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Michigan Tax Power of Attorney Form

The Michigan tax power of attorney is a legal document used by the grantor to authorize the attorney-in-fact to act on his/her behalf in his/her tax related matters.

Michigan Tax Power of Attorney Form
Michigan Tax Power of Attorney Form
Michigan Department of Treasury
151 (Rev. 11-12)
Authorized Representative Declaration (Power of Attorney)
Issued under authority of Public Act 122 of 1941.
Complete this form to appoint someone to represent you to the State of Michigan on tax, benet, and debt matters. Also complete
this form if you wish to revoke or change your authorized representation. Read the instructions thoroughly in each section. This form
allows the Department to share condential information with your authorized representative.
PART 1: TAXPAYER INFORMATION
Enter the taxpayer’s or debtor’s name, address, telephone number and fax number, if applicable. Enter an account number for either the individual or
business. Enter an additional business account number, if desired.
Taxpayer’s Name and Address. If ling joint return, include
spouse’s name. *If taxpayer is deceased, see note below.
(Required)
If a business, enter DBA, trade or assumed name
Daytime Telephone Number (Required) Fax Number
E-mail Address
FEIN, ME or TR Number Additional FEIN, ME or TR Number
Taxpayer’s Social Security Number Spouse’s Social Security Number
PART 2: REPRESENTATIVE INFORMATION AND AUTHORIZATION DATES
Your authorized representative may be an organization, rm, or individual. If your representative is not an individual you must designate
a contact person. You may authorize a second contact person from the same rm in the box provided. Specify an authorization start date and
expiration date. If none is listed, authorization will begin on the date this document is signed and continue until you notify Treasury in writing that it is
revoked.
Authorization Start Date (mm/dd/yyyy) Authorization Expiration Date (mm/dd/yyyy)
Representative’s Name and Address (Required) Contact Name (Required) Additional Contact Name
Telephone Number (Required) Telephone Number
Fax Number Fax Number
E-mail Address E-mail Address
PART 3: CHANGE IN AUTHORIZATION
To add this document to your existing authorizing documents on le with the Department, skip this section. To replace or revoke your previously
submitted authorizing documents, please follow the instructions below.
Check this box to CHANGE AUTHORIZED REPRESENTATION. This form replaces all earlier Authorized Representation Declarations.
Check this box to REVOKE PREVIOUS AUTHORIZATION: I revoke all Authorized Representation Declarations, and will represent myself in
all tax matters.
*
If taxpayer is deceased, include claimant’s Claim For Refund Due A Deceased Taxpayer, (MI-1310) with death certicate and/or a letter of
authority for personal representative. Claimant’s or personal representative’s name and address are required. In Part 5, claimant or personal
representative needs to sign on taxpayer’s behalf.
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Michigan Tax Power of Attorney Form
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