Free Tax POA dr 835 Form
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Florida Department of Revenue |
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Florida |
R. 10/11 |
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Effective 01/12 |
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POWER OF ATTORNEY |
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and Declaration of Representative |
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Administrative Code |
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Rule |
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See Instructions for additional information |
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PART I - POWER OF ATTORNEY
Section 1. Taxpayer Information. Taxpayer(s) must sign and date this form on Page 2, Part I, Section 8.
Taxpayer name(s) and address(es) |
Federal ID no(s). (SSN*, FEIN, etc.) |
Florida Tax Registration Number(s) |
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(Business Part. No., Sales Tax No., R.T. Acct No., etc.) |
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Contact person |
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The Taxpayer(s) hereby appoint(s) the following representative(s) as
Section 2. Representative(s). Each representative must be listed individually, and must sign and date this form on Page 2, Part II.
Name and address (include name of frm if applicable) |
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Telephone number |
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Cell phone number |
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Name and address (include name of frm if applicable) |
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Name and address (include name of frm if applicable) |
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Telephone number |
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To represent the taxpayer(s) before the Florida Department of Revenue in the following tax matters:
Section 3. Tax Matters. Do not complete this section if completing Section 4.
Type of Tax (Corporate, Sales, Reemployment, formerly Unemployment, etc.)
Year(s) / Period(s)
Tax Matter(s) (Tax Audits, Protests, Refunds, etc.)
Section 4. To Appoint a Reemployment Tax (formerly Unemployment Tax) Agent Only. Do not complete Sections 3 and 6 if completing Section 4.
By completing this section, an employer (taxpayer) appoints a representative to act as its Florida reemployment tax agent before the Florida Department of Revenue on a continuing basis and to receive confdential information with respect to mailings, flings, and other tax matters related to the Florida reemployment assistance program law. All other sections of this form (except Sections 3 and 6) must also be completed.
Do not complete Section 4 unless you wish to appoint a reemployment tax agent on a continuing basis.
Agent name |
Agent number (required) |
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Firm name |
Federal I.D. No. (required) |
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Address (if different from above) |
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Mail Type: See Instructions for explanations. Check one box only. ❑ 1 (Primary) ❑ 2 (Reporting) ❑ 3 (Rate) ❑ 4 (Claim)
Section 5. Acts Authorized.
The representative(s) are authorized to receive and inspect confdential tax information and to perform any and all acts that I (we) can perform with respect to the tax matters described in Section 3 and Section 4 (for example, the authority to sign any agreements, consents, or other documents). Except as otherwise provided, the authority specifcally includes the power to execute waivers of restrictions on assessment or collection of defciencies in tax, to execute consents extending the statutory period for assessment or claims for refund of taxes, and to execute closing agreements under section 213.21, Florida Statutes. This authority does not include the power to endorse or cash warrants, or the power to sign certain returns.
If you want to authorize a representative named in Section 2 to receive (but not to endorse or cash) refund warrants, write the name of the
representative on this line and check the box |
u___________________________________________________________________________ ❑ |
List any specifc limitations or deletions to the acts otherwise authorized in this Power of Attorney.
______________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________
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111111111111111111111111111111111111111 |
R. 10/11 |
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Page 2 |
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Florida Tax Registration Number: |
Taxpayer Name(s): |
Federal Identifcation Number: |
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•Taxpayer(s) must complete Page 1 of this Power of Attorney or it will not be processed.
Section 6. Notices and Communication. Do not complete Section 6 if completing Section 4.
•Notices and other written communications will be sent to the first representative listed in Part I, Section 2, unless the taxpayer selects one of the options below. Receipt by either the representative or the taxpayer will be considered receipt by both.
a. |
If you want notices and communications sent to both you and your representative, check this box |
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❑ |
b. |
If you want notices or communications sent to you and not your representative, check this box |
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❑ |
Certain
Section 7. Retention / Nonrevocation of Prior Power(s) of Attorney.
The fling of this Power of Attorney will not revoke earlier Power(s) of Attorney on fle with the Florida Department of Revenue, even for the same tax matters and years or periods covered by this document. If you want to revoke a prior Power of
Attorney, check this box |
u ❑ |
You must attach a copy of any Power of Attorney you wish to revoke.
Section 8. Signature of Taxpayer(s).
If a tax matter concerns a joint return, both husband and wife must sign if joint representation is requested. If signed by a corporate offcer, partner, member/managing member, guardian, tax matters partner/person, executor, receiver, administrator, trustee, or fduciary on behalf of the taxpayer, I declare under penalties of perjury that I have the authority to execute this form on behalf of the taxpayer.
Under penalties of perjury, I (we) declare that I (we) have read the foregoing document, and the facts stated in it are true.
If this Power of Attorney is not signed and dated, it will be returned.
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Signature |
Date |
Title (if applicable) |
_______________________________________________________________________________________ |
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Print name |
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_______________________________________________________________________________________ |
________________________________________ |
_________________________________________ |
Signature |
Date |
Title (if applicable) |
_______________________________________________________________________________________ |
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Print name |
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PART II - DECLARATION OF REPRESENTATIVE
Under penalties of perjury, I declare that:
•I am familiar with the mandatory standards of conduct governing representation before the Department of Revenue, including Rules
•I am familiar with the law and facts related to this matter and am qualified to represent the taxpayer(s) in this matter.
•I am authorized to represent the taxpayer(s) identified in Part I for the tax matter(s) specified therein, and to receive and inspect confidential taxpayer information.
•I am one of the following:
a.Attorney - a member in good standing of the bar of the highest court of the jurisdiction shown below.
b.Certifed Public Accountant - duly qualifed to practice as a certifed public accountant in the jurisdiction shown below.
c.Enrolled Agent – enrolled as an agent pursuant to the requirements of Treasury Department Circular Number 230.
d.Former Department of Revenue Employee. As a representative, I cannot accept representation in a matter upon which I had direct involvement while I was a public employee.
e.Reemployment Tax Agent authorized in Section 4 of this form.
f.Other Qualifed Representative
•I have read the foregoing Declaration of Representative and the facts stated in it are true.
If this Declaration of Representative is not signed and dated, it will not be processed.
Designation – Insert |
Jurisdiction (State) and |
Signature |
Letter from Above (a |
Enrollment Card No. (if any) |
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Date
Made fillable by FormsPal.
POWER OF ATTORNEY INSTRUCTIONS
R.10/11 Page 3
Purpose of this form
A Power of Attorney (Form
to an attorney, certifed public accountant, enrolled agent, former Department employee, reemployment tax agent, or any other qualifed individual. A Power of Attorney is a legal document authorizing someone other than yourself to act as your representative.
You may use this form for any matters affecting any tax administered by the Department of Revenue. This includes both the audit and collection processes. A Power of Attorney will remain in effect until you revoke it. If you provide more than one Power of Attorney with respect to a tax and tax period, the Department employee handling your case will address notices and correspondence relative to that issue to the frst person listed on the latest Power of Attorney.
A Power of Attorney Form is generally not required, if the representative is, or is accompanied by: a trustee, a receiver, an administrator, an executor of an estate, a corporate offcer, or an authorized employee of the taxpayer.
Photocopies and fax copies of Form
How to Complete Form
PART I POWER OF ATTORNEY
Section 1 – Taxpayer Information
•For individuals and sole proprietorships: Enter your name, address, social security number, and telephone number(s) in the spaces provided. Enter your federal employer identifcation number (FEIN), if you have one. If a joint return is involved, and you and your spouse are designating the same
•For a corporation, limited liability company, or partnership: Enter the name, business address, FEIN, a contact person familiar with this matter, and telephone number(s).
•For a trust: Enter the name, title, address, and telephone number(s) of the fduciary, and name and FEIN of the trust.
•For an estate: Enter the name, title, address, and telephone number(s) of the decedent’s personal representative, and the name and identifcation number of the estate. The identifcation number for an estate includes both the FEIN if the estate has one and the decedent’s social security number.
•For any other entity: Enter the name, business address, FEIN, and telephone number(s), as well as the name of a contact person familiar with this matter.
•Identifcation Number: The Department may have assigned you a Florida tax registration number such as a sales tax number, a reemployment tax account number, or a business partner number. These numbers further assist the Department in identifying your particular tax matter, and you should enter them in the appropriate box. If you do not provide this information, the Department may not be able to process the Power of Attorney.
Section 2 – Representative(s)
Enter the individual name, frm name (if applicable), address, telephone number(s), and fax number of each individual appointed as
Section 3 – Tax Matters
Enter the type(s) of tax this Power of Attorney authorization applies to and the years or periods for which the Power of Attorney is granted. The word “All” is not specifc enough. If your tax situation does not ft into a tax type or period (for example, a specifc administrative appeal, audit, or collection matter), describe it in the blank space provided for “Tax Matters.” The Power of Attorney can be limited to specifc reporting period(s) that can be stated in year(s), quarter(s), month(s), etc., or can be granted for an indefnite period. You must indicate the tax types, periods, and/or matters for which you are authorizing representation by your
Examples: |
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Sales and Use Tax |
First and second quarter 2008 |
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Corporate Income Tax |
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7/1/07 – 6/30/08 |
Communications Services Tax |
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2006 thru 2008 |
Insurance Premium Tax |
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1/1/06 – 12/31/08 |
Technical Assistance Advisement Request |
dated 8/6/08 |
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Claim for Refund |
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3/7/07 |
Section 4 – To Appoint a Reemployment Tax Agent Complete this section only if you wish to appoint an agent for reemployment taxes on a continuing basis. You should not complete Section 3 or Section 6, but you must complete the remaining sections of Form
Enter the agent’s name. It must be the same name as found in Section 2. Enter the frm name and address. You do not need to complete the address line if you reported that information in Section 2.
