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Fillable Printable IL-2848 - Power of Attorney Form - Illinois Department of Revenue

Fillable Printable IL-2848 - Power of Attorney Form - Illinois Department of Revenue

IL-2848 - Power of Attorney Form - Illinois Department of Revenue

IL-2848 - Power of Attorney Form - Illinois Department of Revenue

Read this information first
Attach a copy of this form to each specific tax return or item of correspondence for which you are requesting power of attorney.
Do not send this form separately.
Step 1: Complete the following taxpayer information
13
Taxpayer’s name Taxpayer’s street address
2
Taxpayer’s identification number(s) City State ZIP
Step 2: Complete the following information
4The taxpayer named above appoints the following representatives as attorneys-in-fact:
Name Name Name
Name of firm Name of firm Name of firm
Street address Street address Street address
City State ZIP City State ZIP City State ZIP
()
()
()
Daytime phone number Daytime phone number Daytime phone number
E-mail address E-mail address E-mail address
Specific tax type Year or period Specific tax type Year or period Specific tax type Year or period
5The attorneys-in-fact named above shall have, subject to revocation, full power and authority to perform any act that the principals can
and may perform, including the authority to receive confidential information.
The attorneys-in-fact named above do not have the power to – Check only the items below you do not wish to grant.
endorse or collect checks in payment of refunds.
receive checks in payment of any refund of Illinois taxes, penalties, or interest.
execute waivers (including offers of waivers) of restrictions on assessment or collection of deficiencies in tax and waivers
of notice of disallowance of a claim for credit or refund.
execute consents extending the statutory period for assessments or collection of taxes.
delegate authority or substitute another representative.
file a protest to a proposed assessment.
execute offers in compromise or settlement of tax liability.
represent the taxpayer before the Illinois Department of Revenue in all proceedings including hearings (requiring
representation by an attorney) pertaining to matters specified above.
obtain a private letter ruling on behalf of the taxpayer.
perform other acts (explain)
6This power of attorney revokes all prior powers of attorney on file with the Illinois Department of Revenue with respect to the same matters
and years or periods covered by this form, except for the following:
Name Name Name
Street address Street address Street address
City State ZIP City State ZIP City State ZIP
()
()
()
Daytime phone number Daytime phone number Daytime phone number
Date granted Date granted Date granted
Illinois Department of Revenue
IL-2848 Power of Attorney
IL-2848 front (R-12/14)
Continued on Page 2
*465201110*
7 Copies of notices and other written communications addressed to the taxpayer in proceedings involving the matters listed on the front of
this form should be sent to the following:
Name Name Name
Street address Street address Street address
City State ZIP City State ZIP City State ZIP
()
()
()
Daytime phone number Daytime phone number Daytime phone number
Step 3:Taxpayer’s signature
If signing as a corporate officer, partner, fiduciary, or individual on behalf of the taxpayer, I certify that I have the authority to execute this
power of attorney on behalf of the taxpayer.
Taxpayer’s signature Title, if applicable Date
Spouse’s signature Title, if applicable Date
If corporation or partnership, signature of officer or partner Title, if applicable Date
Step 4: Complete the following if the power of attorney is granted to an attorney,
a certified public accountant, or an enrolled agent
I declare that I am not currently under suspension or disbarment and that I am
a member in good standing of the bar of the highest court of the jurisdiction indicated below; or
duly qualified to practice as a certified public accountant in the jurisdiction indicated below; or
enrolled as an agent pursuant to the requirements of United States Treasury Department Circular Number 230.
Designation (attorney, C.P.A., enrolled agent) Jurisdiction (state(s), etc.) Signature Date
Designation (attorney, C.P.A., enrolled agent) Jurisdiction (state(s), etc.) Signature Date
Designation (attorney, C.P.A., enrolled agent) Jurisdiction (state(s), etc.) Signature Date
Step 5: Complete the following if the power of attorney is granted to a person other
than an attorney, a certified public accountant, or an enrolled agent
If the power of attorney is granted to a person other than an attorney, a certified public accountant, or an enrolled agent, this document must
be witnessed or notarized below. Please check and complete one of the following.
Any person signing as or for the taxpayer
is known to and this document is signed in the presence of
the two disinterested witnesses whose signatures appear here.
Signature of witness Date
Signature of witness Date
appeared this day before a notary public and acknowledged
this power of attorney as his or her voluntary act and deed.
Signature of notary Date Notary seal
IL-2848 back (R-12/14)
*465202110*
This form is authorized as outlined under the Illinois Income Tax Act. Disclosure of
this information is required. Failure to provide information could result in a penalty.
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