Form DR-835 "Power of Attorney and Declaration of Representative" - Florida

What Is Form DR-835?

This is a legal form that was released by the Florida Department of Revenue - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2011;
  • The latest edition provided by the Florida Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DR-835 by clicking the link below or browse more documents and templates provided by the Florida Department of Revenue.

ADVERTISEMENT
ADVERTISEMENT

Download Form DR-835 "Power of Attorney and Declaration of Representative" - Florida

Download PDF

Fill PDF online

Rate (4.5 / 5) 54 votes
DR-835
Florida Department of Revenue
R. 10/11
POWER OF ATTORNEY
TC
and Declaration of Representative
Rule 12-6.0015
Florida Administrative Code
Effective 01/12
See Instructions for additional information
PART I - POWER OF ATTORNEY
Taxpayer(s) must sign and date this form on Page 2, Part I, Section 8.
Section 1. Taxpayer Information.
Florida Tax Registration Number(s)
Taxpayer name(s) and address(es)
Federal ID no(s). (SSN*, FEIN, etc.)
(Business Part. No., Sales Tax No., R.T. Acct No., etc.)
(
)
Contact person
Telephone number
(
)
Fax number
The Taxpayer(s) hereby appoint(s) the following representative(s) as attorney(s)-in-fact:
Each representative must be listed individually, and must sign and date this form on Page 2, Part II.
Section 2. Representative(s).
(
)
Name and address (include name of firm if applicable)
Telephone number
(
)
Fax number
(
)
Cell phone number
E-mail address:
(
)
Name and address (include name of firm if applicable)
Telephone number
(
)
Fax number
(
)
Cell phone number
E-mail address:
(
)
Name and address (include name of firm if applicable)
Telephone number
(
)
Fax number
(
)
Cell phone number
E-mail address:
To represent the taxpayer(s) before the Florida Department of Revenue in the following tax matters:
Do not complete this section if completing Section 4.
Section 3. Tax Matters.
Type of Tax (Corporate, Sales, Reemployment, formerly Unemployment, etc.)
Year(s) / Period(s)
Tax Matter(s) (Tax Audits, Protests, Refunds, etc.)
Do not complete Sections 3 and 6 if completing Section 4.
Section 4. To Appoint a Reemployment Tax (formerly Unemployment Tax) Agent Only
.
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 confidential information with respect to mailings, filings, 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 number (required)
Agent name
Firm name
Federal I.D. No. (required)
Address (if different from above)
(
)
Telephone number
4 (Claim)
2 (Reporting)
3 (Rate)
Mail Type: See Instructions for explanations. Check one box only.
1 (Primary)
Section 5. Acts Authorized
The representative(s) are authorized to receive and inspect confidential 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 specifically includes the power to execute waivers of restrictions on assessment or collection of deficiencies
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 .......................
List any specific limitations or deletions to the acts otherwise authorized in the Power of Attorney.
DR-835
Florida Department of Revenue
R. 10/11
POWER OF ATTORNEY
TC
and Declaration of Representative
Rule 12-6.0015
Florida Administrative Code
Effective 01/12
See Instructions for additional information
PART I - POWER OF ATTORNEY
Taxpayer(s) must sign and date this form on Page 2, Part I, Section 8.
Section 1. Taxpayer Information.
Florida Tax Registration Number(s)
Taxpayer name(s) and address(es)
Federal ID no(s). (SSN*, FEIN, etc.)
(Business Part. No., Sales Tax No., R.T. Acct No., etc.)
(
)
Contact person
Telephone number
(
)
Fax number
The Taxpayer(s) hereby appoint(s) the following representative(s) as attorney(s)-in-fact:
Each representative must be listed individually, and must sign and date this form on Page 2, Part II.
Section 2. Representative(s).
(
)
Name and address (include name of firm if applicable)
Telephone number
(
)
Fax number
(
)
Cell phone number
E-mail address:
(
)
Name and address (include name of firm if applicable)
Telephone number
(
)
Fax number
(
)
Cell phone number
E-mail address:
(
)
Name and address (include name of firm if applicable)
Telephone number
(
)
Fax number
(
)
Cell phone number
E-mail address:
To represent the taxpayer(s) before the Florida Department of Revenue in the following tax matters:
Do not complete this section if completing Section 4.
Section 3. Tax Matters.
Type of Tax (Corporate, Sales, Reemployment, formerly Unemployment, etc.)
Year(s) / Period(s)
Tax Matter(s) (Tax Audits, Protests, Refunds, etc.)
Do not complete Sections 3 and 6 if completing Section 4.
Section 4. To Appoint a Reemployment Tax (formerly Unemployment Tax) Agent Only
.
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 confidential information with respect to mailings, filings, 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 number (required)
Agent name
Firm name
Federal I.D. No. (required)
Address (if different from above)
(
)
Telephone number
4 (Claim)
2 (Reporting)
3 (Rate)
Mail Type: See Instructions for explanations. Check one box only.
1 (Primary)
Section 5. Acts Authorized
The representative(s) are authorized to receive and inspect confidential 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 specifically includes the power to execute waivers of restrictions on assessment or collection of deficiencies
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 .......................
