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Michigan Department of Treasury                                                                           Issued under authority of Public Act 122 of 1941. 
151 (Rev. 11-21) 
Authorized Representative Declaration (Power of Attorney) 
Detailed instructions on page 2. 
NOTE:  All information designated as “required” must be supplied for this authorization to be effective. Use Part 2 to revoke previous 
authorizations in total or in part. To add a new representative Part 3 must be completed along with at least one box from Parts 4 or 5. 
PART 1: TAXPAYER OR DEBTOR INFORMATION 
Taxpayer’s Name (Required) If a business, include any DBA, trade or FEIN, ME or TR Number (Required for business taxes) 
assumed name. If filing joint return, include spouse’s name. 

Taxpayer or Business Address (Required)                             Taxpayer’s Social Security Number (Required if Spouse’s Social Security Number 
                                                                    no FEIN, ME, or TR Number listed) 

Taxpayer’s E-mail Address                                           Daytime Telephone Number                       Fax Number 

PART 2: REVOKE PREVIOUS AUTHORIZATION 
To revoke the authority of your current representative, check the applicable box in this section. 
1. I revoke all prior authorizations. I will represent myself. 
2. I revoke prior authorizations in the matter(s) listed here:      Tax Type(s), Debt Type, or Fee                       Tax Year(s)/Period(s) 

3. I      revoke prior authorizations directing Treasury to send    Tax Type(s)                                          Tax Year(s)/Period(s) 
          copies to my representative for dispute(s) listed here: 
PART 3: REPRESENTATIVE APPOINTMENT 
Your representative may be an entity or an individual. If you designate an entity you must also provide an individual as a contact. If no start date is 
indicated the authorization is effective as of the date this form is signed. If no expiration date is indicated the authorization is effective until revoked. 
Authorized Representative’s Name (Required)                         Contact Name (Required if an entity is named) 

Authorized Representative’s Address (Required)                      Telephone Number (Required)                    Fax Number 

                                                                    Authorization Start Date (mm/dd/yyyy)          Authorization Expiration Date (mm/dd/yyyy) 

                                                                    Authorized Representative’s E-mail Address 

PART 4: TYPE OF AUTHORITY 
If you check a box, you authorize your representative to act in that capacity. 
1. Receive         and inspect oral or written confidential information (upon request only). (To have your representative receive copies of all 
          future letters and notices involving a tax dispute [other than City Income tax], you must complete Part 5.) 
2. Make oral or written presentation of fact or argument.               You may restrict authority in boxes 1-4 to a specific matter. (Not required.) 
                                                                        Tax Type(s), Debt Type or Fee                    Year(s)/Period(s) 
3. Sign returns. 
4. Enter into agreements. 
PART 5: REQUEST COPIES OF LETTERS AND NOTICES REGARDING A TAX DISPUTE (other than City Income Tax) 
By checking this box, you are directing Treasury to send a          Tax Type                                             Tax Year/Period 
copy of all future notices and letters involving a particular 
tax dispute to your representative named in Part 3 under            Tax Type                                             Tax Year/Period 
section 8 of the Revenue Act (MCL 205.8). Enter the 
tax (income tax, sales tax, use tax, etc.) and year(s) or 
period(s) in the fields at right. (Tax and year(s) or period(s)     Tax Type                                             Tax Year/Period 
are both required if this box is checked.) 
PART 6: TAXPAYER OR DEBTOR AUTHORIZATION 
By signing this form, I authorize Treasury to communicate with my representative consistent with the authority granted. 
Signature (Required)                            Print Name (Required)                     Title (Required if a business) Date (Required) 

Spouse’s Signature                              Print Name                                Title                          Date (Required if spouse signs) 

                                                             TREASURY USE ONLY 
                                                                                 Division Name                                    Reviewer Initials 
          Accepted              Rejected 

