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Colorado Tax Matters Power of Attorney Form


Colorado Tax Matters Power of Attorney Form
Colorado Tax Matters Power of Attorney Form
DR 0145 (03/17/11)
COLORADO DEPARTMENT OF REVENUE
TAXPAYER SERVICE DIVISION
1375 SHERMAN ST DENVER, CO 80261
www.TaxColorado.com
POWER OF ATTORNEY
For Department-Administered Tax Matters
1. Taxpayer Information and Identication. 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:
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.
Period From ___________ To ___________
4. Acts Authorized — The representatives are authorized to receive and inspect condential 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 specically addressed below.
5. Added or Deleted Acts— List any specic additions or deletions to the acts otherwise authorized in this power of attorney: _____________________
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Colorado Tax Matters Power of Attorney Form
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