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Missouri Tax Power of Attorney Form

The Missouri tax power of attorney is a legal document used by the grantor to authorize the attorney-in-fact to act on his/her behalf in his/her tax related matters.

Missouri Tax Power of Attorney Form
Missouri Tax Power of Attorney Form
All Forms 
All Registration Forms
Form (s) _______________ Only
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/business in any proceeding before the Administrative Hearing Commission.  
Information involving the above tax matter(s) may be sent as indicated below: Failure of representative to receive notice does not relieve the 
taxpayer of responsibility to respond to notices.
1.  The representative first named above; or
2.  The following named representative(s) (no more than two):
Revocation of prior Powers of Attorney (Must check one of the boxes below)
All other powers of attorney on file with the Department shall remain in effect; or
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  authori- 
zations.)  Attach additional forms if needed.
DOR-2827 (07-2012)
MISSOURI DEPARTMENT OF REVENUE
POWER OF ATTORNEY
TAXPAYER’S NAME OR BUSINESS NAME  SOCIAL SECURITY NUMBER/FEDERAL I.D. NUMBER
SPOUSE’S NAME OR IF A D/B/A, STATE THE BUSINESS NAME   SPOUSE’S SSN/FEDERAL I.D. NUMBER
STREET ADDRESS  MISSOURI TAX I.D. NUMBER
CITY OR TOWN, STATE, ZIP CODE  TELEPHONE NUMBER  MISSOURI CHARTER NUMBER
E-MAIL ADDRESS
TAXPAYER(S) HEREBY APPOINTS (Please print or type - attach additional forms if needed)
PLEASE TYPE OR PRINT
(Submission of a DOR-2827, Power of Attorney, by a taxpayer is not in itself sufficient as official notice to the
Department of Revenue of an address change.)
NAME OF APPOINTED REPRESENTATIVE  ADDRESS 
TELEPHONE NUMBER  E-MAIL 
NAME OF APPOINTED REPRESENTATIVE  ADDRESS 
TELEPHONE NUMBER  E-MAIL 
NAME OF APPOINTED REPRESENTATIVE  ADDRESS 
TELEPHONE NUMBER  E-MAIL 
NAME OF APPOINTED REPRESENTATIVE  ADDRESS 
TELEPHONE NUMBER  E-MAIL 
as attorney(s)-in-fact to represent taxpayer(s) before the Missouri Department of Revenue, with respect to the following tax matter(s) (the tax 
type and year(s) to which this form applies must be listed below):
TYPE OF TAX
YEAR(S) OR PERIOD(S)
(DATE OF DEATH IF ESTATE TAX)
Note: All appointed representatives must sign on reverse side of this form.
__ __ __ __ __ __ __ __ __
__ __ __ __ __ __ __ __ __
__ __ __ __ __ __ __ __
__ __ __ __ __ __ __ __ __ __
(__ __ __) __ __ __ - __ __ __ __
(__ __ __) __ __ __ - __ __ __ __
Withholding  Individual
Sales/Use  Motor Fuel
Corporate Income/Franchise  Other ________________
Cigarette/Other Tobacco Products
MISSOURI TAX FORMS
(__ __ __) __ __ __ - __ __ __ __
(__ __ __) __ __ __ - __ __ __ __
(__ __ __) __ __ __ - __ __ __ __
All Periods
Tax Year/Period(s) Only _____________
______________  to  _______________
Date of death  _____________________
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Missouri Tax Power of Attorney Form
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