Form 2827 - Power Of Attorney
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Missouri Department of Revenue
Form
2827
Power of Attorney
Please print on white paper only
All appointed representatives must sign on reverse side of this form.
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Taxpayer’s Name or Business Name
Social Security Number or Federal I.D. Number
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Spouse’s Name or if a dba, state the business name
Spouse’s SSN or Federal I.D. Number
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Street Address
Missouri Tax I.D. Number
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City
State
Zip Code
Missouri Charter Number
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E-mail Address
Telephone Number
(__ __ __) __ __ __ - __ __ __ __
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Name of Appointed Representative
Address
Telephone Number
E-mail Address
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Name of Appointed Representative
Address
Telephone Number
E-mail Address
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Name of Appointed Representative
Address
Telephone Number
E-mail Address
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Name of Appointed Representative
Address
Telephone Number
E-mail Address
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Cigarette or Other Tobacco Products
C orporate Income or Franchise
A ll Forms
All Registration Forms
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Personal Income
M otor Fuel
Sales or Use
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Only Form(s) _________________________________
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W ithholding
Other
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A ll Tax Periods
T ax Year or Period(s) Only ___________________________________________
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Range of Tax
Date of Death (if estate tax) ___ ___ / ___ ___ / ___ ___ ___ ___
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Periods or Years _________________ to _________________
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Each attorney-in-fact is authorized, subject to revocation, to receive confidential information and perform any and all acts that the taxpayer(s) can
perform with respect to the above specified tax matters, but not the power to endorse or receive checks in payment of any refunds or to represent
the taxpayer or business in any proceeding before the Administrative Hearing Commission.
Information involving the above tax matter(s) may be sent as indicated below. Failure of a representative to receive notice does not relieve the
taxpayer of responsibility to respond to notices.
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The representative first named above, or
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The following named representative(s) (no more than two): _____________________________________________________________________
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All other powers of attorney on file with the Department shall remain in effect, or
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By execution of this power of attorney, all earlier powers of attorney on file with the Department are hereby revoked, except the following: (specify
to whom the power of attorney was granted, date and address, or refer to attached copies of earlier powers of attorney and authorizations.)
Attach additional forms if needed.
Form 2827 (Revised 08-2013)
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Parent category: Financial