Minnesota Business Power Of Attorney Form REV 184b

Information you will need

• Business Taxpayer Name
• Filing Entity FEIN or Taxpayer Identification Number
• Print Name and Title
• Name of Business Taxpayer
• MN ID or FEIN
• Authority Expiration Day
• Business Taxpayer Minnesota ID or FEIN
• Business Taxpayer Street Address or PO Box
• Business Taxpayer Phone Number
• Business Taxpayer Fax Number
• Business Taxpayer Apartment or Suite
• Business Taxpayer City
• Business Taxpayer State
• Business Taxpayer ZIP Code
• Combined Business Returns Entity Name
• Attorney Number, Accountant Number, or PTIN
• Appointee Name
• Appointee Street Address or PO Box
• Appointee Phone Number
• Appointee Fax Number
• Appointee Email Address
• Appointee State
• Appointee Zip Code
• Authority Granted

…and 22 more fields in the PDF.

Completed by the agent and the employer and the employee.

The form includes 3 signature lines.