) 457-5431 and request Publication 54,
Privacy Notication.
The Commissioner of the New York City Department of Finance
is authorized to require disclosure of identifying numbers by
section 11-102.1 of the Administrative Code of the City of New York.
Instructions
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POA-1 Power of Attorney Read instructions on the (New York State)

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Completed 20 April 2021

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