Form 2848

(Rev. October 2011) 

Department of the Treasury 

Internal Revenue Service 

Power of Attorney 

and Declaration of Representative 

▶ Type or print. ▶ See the separate instructions. 

OMB No. 1545-0150 

For IRS Use Only 

Received by: 

Name 

Telephone 

Function 

Date / / 

Part I Power of Attorney 

Caution: Form 2848 will not be honored for any purpose other than representation before the IRS. 

1 Taxpayer information. Taxpayer must sign and date this form on page 2, line 7. 

Taxpayer name and address Identifying number 

Daytime telephone number Plan number (if applicable) 

hereby appoints the following representative(s) as attorney(s)-in-fact: 

2 Representative(s) must sign and date this form on page 2, Part II. 

Name and address

Check if to be sent notices and communications

CAF No. 

PTIN

Telephone No. 

Fax No. 

Check if new: Address Telephone No. Fax No. 

Name and address

Check if to be sent notices and communications

CAF No. 

PTIN

Telephone No. 

Fax No. 

Check if new: Address Telephone No. Fax No. 

Name and address CAF No. 

PTIN

Telephone No. 

Fax No. 

Check if new: Address Telephone No. Fax No. 

to represent the taxpayer before the Internal Revenue Service for the following matters: 

3 Matters 

Description of Matter (Income, Employment, Excise, Whistleblower, 

PLR, FOIA, Civil Penalty, etc.) (see the instructions for line 3) 

Tax Form Number 

(1040, 941, 720, etc.) (if applicable) 

Year(s) or Period(s) (if applicable) 

(see the instructions for line 3) 

4 Specific use not recorded on Centralized Authorization File (CAF). If the power of attorney is for a specific use not recorded on CAF, 

check this box. See the instructions for Line 4. Specific Uses Not Recorded on CAF . . . . . . . . . . . . . . ▶

5 Acts authorized. Unless otherwise provided below, the representatives generally are 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 on line 3, for example, the authority to 

sign any agreements, consents, or other documents. The representative(s), however, is (are) not authorized to receive or negotiate any 

amounts paid to the client in connection with this representation (including refunds by either electronic means or paper checks). Additionally, 

unless the appropriate box(es) below are checked, the representative(s) are not authorized to substitute another representative or add 

additional representatives, to sign certain returns, or to execute a request for disclosure of tax returns or return information to a third party. 

See the line 5 instructions for more information. 

Exceptions. An unenrolled return preparer cannot sign any document for a taxpayer and may only represent taxpayers in limited situations. 

An enrolled actuary may only represent taxpayers to the extent provided in section 10.3(d) of Treasury Department Circular No. 230 (Circular 

230). An enrolled retirement plan agent may only represent taxpayers to the extent provided in section 10.3(e) of Circular 230. A registered tax 

return preparer may only represent taxpayers to the extent provided in section 10.3(f) of Circular 230. See the line 5 instructions for restrictions 

on tax matters partners. In most cases, the student practitioner’s (level k) authority is limited (for example, they may only practice under the 

supervision of another practitioner). 

Disclosure to third parties; Signing a return; Substitute or add representatives;

Other (see instructions for more information)

List any specific deletions to the acts otherwise authorized in this power of attorney: 

For Privacy Act and Paperwork Reduction Act Notice, see the instructions. Cat. No. 11980J Form 2848 (Rev. 10-2011) 
Form 2848 (Rev. 10-2011) Page 2 

6 Retention/revocation of prior power(s) of attorney. The filing of this power of attorney automatically revokes all earlier power(s) of 

attorney on file with the Internal Revenue Service for the same matters and years or periods covered by this document. If you do not want 

to revoke a prior power of attorney, check here . . . . . . . . . . . . . . . . . . . . . . . . . . ▶

YOU MUST ATTACH A COPY OF ANY POWER OF ATTORNEY YOU WANT TO REMAIN IN EFFECT. 

7 Signature of taxpayer. If a tax matter concerns a year in which a joint return was filed, the husband and wife must each file a separate power 

of attorney even if the same representative(s) is (are) being appointed. If signed by a corporate officer, partner, guardian, tax matters partner, 

executor, receiver, administrator, or trustee on behalf of the taxpayer, I certify that I have the authority to execute this form on behalf of the 

taxpayer. 

▶ IF NOT SIGNED AND DATED, THIS POWER OF ATTORNEY WILL BE RETURNED TO THE TAXPAYER. 

Signature Date Title (if applicable) 

Print Name PIN Number Print name of taxpayer from line 1 if other than individual 

Part II Declaration of Representative 

 Under penalties of perjury, I declare that: 

• I am not currently under suspension or disbarment from practice before the Internal Revenue Service; 

• I am aware of regulations contained in Circular 230 (31 CFR, Part 10), as amended, concerning practice before the Internal Revenue Service;

• I am authorized to represent the taxpayer identified in Part I for the matter(s) specified there; and 

• I am one of the following: 

a Attorney—a member in good standing of the bar of the highest court of the jurisdiction shown below. 

b Certified Public Accountant—duly qualified to practice as a certified public accountant in the jurisdiction shown below. 

c Enrolled Agent—enrolled as an agent under the requirements of Circular 230. 

d Officer—a bona fide officer of the taxpayer’s organization. 

e Full-Time Employee—a full-time employee of the taxpayer. 

f Family Member—a member of the taxpayer’s immediate family (for example, spouse, parent, child, grandparent, grandchild, step-parent, stepchild, brother, or sister). 

g Enrolled Actuary—enrolled as an actuary by the Joint Board for the Enrollment of Actuaries under 29 U.S.C. 1242 (the authority to practice before 

the Internal Revenue Service is limited by section 10.3(d) of Circular 230). 

h Unenrolled Return Preparer - Your authority to practice before the Internal Revenue Service is limited. You must have been eligible to sign the 

return under examination and have signed the return. See Notice 2011-6 and Special rules for registered tax return preparers and unenrolled 

return preparers in the instructions.

i Registered Tax Return Preparer—registered as a tax return preparer under the requirements of section 10.4 of Circular 230. Your authority to 

practice before the Internal Revenue Service is limited. You must have been eligible to sign the return under examination and have signed the 

return. See Notice 2011-6 and Special rules for registered tax return preparers and unenrolled return preparers in the instructions.

k Student Attorney or CPA—receives permission to practice before the IRS by virtue of his/her status as a law, business, or accounting student 

working in LITC or STCP under section 10.7(d) of Circular 230. See instructions for Part II for additional information and requirements.

r Enrolled Retirement Plan Agent—enrolled as a retirement plan agent under the requirements of Circular 230 (the authority to practice before the 

Internal Revenue Service is limited by section 10.3(e)). 

▶ IF THIS DECLARATION OF REPRESENTATIVE IS NOT SIGNED AND DATED, THE POWER OF ATTORNEY WILL BE 

RETURNED. REPRESENTATIVES MUST SIGN IN THE ORDER LISTED IN LINE 2 ABOVE. See the instructions for Part II. 

Note: For designations d-f, enter your title, position, or relationship to the taxpayer in the "Licensing jurisdiction" column. See the instructions for Part II 

for more information. 

Designation—Insert 

above letter (a–r) 

Licensing jurisdiction 

(state) or other 

licensing authority 

(if applicable) 

License/Bar or 

Enrollment Number 

(if applicable)

Signature Date 

Form 2848 (Rev. 10-2011)