Virginia Designation of Tax Matters Representative for Agricultural BestManagement Practices Credit

Designation of Tax Matters Representative for Agricultural BestManagement Practices Credit
Form TMR - Designation of Tax Matters Representative for Agricultural Best Management Practices Tax Credit
Form TMR

Designation of Tax Matters Representative
for Agricultural Best Management
Practices Tax Credit

VA Department of Taxation
Tax Credit Unit
P.O. Box 715
Richmond, VA 23218-0715

Fax to:	 (804) 774-3902
Call:	
	

(804) 786-2992
for assistance

Taxpayer Information – An authorized representative of the taxpayer must sign and date this form.
Pass-Through Entity Name

FEIN

Taxpayer Address

Daytime Phone Number

Credit Amount

Taxable Year(s) for Which This
Designation is Being Made

Taxpayer Email

Hereby authorizes the following representative:

Designation of Tax Matters Representative
A pass-through tax entity, such as a partnership, limited liability company, or electing small business corporation (S corporation), may
appoint a tax matters representative, who is a general partner, member-manager, or shareholder, and register that representative
with the Tax Commissioner. The Tax Commissioner will deal with the tax matters representative as representative of the taxpayers
to whom Agricultural Best Management Practices Tax Credits have been allocated. In the event a pass-through tax entity allocates
Agricultural Best Management Practices Tax Credits to its partners, members, or shareholders and the allocated credits are
disallowed, in whole or in part, such that an assessment of additional tax against a taxpayer will be made, the Tax Commissioner will
first make written demand for payment of any additional tax, together with interest and penalties, from the tax matters representative.
In the event payment is not made, the Tax Commissioner will proceed to collection against the taxpayers.
Name and Address

Phone Number

Fax Number

Email
General Partner	

Member Manager	

TMR Signature

Shareholder
Print Name

Date

Authorization - This Authorization revokes all previous Authorizations received by the Department of Taxation for a Tax
Matters Representative for this credit.
Signature - As an authorized representative of the taxpayer, I certify that I have the authority to execute this form on behalf
of the taxpayer.

Authorized Signature
Authorized Pass-Through Entity Signature

Print Name

Va. Dept. of Taxation  6200000  Rev. 08/17

Title

Phone Number

Date

Email Address