List any specific limitations or deletions to the acts otherwise authorized in the Power of Attorney.
DR-835
R. 10/11
Florida Tax Registration Number:
Page 2
Taxpayer Name(s):
Federal Identification Number:
Taxpayer(s) must complete Page 1 of this Power of Attorney or it will not be processed.
Do not complete Section 6 if completing Section 4.
Section 6. Notices and Communication.
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............................
b. If you want notices or communications sent to you and not your representative, check this box.................................
Certain computer-generated notices and other written communications cannot be issued in duplicate due to current system constraints. Therefore, we
will send these communications to only the taxpayer at his or her tax registration address.
Section 7. Retention / Nonrevocation of Prior Power(s) of Attorney.
The filing of this Power of Attorney will not revoke earlier Power(s) of Attorney on file 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......................................................................................................................................................
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 officer,
partner, member/managing member, guardian, tax matters partner/person, executor, receiver, administrator, trustee, or fiduciary 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.
Signature
Date
Title (if applicable)
Print Name
Signature
Date
Title (if applicable)
Print Name
PART II - DECLARATION OF REPRESENTATIVE
I am familiar with the mandatory standards of conduct governing representation before the Department of
Under penalties of perjury, I declare that:
Revenue, including Rules 12-6.006 and 28-106.107 of the Florida Administrative Code, as amended.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:Attorney - a member in good standing of the
bar of the highest court of the jurisdiction shown below.Certified Public Accountant - duly qualified to practice as a certified public accountant in the
jurisdiction shown below.Enrolled Agent - enrolled as an agent pursuant to the requirements of Treasury Department Circular Number 230.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.Reemployment Tax Agent authorized in Section 4 of this form.Other Qualified RepresentativeI 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
Date
Letter from Above (a-f)
Enrollment Card No. (if any)
DR-835
R. 10/11
Page 3
POWER OF ATTORNEY INSTRUCTIONS
Section 2 - Representative(s)
Purpose of this form
Enter the individual name, firm name (if applicable), address, telephone
A Power of Attorney (Form DR-835) signed by the taxpayer and the
number(s), and fax number of each individual appointed as attorney-in-
representative is required by the Florida Department of Revenue in
fact and representative. If the representatives have the same address,
order for the taxpayer's representative to perform certain acts on behalf
simply write "same" in the appropriate box. If you wish to appoint more
of the taxpayer and to receive and inspect confidential tax information.
than three representatives, you should attach a letter to Form DR-835
You and your representative must complete, sign, and return Form
listing those additional individuals.
DR-835 if you want to grant Power of Attorney to an attorney, certified
public accountant, enrolled agent, former Department employee,
Section 3 - Tax Matters
reemployment tax agent, or any other qualified individual. A Power of
Enter the type(s) of tax this Power of Attorney authorization applies to
Attorney is a legal document authorizing someone other than yourself
and the years or periods for which the Power of Attorney is granted.
to act as your representative.
The word "All" is not specific enough. If your tax situation does not fit
You may use this form for any matters affecting any tax administered
into a tax type or period (for example, a specific administrative appeal,
by the Department of Revenue. This includes both the audit and
audit, or collection matter), describe it in the blank space provided for
collection processes. A Power of Attorney will remain in effect until you
"Tax Matters." The Power of Attorney can be limited to specific
revoke it. If you provide more than one Power of Attorney with respect
reporting period(s) that can be stated in year(s), quarter(s), month(s),
to a tax and tax period, the Department employee handling your case
etc., or can be granted for an indefinite period. You must indicate the
will address notices and correspondence relative to that issue to the
tax types, periods, and/or matters for which you are authorizing
first person listed on the latest Power of Attorney.
representation by your attorney-in-fact.
A Power of Attorney Form is generally not required, if the representative
Examples:
is, or is accompanied by: a trustee, a receiver, an administrator, an
Sales and Use Tax
First and second quarter 2008
executor of an estate, a corporate officer, or an authorized employee of
Corporate Income Tax
7/1/07 - 6/30/08
the taxpayer.
Communications Services Tax
2006 thru 2008
Photocopies and fax copies of Form DR-835 are usually acceptable.
Insurance Premium Tax
1/1/06 - 12/31/08
E-mail transmissions or other types of Powers of Attorney are not
Technical Assistance Advisement Request
dated 8/6/08
acceptable. Copies of Form DR-835 are readily available by visiting our
Claim for Refund
