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The Wisconsin 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.
If signed by a corporate officer, partner, or fiduciary on behalf of the taxpayer, I certify that I have the authority to execute this Power
of Attorney on behalf of the taxpayer.
Type of TaxTax Year(s) or Period(s) Covered
Telephone Number NameFirm Name/Address
Power of Attorney
See instructions on reverse side
(Please print or type)
Taxpayer NameSpouse NameSocial Security Number(s)Wisconsin Tax Account Number
Taxpayer Address (number and street)Spouse Address (if different from taxpayer)Federal Identification NumberTelephone Number – Daytime
City, State, and Zip CodeCity, State, and Zip CodeE-mail Address
Hereby appoint(s) the following individual(s) as attorney(s)-in-fact to represent the taxpayer(s) before the Department of
Revenue for the tax matter(s) specied in Part 3.
Individual Income Tax...................
Corporation Franchise or Income Tax......
Excise Tax ...........................
Field/office audit mattersAppeal of notice dated
Other (list type of tax/matter)
Complete if Power of Attorney is limited to:
Send notices and other written communications to:
► I understand, agree, and accept:
If the Attorney-in-fact box is checked, any notices and written communications will be sent to only the attorney-in-fact, except as required
by statute. If the Taxpayer box is checked, any notices and written communications will be sent to only the taxpayer. Notice to the attorney-
in-fact is notice to the taxpayer and vice versa. If no box is checked or both boxes are checked, any notices and written communications
will be sent only to the taxpayer.
The Power of Attorney revokes all prior Powers of Attorney on file with the Wisconsin Department of Revenue with respect to
the same matters and years or periods covered by this instrument, except the following:
(Specify to whom granted, date, and address, or refer to attached copies of prior powers of attorney)
I understand that the execution of this Power of Attorney does not relieve me of personal responsibility for correctly and
timely reporting and paying taxes, or from the penalties for failure to do so, all as provided for under Wisconsin tax law.
I understand a photocopy and/or faxed copy of this form has the same authority as the signed original.
A-222 (R. 6-12)
This Power of Attorney is not valid unless signed by the individual(s), corporate officer, partner or fiduciary.
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