How to Write
1 – Find The Required Paperwork Then Open It
The ability of one individual (Agent or Attorney-in-Fact) to act with the same Powers as another individual (Principal) can be granted through the Principal’s Execution of the form on this page. This document is accessible using the buttons immediately under the image preview.
2 – Present The Taxpayer’s Name, Address, and ID Number
The first section, “Taxpayer’s Name And Address,” will present a table where the Principal may indicate his, her, or its Status Type simply by filling out the appropriate column.
The first row in this table will be dedicated to having a report on the Identity of the Principal Taxpayer. If the Principal Taxpayer is a private citizen or an individual then enter his or her Full Name in the blank space labeled “Name Of Taxpayer.” If the Principal Taxpayer is a Business Entity then record the Legal Name (including applicable suffix) of the Principal Taxpayer Entity on the blank space labeled “Business Name”
The second row and third rows in this table will seek to identify the Location of the Principal Taxpayer. Use the first space, in the second row,” labeled “Address (Street Or Other Mailing Address)” to report the Individual Taxpayer’s Street Address. If the Principal Taxpayer is a Business Entity, then use the space labeled “Business Address (Street Or Other Mailing Address)” to report its Legal Address.
Complete the Address Report of the Principal Taxpayer using the third row. Enter the Individual Taxpayer’s City, State, and Zip Code in the same column as the Individual Taxpayer’s Name. If the Principal Taxpayer is a Business Entity, then enter Taxpaying Entity’s City, State, and Zip Code on the third row in the same column as its Name.
Use the last row to record the Identification Number of the Principal Taxpayer. If this Principal Taxpayer is an individual then enter the Principal Taxpayer’s Nebraska I.D. Number or Social Security Number in the first column. If the Principal Taxpayer is a Business Entity, then enter the Business Entity’s Federal Entity Identity Number or the Business Owner’s Social Security Number in the second column.
3 – Document The Attorney-in-Fact’s Name, Address, And Contact Information
The next section, “Attorney-in-Fact’s Name And Address,” will display a table where the Attorney-in-Fact may be officially named. There will be enough room to designate Two Attorneys-in-Fact; one in each column. If more than two Attorneys-in-Fact must be assigned with Principal Powers, you should list their information, Name and Contact Information, on an attachment (which must be present at the time of Principal Signing).
Use the first row of the available columns to report the Attorney-in-Fact’s Name. If the Attorney-in-Fact has a Title or is associated with a Firm, then use the second row to record this information in the appropriate column.
When the Identity of the Attorney-in-Fact(s) has been properly documented, use the third and fourth rows to enter each Agent’s Street Address, City, State, and Zip Code in the column corresponding to his or her Name.
The last row of this table will complete the Attorney-in-Fact’s Report with his or her E-Mail Address and Telephone Number. Enter each Agent’s “Email Address” and “Phone Number” in the correct column.
4 – Discuss The Principal Power Being Delegated To The Attorney-in-Fact
The Attorney-in-Fact will be granted the Authority to act as if he or she were the Principal regarding the Principal’s Tax Matters with the Nebraska Department Of Revenue. These Powers will need to be accurately defined in this document to be Effective. We will address this issue in the next available table.
Record the Type(s) of Tax Matter(s) the Attorney-in-Fact(s) may represent the Principal in with the first column. Then, use the next column to record the exact “Tax Matter Of Representation” the Principal will appoint to the Agent. The third column (“Tax Period”) has been provided so that you may enter the Time Period when these Principal Powers will be Effective in the Tax Matters defined.
In addition to the table, there will be a series of bulleted Action Statements. Each statement will define a Principal Action the Attorney-in-Fact may take with Principal Power. The Principal should read through this list. If the Principal does not wish to give the Attorney-in-Fact the Principal Power to carry out one of these statements, he or she should strike through that statement. The Attorney-in-Fact will not have the Principal Approval to carry out the actions defined in a statement that has been crossed out at the time of Principal Signing.
If the Principal does not give the Attorney-in-Fact the Principal Power to “Fully Represent The Taxpayer In Any Hearing, Determination, Or Appeal” then he or she should draw a horizontal line through the first bulleted statement.
If the Principal wishes to restrict the Attorney-in-Fact’s Principal Powers from entering (on behalf of the Principal) “Any Compromise With The Department” Of Revenue, the Principal will need to strike through the second bullet.
The Principal should cross out the third bulleted item, if he or she wishes to prevent the Agent from Executing “Waivers, Including Offers Of Waivers, Of Restrictions On Assessment Or Collection Of Tax Deficiencies” in the Tax Matters listed above.
The fourth bulleted item will deliver the Principal Authority needed by the Attorney-in-Fact to “Execute Waivers Of Notice Of Disallowance Of A Claim For Credit Or Refund” on behalf of the Principal. The Principal should cross out this statement to exclude it from the Principal Powers being delivered here.
If the Principal does not wish the Attorney-in-Fact to have the Power to “Execute Consents Extending The Statutory Period For Issuing A Notice Of Deficiency Determination” then he or she should cross out the fifth bulleted Item.
The Principal can withhold granting the Attorney-in-Fact the Principal Power to receive payments in the form of checks if he or she crosses out the sixth bulleted item. If the Principal does grant this Power, by leaving it unmarked, it should be noted the Attorney-in-Fact will be able to receive Checks on behalf of the Principal but not endorse them.
If the Principal intends to restrict the Attorney-in-Fact from “Receiving All Notices And Other Written Communications” on his or her behalf, he or she should strike out the seventh bulleted item. If the Principal does wish the Attorney-in-Fact to “Receive All Notices And Other Written Communication” regarding the Tax Matters listed above, then he or she must enter which Attorney-in-Fact should receive such information on the blank line provided.
If the Principal wishes to specifically name the Attorney-in-Fact with the Power to carry out specific functions that have not been named thus far, he or she should record such Power Additions or Extensions on the blank lines in the last bulleted item. If no such additions exist, then he or she should cross out the words “Perform Other Acts, Specifically.”
5 – Deliver The Status Of Any Previous Delegated Powers
It will be important to define how this document will interact with other Powers of Attorney that have been issued by the time the Principal signs this document. This definition must be provided in the section labeled “Revocation Of Prior Powers Of Attorney.
If the Principal wishes to keep one or more previous Authorities in Effect, after this document goes into Effect, then he or she should mark the check box corresponding to the first check box, enter the exact Title of the document to remain active, and attach a copy of the previously issued Authority to this paperwork.
If the Principal chooses to revoke any and all previously issued Powers, then mark the check box corresponding to the second statement.
6 – The Principal Taxpayer Must Verify His Or Her Intent Through A Signature
The final section will execute this document through the Principal’s Signature. If the Principal Taxpayer has/had a Spouse who he or she filed jointly with, this individual will need to Sign this form as well and provide the same items. If the Principal Taxpayer is a Corporation/Association, an Officer authorized to sign this paperwork on behalf of the Business Entity should sign this document. If the Principal Taxpayer is an LLC, all the Members of the LLC should sign this document. If all the members are unavailable a Manager, authorized to provide such a signature, may satisfy this item requirement.
Each Principal Taxpayer must sign his or her Name on the Signature line and provide the Date of that Signature.
On the next row, the Signature Taxpayer must present his or her Printed Name, Email Address, and any applicable Title Print his or her Name on the “Print Name” line.
You may send this document by Mailing or Faxing this paperwork to the Nebraska Department Of Revenue.
Mail To:
Nebraska Department Of Revenue
P.O. Box 94818A
Lincoln, NE 68509-4818
Fax To:
(402) 471-5608