Form M-2848 "Power of Attorney and Declaration of Representative" - Massachusetts

What Is Form M-2848?

This is a legal form that was released by the Massachusetts Department of Revenue - a government authority operating within Massachusetts. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2014;
  • The latest edition provided by the Massachusetts Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form M-2848 by clicking the link below or browse more documents and templates provided by the Massachusetts Department of Revenue.

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Download Form M-2848 "Power of Attorney and Declaration of Representative" - Massachusetts

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Rev. 7/14
Form M-2848
Massachusetts
Power of Attorney and
Department of
Declaration of Representative
Revenue
See separate instructions. Please print or type.
Part 1. Power of Attorney
A
Name of taxpayer(s) or principal reporting corporation
Social Security number(s)
Number and street, including apartment number or rural route
Federal Identification number
City/Town
State
Zip
B
Hereby appoint(s) the following individual(s) as attorney(s)-in-fact to represent the taxpayer(s) before any office of the Massachusetts Department of
Revenue for the following tax matter(s) (specify the type(s) of tax and year(s) or period(s) (date of death if estate tax)):
Name
Address
Telephone number
Type of tax (individual, corporate, etc.)
Year(s) or period(s) (date of death if estate tax)
C
The attorney(s)-in-fact (or any of them) are authorized, subject to any limitations set forth below or to revocation, to receive confidential information and to
perform any and all acts that the principal(s) can perform with respect to the above specified tax matters, such as the authority to sign any agreements,
consents or other documents.The authority does not include the power to substitute another representative (unless specifically added below) or the power
to receive refund checks.
List any specific additions or deletions to the acts otherwise authorized in this power of attorney:
D
Originals of notices and other written communications go to the taxpayer(s). Send copies of all notices and all other written communications addressed
to the taxpayer(s) in proceedings involving the above tax matters to:
1
the appointee first named above, or
2
(name of another appointee designated above)
This power of attorney revokes all earlier powers of attorney on file with the Department of Revenue for the same tax matters and years or periods cov-
ered by this power of attorney, except the following (specify to whom granted, date and address including Zip code or attach copies of earlier powers):
E
Signature of or for taxpayer(s) or principal reporting corporation. 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 and/or principal reporting corporation.
Signature
Title (if applicable)
Date
If signing for a taxpayer who is not an individual or a principal reporting corporation, type or print your name
Signature
Title (if applicable)
Date
Rev. 7/14
Form M-2848
Massachusetts
Power of Attorney and
Department of
Declaration of Representative
Revenue
See separate instructions. Please print or type.
Part 1. Power of Attorney
A
Name of taxpayer(s) or principal reporting corporation
Social Security number(s)
Number and street, including apartment number or rural route
Federal Identification number
City/Town
State
Zip
B
Hereby appoint(s) the following individual(s) as attorney(s)-in-fact to represent the taxpayer(s) before any office of the Massachusetts Department of
Revenue for the following tax matter(s) (specify the type(s) of tax and year(s) or period(s) (date of death if estate tax)):
Name
Address
Telephone number
Type of tax (individual, corporate, etc.)
Year(s) or period(s) (date of death if estate tax)
C
The attorney(s)-in-fact (or any of them) are authorized, subject to any limitations set forth below or to revocation, to receive confidential information and to
perform any and all acts that the principal(s) can perform with respect to the above specified tax matters, such as the authority to sign any agreements,
consents or other documents.The authority does not include the power to substitute another representative (unless specifically added below) or the power
to receive refund checks.
List any specific additions or deletions to the acts otherwise authorized in this power of attorney:
D
Originals of notices and other written communications go to the taxpayer(s). Send copies of all notices and all other written communications addressed
to the taxpayer(s) in proceedings involving the above tax matters to:
1
the appointee first named above, or
2
(name of another appointee designated above)
This power of attorney revokes all earlier powers of attorney on file with the Department of Revenue for the same tax matters and years or periods cov-
ered by this power of attorney, except the following (specify to whom granted, date and address including Zip code or attach copies of earlier powers):
E
Signature of or for taxpayer(s) or principal reporting corporation. 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 and/or principal reporting corporation.
