Form Dr 0145 - Colorado Power Of Attorney For Department-Administered Tax Matters
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2DR 0145 (03/17/11)
COLORADO DEPARTMENT OF REVENUE
TAXPAYER SERVICE DIVISION
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)
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:
Period From ___________ To ___________
State Sales Tax
All Department Administered Sales Taxes
Period From ___________ To ___________
State Consumers Use Tax
All Dept. Administered Consumers Use Taxes
Period From ___________ To ___________
Individual Income Tax
Corporate Income Tax
Other (specify)
Period From ___________ To ___________
Wage Withholding
Period From ___________ To ___________
Other Tax (specify)
Period From ___________ To ___________
All Taxes within the scope of §39-21-102, 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 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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