Form Tc-737 - Power Of Attorney And Declaration Of Representative
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1Utah State Tax Commission
Power of Attorney and Declaration of Representative
Clear form
Taxpayer name(s) and addresses
Social Security/Account number
The taxpayer(s) named above hereby appoint the following representative(s) as attorney(s)-in-fact
(attach additional sheets if necessary)
Telephone number
Name and address
Fax number
Telephone number
Name and address
Fax number
Name and address
Telephone number
Fax number
Tax matters to be represented for the taxpayer(s) before the Utah State Tax Commission
Type of tax
Social Security/Account number
Year or period
Appeal number if known
Type of tax
Social Security/Account number
Year or period
Appeal number if known
Type of tax
Social Security/Account number
Year or period
Appeal number if known
Subject to revocation in writing, my representative is authorized to receive, inspect or review confidential tax information and to
perform any and all acts on my behalf to facilitate audits, to negotiate or enter agreements, and to act as my representative in
adjudicative proceedings before the Commission. The authority does not include the power to receive refund checks, the power
to substitute another representative or the authority to disclose confidential tax information to other parties.
Retention/revocation of prior power(s) of attorney. The filing of this power of attorney automatically revokes (unless you
check the box below) all earlier power(s) of attorney on file with the Utah State Tax Commission for the same matters and years
or periods covered by this document.
Check the box if you do not want to revoke a prior power of attorney.
Signature of taxpayer(s)
Date
If signed by a corporate officer, partner, 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 of tax representative(s)
Title
Date
TC-737 Rev. 1/11
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