3/7/07
Internet site
(www.floridarevenue.com/forms).
How to Complete Form DR-835, Power of Attorney
Section 4 - To Appoint a Reemployment Tax Agent
Complete this section only if you wish to appoint an agent for
PART I POWER OF ATTORNEY
reemployment taxes on a continuing basis. You should not complete
Section 1 - Taxpayer Information
Section 3 or Section 6, but you must complete the remaining sections
Enter your name,
:
• For individuals and sole proprietorships
of Form DR-835.
address, social security number, and telephone number(s) in the
spaces provided. Enter your federal employer identification number
Enter the agent's name. It must be the same name as found in Section
(FEIN), if you have one. If a joint return is involved, and you and your
2. Enter the firm name and address. You do not need to complete the
spouse are designating the same attorney(s)-in-fact, also enter your
address line if you reported that information in Section 2.
spouse's name and social security number, and your spouse's
1.
Enter the agent number. The agent number is a seven-digit
address if different from yours.
number assigned by the Department of Revenue.
Enter
For a corporation, limited liability company, or partnership:
2.
Enter the federal employer identification number. The FEIN is a
the name, business address, FEIN, a contact person familiar with
nine-digit number assigned to the agent by the Internal Revenue
this matter, and telephone number(s).
Service.
Enter the name, title, address, and telephone number(s)
For a trust:
3.
Select the mail type.
of the fiduciary, and name and FEIN of the trust.
If you select primary mail, the agent will receive all
Enter the name, title, address, and telephone
Primary Mail.
For an estate:
documents from the Department of Revenue related to this
number(s) of the decedent's personal representative, and the name
reemployment tax account, and will be authorized to receive
and identification number of the estate. The identification number
confidential information and discuss matters related to the tax and
for an estate includes both the FEIN if the estate has one and the
wage report, benefit information, claims, and the employer's rate.
decedent's social security number.
If you select reporting mail, the agent will receive the
Enter the name, business address, FEIN, and
Reporting Mail.
For any other entity:
Employer's Quarterly Report (Form RT-6), certification, and
telephone number(s), as well as the name of a contact person
correspondence related to reporting. The agent will be authorized to
familiar with this matter.
receive confidential information and discuss the tax and wage report,
The Department may have assigned you a
certification, and correspondence with the Department.
Identification Number:
Florida tax registration number such as a sales tax number, a
If you select rate mail, the agent will receive tax rate notices
reemployment tax account number, or a business partner number.
Rate Mail.
and correspondence related to the rate and will be authorized to
These numbers further assist the Department in identifying your
receive confidential information and discuss the employer's rate notices
particular tax matter, and you should enter them in the appropriate
and rate with the Department.
box. If you do not provide this information, the Department may not
be able to process the Power of Attorney.
If you select claims mail, the agent will receive the notice
Claims Mail.
of benefits paid, and will be authorized to receive confidential
information and discuss matters related to benefits.
Duplicate copies of certain computer-generated notices and
Note:
other written communications cannot be issued due to current system
constraints and therefore, these communications will be sent only to
the representative.
DR-835
R. 10/11
Page 4
in this matter and will comply with the mandatory standards of conduct
If you wish to appoint a representative to act on your behalf in a
Note:
specific and non-continuing reemployment tax matter, you should
governing representation before the Department of Revenue. The
complete Section 3 and Section 6 and not Section 4. For example, if
representative(s) must also declare, under penalties of perjury, that he
you hire a representative to assist you with a single matter, such as a
or she has been authorized to represent the taxpayer(s) in this matter
reemployment tax audit or contesting the payment of a claim, and wish
and authorized by the taxpayer(s) to receive confidential taxpayer
that representative to handle just that one matter, you should not
information.
complete Section 4 to authorize that representation. Instead, you
The representative(s) you name must sign and date this declaration and
should fill out Section 3 and specify the exact matter the representative
enter the designation (i.e., items a-f) under which he or she is
is handling.
authorized to represent you before the Department of Revenue.
Section 5 - Acts Authorized
a.
Attorney - Enter the two-letter abbreviation for the state (for
Your signature on the back of the Power of Attorney authorizes the
example "FL" for Florida) in which admitted to practice, along
individual(s) you designate (your representative or "attorney-in-fact") to
with your bar number.
perform any act you can perform with respect to your tax matters,
except that your representative may not sign certain returns for you nor
b.
Certified Public Accountant - Enter the two-letter abbreviation
