Form Dr 0145 - Power Of Attorney
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2DR 0145 (05/95)
COLORADO DEPARTMENT OF REVENUE
1375 SHERMAN ST
DENVER CO 80261
POWER OF ATTORNEY
For Department Administered Tax Matters
1. Taxpayer Information and Identification. Taxpayers must sign on reverse side.
Taxpayer Name(s) and address
( include any trade name or DBA)
Phone Number
(
)
Social Security Numbers for Individuals, or
Colorado Tax ID Number(s)
Hereby appoint(s) the following representative(s) as attorney(s)-in-fact
2. Representative(s). Representative(s) must sign on reverse side.
Phone Number
A. Name(s) and address
(
)
Fax Number
(
)
Attorney Reg Number or FEIN
(if applicable)
B. Name(s) and address
Phone Number
(
)
Fax Number
(
)
Attorney Reg Number or FEIN
(if applicable)
3. Tax matters approved for representation:
Period From ____________ To ____________
Sales Tax
All Department Administered Sales Taxes
Period From ____________ To ____________
Consumers Use Tax
All Dept. Administered Consumers Use Taxes
Period From ____________ To ____________
Income Tax
Corporate
Individual
Other (specify)
Period From ____________ To ____________
Wage Withholding
Period From ____________ To ____________
Period From ____________ To ____________
All taxes within the scope of 39-21-102(1), C.R.S.
4. Acts Authorized — The representatives are authorized to receive and inspect confidential tax information and records and
to perform any and all acts that the taxpayer named above can perform with respect to the tax matters described in number 3,
for example, the authority to sign and bind the taxpayer above to agreements, consents, or other documents. The authority does
not include the power to receive refund checks or the power to sign tax returns.
5. Added or Deleted Acts — List any specific additions or deletions to the acts otherwise authorized in this power of attorney:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
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