Form 285 I - Individual Income Tax Disclosure/representation Authorization Form - 2000
Download a blank fillable Form 285 I - Individual Income Tax Disclosure/representation Authorization Form - 2000 in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 285 I - Individual Income Tax Disclosure/representation Authorization Form - 2000 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1285 I
Form
Individual Income Tax Disclosure/Representation
Arizona Department of Revenue
Authorization Form
P.O. Box 29080
Phoenix, AZ 85038
1. Taxpayer Information.
Taxpayer(s) name(s) and address
Daytime telephone number
Social Security number(s)
-
-
-
-
2. Appointee Information.
Provide one of the following identification numbers
State and State Bar Number
Name and address (additional Appointees on supplemental sheet)
State and Certified Public Accountant Number
Internal Revenue Service Enrolled Agent Number
Social Security or other ID number (number and type)
Daytime telephone number
3. Tax Matters. The appointee is authorized to receive confidential information relating to individual income tax for the
following tax years:
Tax Year(s):
4. Scope of Authorization. By signing this form, I hereby authorize the Department to release confidential information of
the taxpayer(s) named above (“Taxpayer”) to the appointee named above (“Appointee”) for the tax type and tax year(s)
specified above.
4a. Additional Representational Authority:
In addition to authorizing the release of the confidential information of
Taxpayer, the following additional representational powers are granted to
the Appointee (please indicate “yes” or “no” in the following box).
(Yes/No)
….. This instrument shall be a POWER OF ATTORNEY granting Appointee the power to represent
Taxpayer, including, pursuant to Rule 31(a)(3) & (4) Ariz. R. Supreme Court, representation at any formal
administrative tax proceedings with regard to the above-mentioned tax matters and tax year(s). The
following limitations apply to Appointee’s POWER OF ATTORNEY (please specify)
5. Revocation of earlier Authorization(s). This authorization does not revoke any earlier authorizations or Powers of
Attorney on file with the Arizona Department of Revenue. If you want to revoke all prior authorizations and Powers of
Attorney, please check the following box. If you wish to revoke only some prior authorizations and/or Powers of Attorney,
please check the box and list below those authorizations and Powers of Attorney that you wish to remain in effect…......
If the above box is checked, the revocation will be effective as to all earlier authorizations and Powers of Attorney on file with
the Department of Revenue except for the following persons:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
6. Signature of Taxpayer. I hereby certify that the Arizona Department of Revenue is authorized to release any and all
confidential information concerning the above-mentioned Taxpayer. I understand that to knowingly prepare or present a
document which is fraudulent or false is a class 5 felony pursuant to A.R.S. § 42-1127(B)(2).
Signature
Date
Signature
Date
Print name
Print name
ADOR 03-0033 (4/00)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial