Power of Attorney and Declaration of Representative (GEN-58 Printable Form)

For faster processing, complete and submit your Form GEN-58, Power of Attorney and Declaration of Representative, electronically

To submit a paper copy of Form GEN-58, follow the instructions below. 

Form GEN-58 Paper Submission

A printable PDF version of Form GEN-58 is available below. You must complete, print, and have all listed taxpayers and representatives sign the form prior to submitting it to the Department.  

The Department of Revenue will not be able to process your request if the following information is not provided:

  • Name
  • Social Security Number(s) and/or Fed Employer ID Number
  • Representative’s Name
  • Type of Tax
  • Year(s) or Period(s)
  • Date
  • Signatures

For faster processing when mailing your Form GEN-58 to the Department, do not attach your Power of Attorney to a tax return or payment.