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Tennessee Tax Power of Attorney Form

The Tennessee 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.

Tennessee Tax Power of Attorney Form
Tennessee Tax Power of Attorney Form
TENNESSEE DEPARTMENT OF REVENUE
POWER OF ATTORNEY
PART 1
Power of Attorney (Please type or print.)
1. Taxpayer Information (Taxpayer must sign and date this form on line 6.)
Taxpayer name and address
Account number(s)
Daytime telephone number
( )
hereby appoints the following representative as attorney-in-fact:
2. Representative (Representative must sign and date this form on page 2, Part II.)
Name and address
Telephone No. ( )
Fax No. ( )
to represent the taxpayer before the Tennessee Department of Revenue for the following tax matters:
3. Tax Matters
Type of Tax (Sales and Use, Franchise, Excise, etc.)
Year(s) or Period(s)
4.
Acts Authorized. --The representative is authorized to receive and inspect confidential tax information and to perform any and
all acts that I can perform with respect to the tax matters described in line 3, for example, the authority to sign any agreements,
consents, or other documents. The authority does not include the power to receive refund checks.
5.
Notices and Communication. --Notices and other written communications will be sent to the first representative listed in line 2.
6.
Signature of Taxpayer.- If signed by a corporate officer, partner, guardian, tax matters partner/person, executor, receiver,
administrator, or trustee on befalf of the taxpayer, I certify that I have the authority to execute this form on behalf of the taxpayer.
Signature
Date
Title (if applicable)
Print Name
RV-F0103801
Tennessee Tax Power of Attorney Form
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