Wisconsin Power of Attorney and Instructions

Power of Attorney and Instructions
September 2019 A-222 Power of Attorney
Wisconsin Department
of Revenue

Power of Attorney

Form

(Please print or type)

A-222

Part 1 – Taxpayer Information
Taxpayer’s last name or business name

Taxpayer’s first name

ID number

Spouse’s last name

Spouse’s first name

Spouse’s ID number

Current address

Daytime telephone number

(	)
City

State

Zip code

Email address (optional)

Part 2 – Representative(s)
If an individual(s) name is provided, authority is limited to that individual(s). If a business name is provided without specifying
an individual, authority is granted to employees of the business.
Check only one (see instructions):
Add - appoints a new or additional representative

Revoke - ends the representative named below

Business legal name

Telephone number

(	)
Individual’s last name

Telephone number

Individual’s first name

(	)
Individual’s last name

Individual’s first name

Telephone number

(	)
Mailing address

Fax number

(	)
City

State

Zip code

Email address

If revoking a representative, skip Part 3 and sign and date the form.

Part 3 – Authority Granted
I grant full authority to the representative(s) - The representative(s) named above has full authority to perform any act with
respect to matters before the department that the taxpayer(s) can and may perform, including receiving confidential Wisconsin
tax information. Note: If granting full authority, do not check any boxes on the next page.

A-222 (R. 9-19)

Form A-222

Page 2 of 2
ID Number

Taxpayer Name

	 Part 3 – Authority Granted (continued)
I grant limited authority to the representative(s) - (check only items below for which you are granting authority.) The
representative(s) named above has authority to perform any act, with respect to the items checked below, that the taxpayer(s)
can and may perform, including the authority to receive confidential Wisconsin tax information.
Limited Authority

Period(s) (optional)

Limited Authority

Income or Franchise Taxes

Employer Withholding Taxes

Sales and Use Taxes

Pass-Through Withholding
Taxes
Nontax Debt

Excise Taxes
Property Taxes

Period(s) (optional)

Other (describe below)

	 Part 4 – Signature of Taxpayer(s)
I understand that the execution of this Power of Attorney does not relieve me of personal responsibility for correctly and timely
reporting and paying taxes, or from the penalties, fees, or interest for failure to do so, all as provided for under Wisconsin tax
law. I understand a photocopy, faxed copy, and/or electronic copy of this form has the same authority as the signed original.
If signed by a corporate officer, general partner, managing member, or fiduciary on behalf of the taxpayer, I certify that I have
the authority to execute this Power of Attorney on behalf of the taxpayer.
Signature

Title

Date

Signature

Title

Date

Note: All notices that are automatically generated by the department’s computer system will be sent only to the taxpayer. If the
representative needs copies of these notices, the representative must request a copy each time a notice is issued if it cannot be
accessed in My Tax Account as an approved third party.