GEN-58 — NC Power of Attorney Instructions (GEN-58 / GEN-58R)

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General InstructionsPurpose of FormsForm GEN-58, Power of Attorney and Declaration of Representative. Grants an individual authority to to represent return information received from the Internal Revenue Service. A taxpayer's execution of a power of attorney does not prohibit the Department from contacting the taxpayer directly when necessary.Form GEN-58R, Power of Attorney Revocation. tax matters.Authority Grantedinformation, and to perform any and all acts that the taxpayer can perform with respect to the tax matters described. This includes the authority to sign any agreements, consents, or other documents. For purposes of this section, federal However, authorizing an individual as power of attorney does not relieve the taxpayer of any tax obligations.FilingYou can submit Forms GEN-58 and GEN-58R electronically using the Department's website (ncdor.gov/poa) or you can submit a paper version of the forms by mail or fax. All sections must be completed. Incomplete forms will not be processed.Fiduciariesof attorney granting the authorization on behalf of the taxpayer.Additional InformationFor more information about powers of attorney for individuals and businesses, please visit the Department's website at ncdor.gov/poaPart 1. Power of AttorneyLine 1. Taxpayer InformationEnter the taxpayer's information in this section based on the instructions provided below for the type of taxpayer requesting representation.Individuals. Do not enter anything on the line beginning with the Entity Legal Name box. That line is reserved for business entities. N.C. Power of Attorney InstructionsWeb-Fill5-24Instructions for Forms GEN-58 and GEN-58R

Enter the taxpayer's mailing address and daytime phone number. If you are submitting Form GEN-58 electronically submitting a paper Form GEN-58, you may include the taxpayer's email address. Corporations, Partnerships, Trusts, or LLCs. Enter the taxpayer's legal name. Select FEIN or SSN in the ID Type daytime phone number. If you are submitting Form GEN-58 electronically on the Department's website, you must also include the taxpayer's email address. Do not enter anything on the lines beginning with the Individuals' First Name box or Spouse's First Name box. These lines are reserved for individuals.Estates.address and daytime phone number of the executor or personal representative of the decedent. If you are submitting Form GEN-58 electronically on the Department's website, you must also include the e-mail address of the executor or include the e-mail address of the executor or personal representative of the decedent.Do not enter anything on the lines beginning with the Individuals' First Name box or Spouse's First Name box. These lines are reserved for individuals.Line 2. Representative(s)Only individuals may be named as representatives. If you are submitting Form GEN-58 electronically via the Department's website, you must also may include the e-mail address of the representative. If you are granting authority to multiple representatives, enter this information for each representative. Line 3. Tax Mattersshould be entered in MM-DD-YYYY format. The Department will not process the form if you do not select at least one tax type and list the tax period beginning and end dates. You may list any tax years or periods that have already ended as of the date you sign the power of attorney. You may include future tax years or periods that end no later than three years from December 31 of the year the power Line 4. Acts Authorizedtaxpayer can perform. Line 5. Signature of Taxpayer(s)Individuals. The taxpayer must sign, print their name, and date the power of attorney. If both spouses will be represented by the same representative(s), both must sign the power of attorney unless one spouse authorizes the other, in writing, to sign for both. In that case, attach a copy of the authorization. However, if the spouses will be represented by different individuals, each taxpayer must execute his or her own power of attorney on a separate Form GEN-58.Corporations.of attorney.Partnerships and LLCs. All partners or members must sign, print their name and title, and date the power of attorney unless one partner or member is authorized to act in the name of the partnership or LLC. A member is authorized to act in the name of the LLC if the member is a manager of the LLC. A partner is authorized to act in the name of the partnership if, under State law, the partner has authority to bind the partnership. Page 2Gen. 58 Instr.Web-Fill5-24

Page 3Gen. 58 Instr.Web-Fill5-24Estates and Trusts. Part 2. Declaration of RepresentativeThe representative(s) named on the form must sign and date this declaration and enter the proper designation (i.e., items a - g). In addition, the representative(s) must list the following in the "Designation" column:a Attorney - Enter the two-letter abbreviation for the state in which admitted to practice.c Enrolled agent - Enter the enrollment card number.e Full-Time Employee - Enter title or position (e.g., comptroller or accountant).f Family Member - Enter the relationship to taxpayer (i.e., spouse, parent, child, brother, or sister).will remain in effect for your spouse until revoked by your spouse.Line 1. Taxpayer InformationEnter the taxpayer's information in this section based on the instructions provided below for the type of taxpayer revoking representation.Individuals. Do not enter anything on the line beginning with the Entity Legal Name box. That line is reserved for business entities. Corporations, Partnerships, Trusts, or LLCs. Enter the taxpayer's legal name. Select FEIN or SSN in the ID Type daytime phone number. Do not enter anything on the lines beginning with the Individuals' First Name box or Spouse's First Name box. These lines are reserved for individuals.Estates.address and daytime phone number of the executor or personal representative of the decedent.Do not enter anything on the lines beginning with the Individuals' First Name box or Spouse's First Name box. These lines are reserved for individuals.Line 2. Tax Mattersmatters to be revoked under "Type of Tax."Note: SignatureThe GEN-58R must be signed by the taxpayer or representative submitting the form. If submitted by the taxpayer: A taxpayer's revocation is effective for all representatives listed in powers of attorney DO NOT complete the representative

Page 4Gen. 58 Instr.Web-Fill5-24information at the bottom of the form. If submitted by the representative:A representative's revocation is only effective for that individual representative's power(s) of attorney for the named Department for other taxpayers. It also does not revoke the taxpayer's power(s) of attorney for other representatives of that taxpayer.