Michigan Authorized Representative Declaration (Power of Attorney)

In the case of wanting to authorize a person to represent the principal on financial-related issues to the State of Michigan, the following form has to be completed and submitted.

Extracted Text for Proper Search

Michigan Department of Treasury 	Issued under authority of Public Act 122 of 1941. 	151 (Rev. 06-17) 
Authorized Representative Declaration (Power of Attorney) 
INSTRUCTIONS: Use this form to authorize the Michigan Department of Treasury to communicate with a named individual or entity acting 
on your behalf.  Also use this form to designate a representative to receive copies of correspondence regarding a particular tax dispute 
(other than City Income Tax).  All information designated as “required” must be supplied for this\
 authorization to be effective. 	
You may restrict authority in boxes 1-4 to a speci�c matter (Not required) 
Tax Type, Debt or Fee  Year(s) or period(s) 	
PART 1: TAXPAYER OR DEBTOR INFORMATION 
Taxpayer’s Name and Address (Required) 
If a business, include any DBA, trade or assumed name. 
If �ling joint return, include spouse’s name.  FEIN, ME or TR Number (Required for business taxes) 
Taxpayer’s Social Security Number 
(Required if 
no FEIN ME or TR Number listed)  Spouse’s Social Security Number 
Taxpayer’s  E-mail Address  Daytime Telephone Number (Required) Fax Number 
PART 2: REVOCATION OF AUTHORITY 
To revoke the authority of your current representative, check the applica\
ble box in this section.  Check only ONE box. 
I revoke all prior authorizations. I will represent myself. 
I revoke prior authorizations in the matter/dispute listed in Part 4 and\
/or Part 5. I will represent myself. 
I revoke prior authorizations in the matter/dispute listed in Part 4 and\
/or Part 5 and appoint a new representative in Part 3 who is authorized \
under Part 4 and/or 5. 
PART 3: REPRESENTATIVE APPOINTMENT 
Your representative may be an entity or an individual. If you designate a\
n entity you must also provide an individual as a contact.  If no start date is 
indicated the authorization is effective as of the date this form is signed.  If no expiration date is in\
dicated the authorization is effective until revoked. 
Authorized Representative’s Name and Address (Required)  Contact Name (Required if an entity is named) 
Telephone Number (Required)  Fax Number 
Authorization Start Date (mm/dd/yyyy)  Authorization Expiration Date (mm/dd/yyyy) 
Authorized Representative’s E-mail Address 
PART 4: TYPE OF AUTHORITY 
If you check a box, you authorize your representative to act in that cap\
acity.  1. Receive and inspect con�dential information (upon request only). ( To have your representative receive copies of all future letters and 
notices involving a tax dispute [other than City Income Tax], you must complete Part 5.) 
2. Make oral or written presentation of fact or argument. 
3. Sign returns. 
4. Enter into agreements. 
5. All of the above. 
PART 5: REQUEST COPIES OF LETTERS AND NOTICES REGARDING A TAX DISPUTE 	(other than City Income Tax) 	
By checking this box, you are directing Treasury to send a copy of all future notices and letters involving a par\
ticular tax dispute to your repre-
sentative named in Part 3 under section 8 of the Revenue Act (MCL205.8). This dispute is for year(s) or period(s) __________________ and 
Tax (income tax, sales tax, use tax, etc.)_____________________________\
____________________________ (Tax and year(s) or period(s) 
are both required if this box is checked.) 	
PART 6: TAXPAYER OR DEBTOR AUTHORIZATION 
By signing this form, I authorize Treasury to communicate with my representative consistent with the author\
ity granted. 
Signature  (Required)  Print Name (Required) Title (Required if a business) Date (Required) 
Spouse’s Signature  Print Name Title Date (Required if spouse signs) 	
TREASURY USE ONLY 	
Division Name  Reviewer Initials	Accepted Rejected