Form 151, Page 2 

Purpose                                                                     PART 4: Type of authority: General or limited. You may 
                                                                            grant  your representative general or limited authority to act 
Use the     Authorized Representative Declaration (Power of                 on your behalf. The actions that your representative may take 
Attorney) (Form  151) to authorize  the  Michigan Department  of            will depend on the boxes that you check in Part 4. Confidential 
Treasury (Treasury) to communicate with a named individual                  information (box 1) will only be provided upon request; Treasury 
or entity acting on your behalf. This form may also be used                 will  not automatically send confidential  information to your 
to revoke your representative’s authority or to designate a                 representative. Granting your representative authority does not 
representative to receive letters and notices regarding a particular        give the representative the right to receive future copies of letters 
tax  dispute.    All  businesses     may  complete  an Authorized           and notices unless Part 5 is also completed. If you want to further 
Representative  form  via  Michigan Treasury Online  at         mto.        restrict the authority of a representative to a specific matter, you 
treasury.michigan.gov.                                                      must enter the Tax Type(s), Debt Type or Fee as well as the Tax 
Required information. If a box includes the word “Required,”                Year(s)/Period(s) in the boxes to the right within Part 4. 
you must provide the information. If a box does not contain the             PART 5: Requesting copies of letters and notices with respect 
required information, the form is invalid and you will be notified          to a tax dispute.  
by letter.  
                                                                            NOTE: This part does not apply to City Income Tax. 
PART 2: Revoking the authority of a representative.        If you  
want to revoke all prior authorizations, including requests to send         If you complete Part 5, you must identify on the line in Part 5 
copies of letters and notices of tax dispute(s) to your representative      one  or more  tax matters that  is in dispute. The  dispute(s) may 
and will be representing yourself, check box 1. If you want to              cover more than one tax period or year. You must identify one 
revoke your representative’s current authority in whole or in part          or more specific taxes and periods; “all taxes” and “all periods” 
for a specific tax matter, check box 2 and enter the appropriate            is unacceptable and will be rejected. Part 5 does not give a 
Tax Type(s), Debt Type, or Fee as well as the Tax Year(s)/                  representative authority to act on your behalf. You must give 
Period(s) in the boxes to the right within Part 2. If you want to           your representative authority to act on your behalf by checking 
revoke a previous request to send copies of letters and notices of          one or more boxes in Part 4 if you want your representative to 
tax  dispute(s)  to  your  representative,  check  box  3  and  enter  the  do more than just  receive future notices and letters. Only one 
appropriate Tax Type(s) and Tax Year(s)/Period(s) in the boxes              representative can be authorized to receive future letters and 
to the right within Part 2. After you revoke your representative’s          notices regarding a specific tax dispute under Part 5. Treasury 
authority, you may represent yourself, or you may appoint a new             will only send future letters and notices to the person identified 
representative by completing Part 3, Part 4 and/or Part 5.                  on the most recent form. If you appoint  an entity as your 
                                                                            representative, future  letters and notices will  be  sent  to the 
PART 3: Appointing an entity as your representative.                        attention of the first “Contact Name.” 
If you appoint an entity as your representative,  then any 
individual within that entity is authorized to act on your                  Deceased taxpayer.     Do not use this form for a deceased 
behalf. For example, if you appoint the XYZ Law Firm as                     taxpayer. File a Claim for Refund Due a Deceased Taxpayer (MI-
your representative, any attorney or paralegal from that firm is            1310) with a death certificate and/or a letter of authority (issued 
authorized to act on your behalf. The “Contact Name” is only                by the probate court) for a personal representative. 
to ensure  that  information sent  to the  entity is directed to the 
individual overseeing your representation. The contact name is              MAILING OR FAXING INSTRUCTIONS 
NOT your sole authorized representative. To appoint an entity,              Individual taxpayers: 
write the name of the entity in the Name box and the address of             Michigan Department of Treasury 
the entity in the Address box. For example:                                 Customer Contact Center 
 Authorized Representative’s Name (Required)                                Individual Correspondence Section 
 XYZ Law Firm                                                               PO Box 30058 
 Authorized Representative’s Address (Required)                             Lansing Ml  48909 
 1234 Street                                                                Fax: 517-636-4488 
 City, State, ZIP Code                                                      When Treasury Collections asks for this form and any 
                                                                            attachments:  
Appointing an individual as your representative. If you  
                                                                            Michigan Department of Treasury — Coll 
appoint a specific individual as your representative, then only  
                                                                            PO Box 30149 
that individual is authorized to act on your behalf. Treasury will  
                                                                            Lansing Ml  48909 
only discuss with or disclose information to that individual. For  
                                                                            Fax: 517-272-5562 
example, if a specific attorney at the XYZ Law Firm is named  
as your representative, Treasury will not discuss with or disclose          When a Treasury field office representative asks for this 
information to any other attorney or paralegal at the same firm.            form, send it as directed by that office. 
If you appoint an individual as your representative, do not fill out        For all others: 
Contact Name; your representative is the contact. To appoint an             Electronically submit through Michigan Treasury Online (MTO) 
individual, write the name of the individual in the Name box and            Email a PDF copy to Treas-Registration-151@michigan.gov 
 the address of the individual in the Address box. For example:             Or mail to: 
 Authorized Representative’s Name (Required)                                Michigan Department of Treasury 
 John Smith                                                                 Customer Contact Center 
 Authorized Representative’s Address (Required)                             Registration Section 
 1234 Street                                                                PO Box 30778 
 City, State, ZIP Code                                                      Lansing Ml 48909