1.Enter the agent number. The agent number is a
2.Enter the federal employer identifcation number. The FEIN is a
3.Select the mail type.
Primary Mail. If you select primary mail, the agent will receive all documents from the Department of Revenue related to this reemployment tax account, and will be authorized to receive confdential information and discuss matters related to the tax and wage report, beneft information, claims, and the employer’s rate.
Reporting Mail. If you select reporting mail, the agent will receive the Employer’s Quarterly Report (Form
Rate Mail. If you select rate mail, the agent will receive tax rate notices and correspondence related to the rate and will be authorized to receive confdential information and discuss the employer’s rate notices and rate with the Department.
Claims Mail. If you select claims mail, the agent will receive the notice of benefts paid, and will be authorized to receive confdential information and discuss matters related to benefts.
Note: Duplicate copies of certain
Note: If you wish to appoint a representative to act on your behalf in a specifc and
Section 5 – Acts Authorized
Your signature on the back of the Power of Attorney authorizes the individual(s) you designate (your representative or
Section 6 – Mailing of Notices and Communications
If you do not check a box, the Department will send notices and other written communications to the frst representative listed in Section 2, unless you select another option. If you wish to have no documents sent to your representative, or documents sent to both you and your representative, you should check the appropriate box in Section 6. Check the second box if you wish to have notices and other written communications sent to you and not to your representative. In certain instances, the Department can only send documents to the taxpayer. Therefore, the taxpayer has the responsibility of keeping the representative informed of tax matters.
Note: Taxpayers completing Section 4 (To Appoint a Reemployment Tax Agent Only) should not complete Section 6. See Section 4 of these instructions for information regarding notices and communications sent to a reemployment tax agent.
Section 7 – Retention/Nonrevocation of Prior Power(s) of Attorney The most recent Power of Attorney will take precedence over, but will not revoke, prior Powers of Attorney. If you wish to revoke a prior Power of Attorney, you must check the box on the form and attach a copy of the old Power of Attorney.
Section 8 – Signature of Taxpayer(s)
The Power of Attorney is not valid until signed and dated by the taxpayer. The individual signing the Power of Attorney is representing, under penalties of perjury, that he or she is the taxpayer or authorized to execute the Power of Attorney on behalf of the taxpayer.
•For a corporation, trust, estate, or any other entity: A corporate offcer or person having authority to bind the entity must sign.
•For partnerships: All partners must sign unless one partner is authorized to act in the name of the partnership.
•For a sole proprietorship: The owner of the sole proprietorship must sign.
•For a joint return: Both husband and wife must sign if the representative represents both. If the representative only represents one spouse, then only that spouse should sign.
PART II – DECLARATION OF REPRESENTATIVE
Any party who appears before the Department of Revenue has the right, at his or her own expense, to be represented by counsel or by a qualifed representative. The representative(s) you name must declare, under penalties of perjury, that he or she is qualifed to represent you in this matter and will comply with the mandatory standards of conduct
R. 10/11
Page 4
governing representation before the Department of Revenue. The representative(s) must also declare, under penalties of perjury, that he or she has been authorized to represent the taxpayer(s) in this matter and authorized by the taxpayer(s) to receive confdential taxpayer information.
The representative(s) you name must sign and date this declaration and enter the designation (i.e., items
a.Attorney – Enter the
b.Certifed Public Accountant – Enter the
c.Enrolled Agent – Enter the enrollment card number issued by the Internal Revenue Service.
d.Former Department of Revenue Employee – Former employees may not accept representation in matters in which they were directly involved, and in certain cases, on any matter for a period of two years following termination of employment. If a former Department of Revenue employee is also an attorney or CPA, then the additional designation, jurisdiction, and enrollment card should also be entered.
e.Reemployment Tax Agent – A person(s) appointed under Section 4 of the Power of Attorney to handle reemployment tax matters on a continuing basis. A separate Power of Attorney form must be completed in order for a reemployment tax agent to handle a specifc and
f.Other Qualifed Representative – An individual may represent a taxpayer before the Department of Revenue if training and experience qualifes that person to handle a specifc matter.