Signature
Title (if applicable)
Date
If signing for a taxpayer who is not an individual or a principal reporting corporation, type or print your name
Signature
Title (if applicable)
Date
F
If the power of attorney is granted to a person other than an attorney, certified public accountant, public accountant or enrolled agent, the taxpayer(s)
signature must be witnessed or notarized below.
The person(s) signing as or for the taxpayer(s) (check and complete one):
is/are known to and 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 a voluntary act and deed.
Signature of notary
Date
Part 2. Declaration of Representative.
All representatives must complete this section.
I declare that I am not currently under suspension or disbarment from practice within the Commonwealth or in any jurisdiction, that I am aware of regula-
tions governing the practice of attorneys, certified public accountants, public accountants, enrolled agents and others, and that I am one of the following:
1 a member in good standing of the bar of the highest court of the jurisdiction shown below;
2 duly qualified to practice as a certified public accountant or public accountant in the jurisdiction shown below;
3 enrolled as an agent under the requirements of Treasury Department Circular No. 230;
4 a bona fide officer of the taxpayer organization or principal reporting corporation;
5 a full-time employee of the taxpayer;
6 a member of the taxpayer’s immediate family (spouse, parent, child or sibling);
7 a fiduciary for the taxpayer;
8 other (attach statement)
and that I am authorized to represent the taxpayer identified in Part 1 for the tax matters specified there.
Designation (insert appropriate
Jurisdiction (state, etc.)
number from above list)
or enrollment card number
Signature
Date
printed on recycled paper
Form M-2848 Instructions
General Information
c. For a principal reporting corporation. Enter the name, federal identifi-
cation number and business address of the principal reporting corporation.
To protect the confidentiality of tax records, Massachusetts law generally
prohibits the Department of Revenue from disclosing information contained
d. For a trust. Enter the name, title and address of the fiduciary, and the
in tax returns or other documents filed with it to persons other than the tax-
name and federal identification number of the trust.
payer or the taxpayer’s representative. For your protection, the Department
e. For an estate. Enter the name, title and address of the decedent’s per-
requires that you file a power of attorney before it will release tax information
sonal representative, and the name and identification number of the estate.
to your representative. The power of attorney will also allow your represen-
The identification number for an estate is the decedent’s social security
tative to act on your behalf to the extent you indicate. Use Form M-2848,
number and includes the federal identification number if the estate has one.
Power of Attorney and Declaration of Representative, for this purpose if
you choose. You may file a power of attorney without using Form M-2848,
B. Appointee(s) and tax matters and years or periods. Enter the name(s),
but it must contain the same information as Form M-2848 would.
address(es) and telephone number(s) of the individual(s) you appoint. Your
representative must be an individual and may not be an organization, firm
You may use Form M-2848 to appoint one or more individuals to represent
or partnership.
you in tax matters before the Department of Revenue. You may use Form
M-2848 for any matters affecting any tax imposed by the Commonwealth,
Consider each tax imposed by the Commonwealth for each tax period as a
and the power granted is limited to these tax matters.
separate tax matter. In the col umns provided, clearly identify the type(s) of
tax(es) and the year(s) or period(s) for which the power is granted. You may
For certain corporate excise matters under G.L. Ch. 63. By executing
list any number of years or periods and types of taxes on the same power of
this agreement an officer of a principal reporting corporation filing under
attorney. If the matter relates to estate tax, enter the date of the taxpayer’s
G.L. Ch. 63, § 32B represents that the principal reporting corporation is
death instead of the year or period.
authorized to execute this agreement as agent for all corporations that par-
ticipated in, or were required to participate in, such filing for any component
If the power of attorney will be used in connection with a penalty that is not
of the corporate excise reported or required to be reported under any sec-
related to a particular tax type, such as personal income or corporate, enter
tion of G.L. Ch. 63 by any such corporation whether relating to the income
the section of the General Laws which authorizes the penalty in the “type
measure, non-income measure, or a minimum excise tax liability under the
of tax” column.
corporate excise.
