Form Dr 0145 - Power Of Attorney For Department Administered Tax Matters
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2DR 0145 (07/03)
COLORADO DEPARTMENT OF REVENUE
1375 SHERMAN ST
DENVER, CO 80261-0005
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)
Daytime Phone Number
(
)
Social Security Number for Individual
Second Social Security Number (if using jointly) or
Colorado Tax ID Number(s)
2. Representative(s). Representative(s) must sign on reverse side.
Hereby appoint(s) the following representative(s) as attorney(s)-in-fact
A. Name(s) and address
Phone Number
(
)
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:
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.
Period From ___________ To ___________
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 deleted acts specifically addressed below.
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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Parent category: Financial