Form 151, Page 2 
Purpose 
Use the Authorized Representative Declaration (Power of 
Attorney)
 (Form 151) to authorize the Michigan Department 
of Treasury (Treasury) to communicate with a named 
individual or entity acting on your behalf.  This form may 
also be used to revoke your representative’s authority or to 
designate a representative to receive letters and notices 
regarding a particular tax dispute. 
Required information.  If a box includes the word 
“Required,” you must provide the information.  If a box does 
not contain the required information, the form is invalid and 
you will be notified by letter.  
Part 2: Revoking the authority of a representative. 
Complete Part 2 if you want to revoke your representative’s 
authority in whole or in part or all prior authorizations. After 
you revoke your representative’s authority, you may represent 
yourself, or you may appoint a new representative. 
Part 3: Appointing an entity as your representative. 
If you appoint an entity as your representative, then any 
individual within that entity is authorized to act on your 
behalf. For example, if you appoint the XYZ Law Firm as 
your representative, any attorney or paralegal from that firm 
is authorized to act on your behalf.  The “Contact Name” is 
only to ensure that information sent to the entity is directed 
to the individual overseeing your representation.  The contact 
name is NOT your sole authorized representative.  To appoint 
an entity, write in the Name and Address box (for example): 
XYZ Law Firm 
1234 St reet 
City, State, ZIP Code 
Appointing an individual as your representative. If you 
appoint a specific individual as your representative, then only 
that individual is authorized to act on your behalf. Treasury 
will only discuss with or disclose information to that 
individual. For example, if a specific attorney at the XYZ 
Law Firm is named as your representative, Treasury will not 
discuss with or disclose information to any other attorney or 
paralegal at the same firm.  To appoint an individual, write in 
the Name and Address box (for example):  Lynn Lee 
XYZ Law Firm 
1234 St reet 
City, State, ZIP Code 
Part 4: Type of authority: General or limited. You may 
grant your representative general or limited authority to act 
on your behalf. The actions that your representative may 
take will depend on the boxes that you check in Part 4. 
Confidential information (box 1) will only be provided upon 
request; Treasury will not automatically send confidential 
information to your representative.  If you check box 5 in 
Part 4, you are granting your representative general authority 
to act on your behalf regarding any tax return and any debt. 
However, granting your representative general authority does 
not give the representative the right to receive future copies 
of letters and notices unless Part 5 is also completed.  Part 5: Requesting copies of letters and notices with 
respect to a tax dispute. 
NOTE:
 This part does not apply to City Income Tax. 
If you complete Part 5, you must identify on the line in Part 5 
a single tax matter that is in dispute. The dispute may cover 
more than one tax period or year.   If you have more than 
one dispute with Treasury and want your representative 
to receive copies of future notices and letters with respect 
to those additional disputes, you must fill out a separate 
form for each dispute.  Part 5 does not give a representative 
authority to act on your behalf.  You must give your 
representative authority to act on your behalf by checking 
one or more boxes in Part 4 if you want your representative 
to do more than just receive future notices and letters.  Only 
one representative can be authorized to receive future letters 
and notices regarding a specific tax dispute under Part 5. 
Treasury will only send future letters and notices to the 
person identified on the most recent form.  If you appoint an 
entity as your representative, future letters and notices will 
be sent to the attention of the first “Contact Name.” 
Deceased taxpayer. Do not use this form for a deceased 
taxpayer. File a Claim for Refund Due a Deceased Taxpayer 
(MI-1310) with a death certificate and/or a letter of authority 
(issued by the probate court) for a personal representative.  	
MAILING OR FAXING INSTRUCTIONS 

Individual taxpayers:  Michigan Department of Treasury

Customer Contact Center
 
Individual Correspondence Section

P.O. Box 30058
 
Lansing, Ml 48909

Fax: 517-636-4488
 
If Treasury Office of Collections or Michigan Accounts 
Receivable Collection System (MARCS) has asked for 
this form and any attachments:  MARCS
 
P.O. Box 30149
 
Lansing, Ml  48909
 
Fa x: 517-272-5562
 
If a Treasury field office representative has asked for this 
form, send it as directed by that office. 
For all others:  Michigan Department of Treasury

Customer Contact Center
 
Registration Section

P.O. Box 30778
 
Lansing, Ml 48909