C. Powers granted by Form M-2848. Your signature on Form M-2848
A principal reporting corporation acts on behalf of all corporations that partic-
authorizes the individual(s) you designate (your representative or “attorney-
ipated in, or were required to participate in, a filing under G.L. Ch. 63, § 32B,
in-fact”) generally to perform any act you can perform. This includes execu -
as stated in the preceding paragraph. Consequently, in the case of such a
ting waivers and offers of waivers of restrictions on as sess ment or collection
filing by a principal reporting corporation, the references in this agreement
of deficiences in taxes, and waivers of notice of disallowance of a claim for
to “taxpayer(s)” shall include all such corporations.
credit or refund. It also includes executing consents extending the legally al-
lowed period for assessment or collection of taxes. The authority does not
Filing the Power of Attorney. You must file the original, a photo copy or
include the power to substitute another representative (unless specifically
facsimile transmission (fax) of the power of attorney with each DOR office
added to Form M-2848) or the power to receive refund checks.
in which your representative is to represent you. You do not have to file
another copy with other DOR officers or counsel who later have the matter
If you do not want your representative to be able to perform any of these or
under consideration unless you are specifically asked to provide an addi-
other specific acts, or if you want to give your representative the power to
tional copy.
delegate authority or substitute another representative, insert language ex-
cluding or adding these acts in the blank space provided.
Revoking a Power of Attorney. If you previously filed a power of attorney
and you want to revoke it, you may use Form M-2848 to change your rep-
D. Where you want copies to be sent. The Department of Revenue rou-
resentatives or alter the powers granted to them. File the form with the of-
tinely sends originals of all notices to the taxpayer. You may also have
fice of DOR in which you filed the earlier power. The new power of
copies of all notices and all other written communications sent to your rep-
attorney will revoke the earlier one for the same matters and tax periods
resentative. Please check box 1 if you want copies of all notices or all com -
unless you specifically state otherwise.
munications sent to the first appointee named at the top of the form.
Check box 2 if you want copies sent to one of your other appointees. In this
If you want to revoke a power of attorney without executing a new one,
case, list the name of the appointee.
send a signed statement to each office of DOR in which you filed the earlier
power of attorney you are now revoking. List in this statement the name
E. Signature of taxpayer(s). For individuals: If a joint return is involved and
and address of each representative whose authority is being revoked.
both spouses will be represented by the same individual(s), both must sign
the power of attorney unless one authorizes the other (in writing) to sign
How to Complete Form M-2848
for both. In that case, attach a copy of the authorization. However, if the
Part 1. Power of Attorney
spouses are to be represented by different individuals, each may execute
A. Taxpayer’s name, identification number and address.
a power of attorney.
a. For individuals. Enter you name, social security number and address in
the space provided. If joint returns involved, and you and your spouse are
For a partnership: All partners must sign unless one partner is authorized
designating the same representative(s), also enter your spouse’s name
to act in the name of the partnership. A partner is authorized to act in the
and social security number and your spouse’s address (if different).
name of the partnership if under state law the partner has authority to bind
the partnership.
b. For a corporation, partnership or association. Enter the name, federal
identification number and business address. If the Power of Attorney for a
For a corporation or association: An officer having authority to bind the en-
partnership will be used in a tax matter in which the name and social secu-
tity must sign.
rity number of each partner have not previously been sent to DOR, list the
For a principal reporting corporation: An officer having authority to bind the
name and social security number of each partner in the available space at
principal reporting corporation of a combined group.
the end of the form or on an attached sheet.
If you are signing the power of attorney for a taxpayer who is not an indi-
vidual, such as a corporation or trust, please type or print your name on
the line below the signature line at the bottom of the form.
F. Notarizing or witnessing the power of attorney. A notary public or
two individuals with no stake in the tax matter must witness a power of at-
torney unless it is granted to an attorney, certified public accountant, public
accountant or enrolled agent.
Part 2. Declaration of Representative
Your representative must complete Part 2 to make a declaration containing
the following:
1. A statement that the representative is authorized to represent you as a
certified public accountant, public accountant, attorney, enrolled agent,
member of your immediate family, etc. If entering “eight” in the “designation”
column, attach a statement indicating your relationship to the taxpayer.
2. The jurisdiction recognizing the representative, if applicable. For an attor -
ney, certified public accountant or public accountant: Enter in the “jurisdic-
tion” column the name of the state, possession, territory, commonwealth
or District of Columbia that has granted the declared professional recogni-
tion. For an enrolled agent: Enter the enrollment card number in the “juris-
diction” column.
3. The signature of the representative and the date signed.
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