Power Of Attorney For Division Administered Tax Matters Form Page 2

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5. Added or Deleted Acts – List any specific additions or deletions to the acts otherwise in this
power of attorney:
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
6. Retention/Revocation of Prior Power(s) of Attorney – The filing of this power of attorney
automatically revokes all earlier power(s) of attorney on file with the City and County of Denver,
Treasury Division for the same tax matters and periods covered by this document. If you do not
want to revoke a prior power of attorney check here…………………………………..
YOU MUST ATTACH A COPY OF ANY POWER OF ATTORNEY YOU WANT TO REMAIN IN EFFECT.
7. Signature of Taxpayer(s) – If this form is not signed, dated, and titled (if applicable), it is
invalid. If signed by a corporate officer, partner, guardian, tax matters partner, executor, receiver,
estate administrator, or trustee on behalf of the taxpayer, I certify that I have authority to execute
this form on behalf of taxpayer.
Signature
Date
Print Name
Title
Signature
Date
Print Name
Title
8. Declaration of Representative – I am authorized to represent the taxpayer(s) identified in
number 1 for the tax matter(s) specified.
Signature
Date
Title
I represent the taxpayer identified in number 1. as:
CO attorney, Reg # __________________
attorney registered in _____________ # ________
CO licensed CPA # __________________
CPA licensed in __________________
other, explain
_____________________________
Signature
Date
Title
I represent the taxpayer identified in number 1. as:
CO attorney, Reg # __________________
attorney registered in _____________ # ________
CO licensed CPA # __________________
CPA licensed in __________________
other, explain
_____________________________
Processing will be faster if addressed to a specific unit or person at the Treasury Division, and if
you can, attach copies of the most recent correspondence from the Treasury Division, such as
Refund Claim, Notice of Final Determination, Assessment, and Demand for Payment, Refund
Denial, Audit Engagement Letter, etc. Where the address does not specify any unit or person, this
form should be directed to City and County of Denver, Treasury Division, Tax Compliance, 201
W. Colfax Avenue, MC 1001, Dept. 1009, Denver, Colorado 80202
Page 2

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