Disclosure/representation Authorization Form Instructions
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1Disclosure/Representation Authorization Form Instructions
PURPOSE OF FORM
Section 4- Scope of Authorization.
Form 285 enables any individual, sole proprietorship, joint filers, corporation,
At minimum, this authorization form authorizes the Department to release Taxpayer’s
group of consolidated or combined corporations, partnership, limited liability
confidential information to Appointee. However, Taxpayer may also grant specific
company, estate, trust, governmental agency, or other organization, association, or
additional powers in section 4 by checking the applicable “yes” box(es). A blank box
group thereof (“Taxpayer”) to designate a person (“Appointee”) to whom the
will be treated as a “no”, even if the Power of Attorney is granted by this form.
Arizona Department of Revenue can release confidential information, if the release
of such information is not otherwise authorized by A.R.S. § 42-2003.
The
The Appointee must be given the Power of Attorney (marking “yes” in Box vi of
disclosure of such confidential information may be necessary to fully discuss tax
Section 4) in order to represent taxpayer during any administrative tax
issues with, or respond to tax questions by such Appointee. The form can also grant
proceedings.
“Administrative tax proceedings” include proceedings before, and
additional powers to the Appointee, up to and including the power to represent
submissions to the Hearing Office or Director of the Department, or the Office of
Taxpayer at any formal administrative tax proceeding.
If Taxpayer grants
Administrative Hearings. In order to represent Taxpayer in an administrative
Appointee the power of representation, this authorization form shall operate as a
proceeding, in addition to receiving a Power of Attorney, the Appointee must
Power of Attorney.
meet the requirements of Rule 31(a)(4)(M) of the Arizona Rules of the Supreme
Court. The following individuals are authorized pursuant to Rule 31(a)(4)(M) to
represent Taxpayers if they have been given a Power of Attorney:
FILING INSTRUCTIONS
(1)
Any individual, IF the total amount in dispute, including tax, penalties, and
interest, is less than $5000.00;
If Taxpayer is working with a specific section/employee of the Arizona Department
(2)
A full-time officer, partner, member or manager of a limited liability company,
of Revenue (“Department”), mail Form 285 to such section/employee. Otherwise,
or employee, IF: (1) taxpayer is a legal entity, such as a corporation, a formal
mail Form 285 to:
partnership, a limited liability company, or a trust; (2) such representation is not
Arizona Department of Revenue
the appointee’s primary duty to the legal entity, but secondary or incidental to
Taxpayer Information and Assistance
other duties relating to the management or operation of the legal entity; and (3)
P.O. Box 29086
the person is not receiving separate or additional compensation (other than
Phoenix, AZ 85038
reimbursement for costs) for such representation.
Taxpayer may file an original, a photocopy, or a facsimile transmission (Fax) of
If either of the above two conditions are not met, then only the following individuals
Form 285.
can represent a Taxpayer if they have been given a Power of Attorney:
(3)
An active member of the State Bar of Arizona;
SPECIFIC INSTRUCTIONS
(4)
An Arizona Certified Public Accountant; or
(5)
A “Federally Authorized Tax Practitioner” within the meaning of Arizona
Section 1- Taxpayer(s) Information.
Revised Statutes § 42-2069(D)(1). Such person includes: (1) an enrolled agent
authorized to practice before the Internal Revenue Service; (2) an out-of-state
Enter Taxpayer’s name, address, and daytime telephone number on the lines
attorney or out-of-state certified public accountant, if such person is not
provided. Taxpayer may attach a supplemental page to the form if section 1 does
currently under suspension or disbarment from practice before the IRS and has
not provide sufficient space for the required information.
If Taxpayer is a
filed with the IRS a written declaration that he or she is currently qualified as an
consolidated or combined group of corporations, Taxpayer must attach a federal
attorney or a CPA; and (3) an individual practicing with a federally authorized
Form 851 or a supplemental sheet, as applicable, containing the names of each
tax practitioner and who is subject to the same standards of practice and ethics
member of the consolidated or combined group and indicating the corporations for
requirements of such person.
which the signator of Form 285 is a principal corporate officer. If the principal
corporate officer signing the form is not a principal corporate officer of all
Section 5- Revocation of Earlier Authorizations.
members of the consolidated or combined group, this form will only be
effective as to the members of the consolidated or combined group in which the
This authorization does not revoke any earlier authorizations or Powers of Attorney
signator is a principal corporate officer.
on file with the Arizona Department of Revenue. If you want to revoke all prior
authorizations and Powers of Attorney, please check the box. If you wish to revoke
An individual taxpayer, sole proprietorship, or joint filer(s) must provide a Social
only some prior authorizations and/or Powers of Attorney, please check the box and
Security number(s), Withholding number, or Transaction Privilege Tax License
list those authorizations and Powers of Attorney that you wish to remain in effect.
number, as applicable. Taxpayers which are corporations, partnerships, or trusts
must provide their Federal Employer Identification number and a Withholding or
Section 6- Signature.
Transaction Privilege Tax License number if applicable. Taxpayers which are
estates must provide either the decedent’s Social Security number or the estate’s
Federal Employer Identification number, as well as a Withholding or Transaction
Type of Entity
Who must sign
Privilege Tax License number if applicable.
The individual/sole proprietor or a joint filer must
Individuals,
sign the authorization. If both husband and wife (or
Section 2- Appointee Information.
Joint Filers
former husband and wife) want to authorize the same
and Sole
Appointee, both spouses (or former spouses) must
Enter the name of the person you are appointing to be authorized to receive
Proprietorships
sign the authorization form.
Taxpayer’s confidential information and/or act on Taxpayer’s behalf. The
Appointee must be an individual. Appointee’s Social Security number, CPA
number, State Bar number, Alternative Preparer Tax Identification number or other
A principal corporate officer within the meaning of
Corporations
identification number must be provided.
Please attach a supplemental sheet
A.R.S. § 42-2003(A)(2) must sign the authorization.
containing the required information if Taxpayer(s) desires to authorize more than
one Appointee to receive Taxpayer’s confidential information and/or act on
Partnerships &
A partner having authority to act in the name of the
Taxpayer’s behalf.
Limited
partnership must sign the authorization.
Partnerships
Section 3- Tax Matters.
Trusts
A Trustee must sign the authorization.
You may use this form for more than one tax type. Please check applicable boxes
and specify the tax year(s) or tax period(s) for which Appointee is authorized to
An Executor/Executrix or the personal representative
Estates
receive Taxpayer’s confidential information and/or act on Taxpayer’s behalf. A
of the estate must sign the authorization.
general reference to “all years”, “all periods”, or periods or years “to present” will
be accepted as applying only to tax years (periods) ending prior to the date the form
Limited Liability
A member having authority to act in the name of the
is signed. A general reference to “all future” years or periods will be subject to a
Companies
company must sign the authorization
four year limitation. Also, check the box that properly describes the form of
ownership of Taxpayer.
Governmental
An officer having authority to act on behalf of the
Agencies
governmental agency must sign the authorization.
ADOR 03-0029 (4/00)
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