Use your 'Mouse' or the 'Tab' key to move through the fields.  Use your 'Mouse' or 'Space Bar' to activate Check Boxes.
                      Illinois Department of Revenue 
                                                                                   *65304201W*
                  Form IL-2848-A 
                     Power of Attorney Additional Information                                   Attachment # _____
Form IL-2848, Step 5, signature date _____  / _____ / _____
                                        mm         dd           yyyy
                                             
  Taxpayer’s Name (person or business)                                                      FEIN, SSN, or Illinois Account ID       

Power       of Attorney Information 
                                                                                                                                                        (Complete Step 6  
Check one box:                      Attorney                      Certified Public Accountant                 Enrolled Agent               Other of Form IL-2848)  
       
  Power of Attorney’s name                                                                               Firm Name               

  Identification Number (Attorney License, PTIN, FEIN, SSN)                                   Email Address                      

  Power of Attorney’s Street Address                                                                      City                           State                ZIP

  (                    )                                                                                 (                    )
  Daytime Phone Number                                                                              Fax Number 
         
If your Power of Attorney is an attorney, certified public accountant, or enrolled agent, the Power of Attorney must complete this section:
I declare that I am not currently under suspension or disbarment, and that I am
•      a member in good standing of the highest court of the jurisdiction indicated;                   
            or
•      duly qualified to practice as a certified public accountant in the 
       jurisdiction indicated;                                                      Power of Attorney Signature                                           Date
            or
•      enrolled as an agent pursuant to the requirements of United 
       States Treasury Circular #230.  
                                                                            Power of Attorney Printed Name                        Jurisdiction

Power       of Attorney Information 
                                                                                                                                                        (Complete Step 6  
Check one box:                      Attorney                      Certified Public Accountant                 Enrolled Agent               Other of Form IL-2848)  
       
  Power of Attorney’s name                                                                               Firm Name               

  Identification Number (Attorney License, PTIN, FEIN, SSN)                                   Email Address                      

  Power of Attorney’s Street Address                                                                      City                           State                ZIP

  (                    )                                                                                 (                    )
  Daytime Phone Number                                                                              Fax Number 
         
If your Power of Attorney is an attorney, certified public accountant, or enrolled agent, the Power of Attorney must complete this section:
I declare that I am not currently under suspension or disbarment, and that I am
•      a member in good standing of the highest court of the jurisdiction indicated;                   
            or
•      duly qualified to practice as a certified public accountant in the 
       jurisdiction indicated; 
            or                                                              Power of Attorney Signature                                           Date
•      enrolled as an agent pursuant to the requirements of United 
       States Treasury Circular #230.  
                                                                            Power of Attorney Printed Name                        Jurisdiction

                                             This form is authorized by various acts found in Illinois Compiled Statutes. Disclosure of 
            IL-2848-A (N-08/20) Front        this information is REQUIRED. Failure to provide information could result in a penalty. 

                                                                                                                             *65304202W*
        Taxpayer’s Name (person or business)        FEIN, SSN, or Illinois Account ID   
Power of Attorney Information          
                                                                                                                                                                           (Complete Step 6 
Check one box:                      Attorney                      Certified Public Accountant                 Enrolled Agent             Other of Form IL-2848)               
       
 Power of Attorney’s name                                                                              Firm Name               
                                                                          
 Identification Number (Attorney License, PTIN, FEIN, SSN)                                  Email Address                      
                                                                                                                                                         
 Power of Attorney’s Street Address                                                                    City                            State                ZIP
 (                    )                                                                                (                    )
 Daytime Phone Number                                                                            Fax Number 
 If your Power of Attorney is an attorney, certified public accountant, or enrolled agent, the Power of Attorney must complete this section:
I declare that I am not currently under suspension or disbarment, and that I am
•      a member in good standing of the highest court of the jurisdiction indicated;                   
       or
•      duly qualified to practice as a certified public accountant in the 
•       jurisdiction indicated;                                                                   Power of Attorney Signature                                           Date
       or
•      enrolled as an agent pursuant to the requirements of United 
       States Treasury Circular #230.                                                             Power of Attorney Printed Name                        Jurisdiction
Power of Attorney Information          
                                                                                                                                                                           (Complete Step 6 
Check one box:                      Attorney                      Certified Public Accountant                 Enrolled Agent             Other   of Form IL-2848)  
       
 Power of Attorney’s name                                                                              Firm Name               
                                                                          
 Identification Number (Attorney License, PTIN, FEIN, SSN)                                  Email Address                      
                                                                                                                                                                           
 Power of Attorney’s Street Address                                                                    City                            State                ZIP
 (                    )                                                                                (                    )
 Daytime Phone Number                                                                            Fax Number 
 If your Power of Attorney is an attorney, certified public accountant, or enrolled agent, the Power of Attorney must complete this section:
I declare that I am not currently under suspension or disbarment, and that I am
•      a member in good standing of the highest court of the jurisdiction indicated;                   
       or
•      duly qualified to practice as a certified public accountant in the 
•       jurisdiction indicated;                                                                   Power of Attorney Signature                                           Date
       or
•      enrolled as an agent pursuant to the requirements of United 
       States Treasury Circular #230.                                                             Power of Attorney Printed Name                        Jurisdiction
Power of Attorney Information          
                                                                                                                                                                           (Complete Step 6 
Check one box:                      Attorney                      Certified Public Accountant                 Enrolled Agent             Other of Form IL-2848)     
       
 Power of Attorney’s name                                                                              Firm Name               
                                                                          
 Identification Number (Attorney License, PTIN, FEIN, SSN)                                  Email Address                      
                                                                                                                                                            
 Power of Attorney’s Street Address                                                                    City                            State                ZIP
 (                    )                                                                                (                    )
 Daytime Phone Number                                                                            Fax Number 
 If your Power of Attorney is an attorney, certified public accountant, or enrolled agent, the Power of Attorney must complete this section:
I declare that I am not currently under suspension or disbarment, and that I am
•      a member in good standing of the highest court of the jurisdiction indicated;                   
       or
•      duly qualified to practice as a certified public accountant in the 
•       jurisdiction indicated;                                                                   Power of Attorney Signature                                           Date
       or
•      enrolled as an agent pursuant to the requirements of United 
       States Treasury Circular #230.                                                             Power of Attorney Printed Name                        Jurisdiction

                                 Printed by the authority of the State of Illinois. Web only, 1 copy                           IL-2848-A (N-08/20) Back
                                                                         RESET                              PRINT