bL375E
                                              Form ID-POA                                                                                                              12-17-2019
                                              Power of Attorney

1.       TAXPAYER/GRANTOR INFORMATION
   *Taxpayer/grantor's last name      ORcompany's name                         *Taxpayer/grantor's first name/middle initial        *Taxpayer/grantor's SSN      OREIN

   *Spouse's last name                                                           *Spouse's first name/middle initial                *    Spouse's SSN

     *Current address                                                                                                            Daytime telephone number

   City*                                                           State            ZIP Code                   Email address

2.       REPRESENTATIVES - If you provide a representative name, authorization is limited to that individual. If a you provide a
         company name without specifying an individual, authorization is granted to employees of the company.
  Firm or company's legal name                                                                                                   PTIN, EIN, or SSN

  Name                                                                                                                           Telephone number

     *Current address                                                                                                            Fax number

   City*                                                           State            ZIP Code                   Email address

Cease date of this POA (optional):

Check here if you DON'T want the representative to receive copies of notices and communications:

3.       TAX MATTERS APPROVED FOR REPRESENTATION
The above representative is hereby appointed as attorney-in-fact to represent the taxpayer/grantors before the Idaho State Tax 
Commission for the following tax or fee matters. You must identify the tax or fee type, permit number (if applicable), and specific tax 
periods.
The representatives generally are authorized to receive and inspect confidential tax or fee information and records and perform any 
and all actions that the taxpayer/grantors named above can perform with respect to the specified tax or fee matters listed. The 
authorization doesn't include the power to receive refund checks or appoint additional representatives.
                                                                                                                                           * Tax Periods
              * Tax or Fee Types                                            State Tax/Fee Permit Number                                  (Check "All" OR provide range)
         Individual income tax             OR Business income tax                                                                     All
          Sales & use tax                                                                                                             All
          Income tax withholding                                                                                                      All
          Other tax/fee (specify) _____________________                                                                               All
          All                                                                                                                         All

        Check here to revoke all prior POAs                              Check here to keep all prior POAs                          Check here to revoke the following POAs
                                                                                                                                    ____________________________________
4.       SIGNATURE OF TAXPAYER/GRANTORS
All parties identified in Section 1 MUST sign.
If signed by a corporate officer, partner, guardian, tax matters partner, executor, receiver, administrator, or trustee on behalf of the 
taxpayer/grantor: I certify that I have the authority to execute this form.

     *Print name                                                 Signature*                                          Title (if applicable)              Date

     *Print name                                                 Signature*                                          Title (if applicable)              Date

         * Required information.      This form is valid if you complete all required information.  We'll return incomplete forms to you.

                                                                      Form ID-POA —  Instructions

PURPOSE OF FORM
A Power of Attorney (POA) is a legal document authorizing someone to represent you. You, the 
taxpayer/grantor, must complete, sign, and return this form if you want to grant power of attorney to an 
accountant, tax return preparer, attorney, family member, or anyone else to act on your behalf with the Idaho 
State Tax Commission.

SPECIFIC INSTRUCTIONS

SECTION 1 – Taxpayer Information
Individuals.  Enter your name, Social Security number (SSN), Individual Taxpayer Identification Number
(ITIN), and/or federal Employer Identification Number (EIN), if applicable; your street address or post office
box; telephone number; and email address. If you file a tax return that includes a sole proprietorship business
(Federal Schedule C) and you're authorizing the listed representatives to represent you for your individual and
business tax matters, enter both your SSN (or ITIN) and your business EIN as your taxpayer identification
numbers.
Corporations, Partnerships, or Associations.  Enter the entity name, EIN, business address, telephone
number, and email address.

SECTION 2 – Representatives
Enter the name, mailing address, Paid Preparer Tax Identification Number (PTIN), EIN, or SSN, telephone
number, fax number, and email address of your representative. If you're appointing a company (such as a
CPA firm) as your representative, the company name is sufficient. You don't need to specify each person
who's authorized. If you want to appoint only a specific person in the company as your representative, you
must include that person's name.
Cease Date.  This form is effective on the date signed and will remain in effect until the cease date or until
revoked. If you want to cease the Power of Attorney, provide a specific date on the cease date line provided,
such as December 31, 2016. If you don't provide a date, the form is in effect until revoked.
If you don't want your representative to receive copies of notices and communications that we send to you,
check the appropriate box under the representative's name and address.

SECTION 3 – Tax Matters Approved for Representation
You can use this form for any matter affecting a tax or fee that the Tax Commission administers, including
audit and collection matters. It doesn't apply to matters before other state agencies or federal agencies,
including the IRS.
Tax or Fee Types.  Check the box for the tax or fee types you're authorizing the representative to discuss.
You can check the box for all tax types.
State Tax/Fee Permit Number.  Enter the state tax/fee permit number if applicable. If you provide a permit
number, authorization is limited to only that account. If you don't provide a number, the form is valid for all
accounts the taxpayer has in that tax type.
Tax Periods. Enter the tax periods you're authorizing the representative to discuss. Examples:
• All box – check the box to cover all the tax periods for the past, current and future (Don't provide specific
  year information)
• Consecutive years – list (2015, 2016, 2017)
• Date range – list year range or month and year (2010–2015 or Jan 2019 – Mar 2019)
• Specific year – list as calendar year (2015)
• Fiscal years - list the ending month and year (07/2019)
Don't use general references (now, present or today). Forms with a general reference or no reference to an
end date will be returned.
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                                                                     Form ID-POA —  Instructions

Replacing a POA.  You can appoint or change representatives at any time by submitting a POA. If you've
previously filed a POA with the Tax Commission and are submitting another POA, you must check the
appropriate box on the POA form to let us know your intent for the previously filed POAs. If no boxes are
checked, the form is considered incomplete and will be returned to you. See the box definitions below.
Check here to revoke all prior POAs.  Checking this box revokes all prior POAs on file with the Tax
Commission for the same tax matters and years or periods covered by this form.
Check here to keep all prior POAs.  Checking this box keeps all prior POAs on file with the Tax
Commission and adds this POA for the same tax matters and years or periods covered by this form.
Check here to revoke the following POAs.  If you check this box, list on the line which specific POAs
you want to revoke.
Revoking a POA.  You may revoke a POA or the representative may withdraw at any time by submitting a
copy of the previously executed POA with "REVOKE" written across the top of the form with your signature
and date. You also can submit a written statement specifying your intent to revoke a POA or withdraw as the
representative. You must sign and date the statement and include the name, address, and SSN/EIN of the
taxpayer/grantor and the name and address of the representatives whose authority is being revoked or
withdrawn.

SECTION 4 - Signature of Taxpayer/Grantors

Individuals.  You must sign and date the form. If you filed a joint return, your spouse must also sign and date
the form.
Corporations.  Officers with the legal authority to bind the corporation must sign and enter their exact titles
and date the form.
Partnerships/LLCs.  If one partner or member is authorized to act in the name of the partnership or LLC, only
that partner or member is required to sign and enter his or her title and date the form.
Estates.  If there is more than one executor, only one co-executor having the authority to bind the estate is
required to sign.

FILING THIS FORM
Mail or fax this completed form to the Tax Commission section OR employee you've been working with.

Otherwise, mail or fax the completed form to:

Idaho State Tax Commission
Account Registration Maintenance
PO Box 36
Boise ID 83722-0410,
fax:   (208) 334-5364

                                             Contact us:
                               In the Boise area: (208) 334-7660 | Toll free: (800) 972-7660
                               Hearing impaired (TDD) (800) 377-3529 
                                             tax.idaho.gov/contact

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