Rule
(a)Engage in conduct involving dishonesty, fraud, deceit, or misrepresentation.
(b)Engage in conduct that is prejudicial to the administration of justice.
(c)Handle a matter that the representative knows or should know that he or she is not competent to handle.
(d)Handle a legal or factual matter without adequate preparation.
*Social security numbers (SSNs) are used by the Florida Department of Revenue as unique identifers for the administration of Florida’s taxes. SSNs obtained for tax administration purposes are confidential under sections 213.053 and 119.071, Florida Statutes, and not subject to disclosure as public records. Collection of your SSN is authorized under state and federal law. Visit our Internet site at www.foridarevenue.com and select “Privacy Notice” for more information regarding the state and federal law governing the collection, use, or release of SSNs, including authorized exceptions.
Where to Mail Form
If Form
If Form
Common mistakes
Filling out the Tax Power of Attorney (POA) Form DR 835 can be a straightforward process, but many individuals make mistakes that can lead to delays or complications. One common error is failing to provide accurate personal information. When entering your name, address, and taxpayer identification number, it is crucial to double-check for any typos or inaccuracies. Even a small mistake can result in the form being rejected or processed incorrectly.
Another frequent mistake involves not signing the form. It may seem obvious, but many people forget to provide their signature or the signature of the designated representative. Without a signature, the IRS will not recognize the authorization, leaving your tax matters unresolved. Always ensure that the form is signed in the appropriate sections before submission.
Some individuals neglect to specify the exact powers they wish to grant to their representative. The Tax POA DR 835 allows you to choose the extent of authority you wish to delegate. Failing to clearly indicate these powers can lead to confusion or limit the representative's ability to act on your behalf effectively. Take the time to review this section carefully.
Additionally, people often overlook the importance of including the correct date. The form should reflect the date it is being signed. This detail is essential for establishing the timeline of the authorization. If the date is missing or incorrect, it may create complications in the processing of your request.
Another mistake that can occur is not providing a valid phone number for the representative. This contact information is vital for the IRS to reach your representative if they need clarification or additional information. Without a valid phone number, communication may be hindered, leading to unnecessary delays.
Finally, many individuals fail to keep a copy of the completed form for their records. Retaining a copy is essential for your own reference and to track the authorization status. If any issues arise, having a copy can help clarify the situation and provide proof of the authorization granted. Always make sure to keep a record of any important documents you submit.
Dos and Don'ts
When filling out the Tax POA DR 835 form, it's important to be careful and thorough. Here’s a list of things you should and shouldn't do:
- Do: Read the instructions carefully before starting.
- Do: Provide accurate personal information, including your name and Social Security number.
- Do: Clearly state the type of tax matters you are authorizing.
- Do: Sign and date the form to validate it.
- Do: Keep a copy of the completed form for your records.
- Don't: Leave any required fields blank.
- Don't: Use incorrect or outdated forms.
- Don't: Forget to check for any additional state requirements.
- Don't: Submit the form without reviewing it for errors.
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Similar forms
The Tax POA DR 835 form serves a specific purpose in granting power of attorney for tax matters. Several other documents share similarities in function or intent. Below is a list of these documents and how they relate to the Tax POA DR 835 form.
- IRS Form 2848: This form allows taxpayers to appoint an individual to represent them before the IRS. Like the Tax POA DR 835, it grants authority to act on behalf of the taxpayer in tax matters.
- State Power of Attorney Forms: Each state has its own version of a power of attorney form. These documents enable individuals to designate someone to manage their affairs, similar to the Tax POA DR 835's focus on tax issues.
- IRS Form 8821: This form authorizes an individual to receive confidential tax information from the IRS. While it does not grant the same level of authority as the Tax POA DR 835, it serves a related purpose of information access.
- Durable Power of Attorney: This document remains effective even if the principal becomes incapacitated. It can cover various areas, including tax matters, similar to how the Tax POA DR 835 focuses on tax representation.
- Limited Power of Attorney: This type of power of attorney restricts the authority granted to specific tasks or time periods. It parallels the Tax POA DR 835 in that both documents can limit the scope of authority to tax-related matters.
- Health Care Power of Attorney: While primarily focused on medical decisions, this document allows someone to make health care choices on behalf of another. It shares the concept of delegation of authority found in the Tax POA DR 835.
- Employment Verification Form: This essential document is used by employers to confirm an individual's employment history, including job title and duration, making it vital in the hiring process. For detailed guidance, refer to the documentonline.org/blank-employment-verification-form.
- Financial Power of Attorney: This document allows an individual to manage another person's financial affairs. Like the Tax POA DR 835, it enables someone to act on behalf of another, although the focus is broader than just tax issues.