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PDF REVENUE DIVISION OF DEPARTMENT OF TREASURY Act 122 of ... 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin with Part 1, where you will enter your Taxpayer or Debtor Information. Ensure to fill in your name, FEIN, and address as these fields are marked as required.
- Move to Part 2 if you need to revoke any previous authorizations. Check the appropriate box based on whether you want to revoke all prior authorizations or specific ones.
- In Part 3, appoint your representative by providing their name and contact details. If appointing an entity, include a contact person’s name.
- Proceed to Part 4 to specify the type of authority you wish to grant your representative. Check the relevant boxes for actions they can perform on your behalf.
- If applicable, complete Part 5 to request copies of letters and notices regarding tax disputes by entering the necessary tax types and periods.
- Finally, sign in Part 6 to authorize Treasury communication with your representative. Ensure all required fields are completed before submitting.
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