Minnesota Authorization to Communicate through Email Transmission (Revised 12/05)

Authorization to Communicate through Email Transmission (Revised 12/05)
REV187, Email Authorization
Form REV187, Email Authorization

Signature

Recipient

Taxpayer

Read instructions before completing this form.
Taxpayer Name	

Social Security Number or ITIN

Street Address or PO Box	

Minnesota or Federal Employer Identification Number (FEIN)

Apt. or Suite		

Phone Number	

City	

Email Address

State 	 ZIP Code	

Name of Person to Receive Email	

Fax Number
Copy me on
all email

Attorney Number, Accountant Number, or PTIN

Email Address	
Expiration Date	
		
This authorization is not valid until it is signed and dated by the taxpayer, or someone with legal authority to sign on behalf of the taxpayer.
Parent, Guardian, Conservator, or Officer: I certify that I have the legal authority to sign this form.
Signature	

Print Name and Title, If Applicable			 Date	

Send a signed copy of this form to the department:
Mail: 	 Minnesota Department of Revenue, Mail Station 4123, 600 N. Robert St., St. Paul, MN 55146
Fax: 	 651-556-5210
Email: 	[email protected]

Form REV187 Instructions
Purpose of This Form

By signing this form, you authorize the Minnesota Department of Revenue to exchange private or nonpublic data using unencrypted email
with the person above. Unencrypted email is not secure.
You accept the risk in the unencrypted email that data may be intercepted by someone other than the intended recipient and understand that
the department is not liable for any damages caused by such interception.
This form does not authorize the department to release private or nonpublic data to anyone other than the recipient unless there is a valid
power of attorney on file.

Copy Me on All Email

You can receive a copy of the email sent to your recipient by checking the box next to your email address.

Your Signature

This authorization is not valid until it is signed and dated by someone with legal authority to sign it. For most people, this is the taxpayer
whose information is being shared.
If granting authority for a joint return, only one spouse needs to sign. Parents or legal guardians must sign for minors.
For legal guardians, conservators, personal representatives, and others signing on behalf of the taxpayer, we require documents and a photo
ID to confirm your legal authority.
We reserve the right to request additional information as needed.

Expiration

This authorization remains in effect until it expires, if indicated above, or is removed in writing. You may remove this authorization at any time.

Questions?

Website:	www.revenue.state.mn.us
Email:	[email protected]
Phone:	 651-556-3003 or 1-800-657-3909
(Rev. 9/22)