may your representative negotiate or cash your refund warrant. This
for the state (for example "FL" for Florida) in which licensed to
authority includes signing consents to a change in tax liability, consents
practice.
to extend the time for assessing or collecting tax, closing agreements,
c.
Enrolled Agent - Enter the enrollment card number issued by the
and compromises. You may authorize your representative to receive,
Internal Revenue Service.
but not negotiate or cash, your refund warrant by checking the box in
Section 5 and writing the name of the representative on the line below.
d.
Former Department of Revenue Employee - Former employees
If you wish to limit the authority of your representative other than in the
may not accept representation in matters in which they were
manner previously described, you must describe those limits on the
directly involved, and in certain cases, on any matter for a period
lines provided in Section 5.
of two years following termination of employment. If a former
Department of Revenue employee is also an attorney or CPA,
Section 6 - Mailing of Notices and Communications
then the additional designation, jurisdiction, and enrollment card
If you do not check a box, the Department will send notices and other
should also be entered.
written communications to the first representative listed in Section 2,
unless you select another option. If you wish to have no documents
e.
Reemployment Tax Agent - A person(s) appointed under Section
sent to your representative, or documents sent to both you and your
4 of the Power of Attorney to handle reemployment tax matters
representative, you should check the appropriate box in Section 6.
on a continuing basis. A separate Power of Attorney form must
Check the second box if you wish to have notices and other written
be completed in order for a reemployment tax agent to handle a
communications sent to you and not to your representative. In certain
specific and non-continuing matter such as a protest of a
instances, the Department can only send documents to the taxpayer.
reemployment tax rate.
Therefore, the taxpayer has the responsibility of keeping the
f.
Other Qualified Representative - An individual may represent a
representative informed of tax matters.
taxpayer before the Department of Revenue if training and
Taxpayers completing Section 4 (To Appoint a Reemployment
experience qualifies that person to handle a specific matter.
Note:
Tax Agent Only) should not complete Section 6. See Section 4 of these
Rule 28-106.107, Florida Administrative Code, sets out mandatory
instructions for information regarding notices and communications sent
standards of conduct for all qualified representatives. A representative
to a reemployment tax agent.
shall not:
Section 7 - Retention/Nonrevocation of Prior Power(s) of Attorney
(a)
Engage in conduct involving dishonesty, fraud, deceit, or
The most recent Power of Attorney will take precedence over, but will
misrepresentation.
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
(b)
Engage in conduct that is prejudicial to the administration of
copy of the old Power of Attorney.
justice.
Section 8 - Signature of Taxpayer(s)
(c)
Handle a matter that the representative knows or should know
The Power of Attorney is not valid until signed and dated by the
that he or she is not competent to handle.
taxpayer. The individual signing the Power of Attorney is representing,
under penalties of perjury, that he or she is the taxpayer or authorized
(d)
Handle a legal or factual matter without adequate preparation.
to execute the Power of Attorney on behalf of the taxpayer.
are used by the Florida Department
*Social security numbers (SSNs)
For a corporation, trust, estate, or any other entity: A corporate
of Revenue as unique identifiers for the administration of Florida's
officer or person having authority to bind the entity must sign.
taxes. SSNs obtained for tax administration purposes are confidential
under sections 213.053 and 119.071, Florida Statutes, and not
For partnerships: All partners must sign unless one partner is
subject to disclosure as public records. Collection of your SSN is
authorized to act in the name of the partnership.
authorized under state and federal law. Visit our Internet site at
and select "Privacy Notice" for more
For a sole proprietorship: The owner of the sole proprietorship
www.floridarevenue.com
information regarding the state and federal law governing the
must sign.
collection, use, or release of SSNs, including authorized exceptions.
For a joint return: Both husband and wife must sign if the
representative represents both. If the representative only
Where to Mail Form DR-835
If Form DR-835 is for a specific matter, mail or fax it to the office or
represents one spouse, then only that spouse should sign.
employee handling the specific matter. You may send it with the
document to which it relates.
PART II - DECLARATION OF REPRESENTATIVE
Any party who appears before the Department of Revenue has the
If Form DR-835 is for a reemployment tax matter and the taxpayer has
right, at his or her own expense, to be represented by counsel or by a
completed Section 4, mail it to the Florida Department of Revenue,
qualified representative. The representative(s) you name must declare,
P.O. Box 6510, Tallahassee FL 32314-6510, or fax it to 850-488-5997.
under penalties of perjury, that he or she is qualified to represent you
Page of 4