General Disclosure/Representation Arizona Form Authorization Form 285 • An estate Phone Numbers • A trust For information or help, call one of the numbers listed: • A governmental agency Phoenix (602) 255-3381 • Any other organization, association, or group. From area codes 520 and 928, toll-free (800) 352-4090 NOTE: A fiduciary (trustee, executor, administrator, Tax Forms, instructions, and other tax information receiver, or guardian) stands in the position of a taxpayer and If you need tax forms, instructions, and other tax information, acts as the taxpayer. A fiduciary does not act as a go to the department’s website at www.azdor.gov. representative and should not file Form 285. If a fiduciary wants to authorize an individual to represent or perform Purpose of Form certain acts on behalf of the entity, the fiduciary must file a signed power of attorney naming that person to act in the A taxpayer may use Form 285 to authorize the department to position of the taxpayer. release confidential information to the taxpayer’s Appointee. The department may have to disclose confidential information Line-by-Line Instructions to fully discuss tax issues with, or respond to tax questions by, the Appointee. A taxpayer may also use Form 285 to grant Section 1 - Taxpayer Information additional powers to the Appointee, up to and including a Enter the taxpayer’s name, current address, and daytime power of attorney. For more information or guidance for telephone number on the lines provided. If more space is completing this form, see General Tax Procedure (GTP) 15-2, needed, attach an additional page. Procedure for Submitting an Authorization for Disclosure of Foreign Address - Confidential Information and Powers of Attorney. If the taxpayer has a foreign address, enter the information in Important Tips - the following order: city, province or state, and country. • Review the instructions and GTP 15-2 before completing Follow the country’s practice for entering the postal code. Do the form. not abbreviate the country name. • Inspect the form and verify you have entered all of the For income tax purposes: required information. • Each individual signing this form must enter his or her • Retain a copy for your files. Social Security Number (SSN) or Individual Tax Identification Number (ITIN). How to File • A corporation, partnership, LLC, trust or estate must If an Arizona Department of Revenue (ADOR) employee enter its employer identification number (EIN). requests that you submit this form, please send the completed For withholding tax purposes: form directly to the address that the employee provides, with An individual, corporation, partnership, LLC, trust, or estate attention to the employee. must enter the EIN. Otherwise, ADOR offers three convenient options to submit For transaction privilege tax (TPT) purposes: your form. If the taxpayer has only one license that is covered by this 1. Email the completed form to: POA@azdor.gov. Form 285, enter that specific TPT license number. 2. Fax the completed form to: (602) 716-6008. If the taxpayer has more than one license number , include a 3. Mail the original or photocopy of the completed form to: separate sheet identifying the license number and location for Arizona Department of Revenue each license that is covered by this Form 285. ATTN: Power of Attorney NOTE: If a taxpayer wants all of its business locations PO Box 29086 covered by this Form 285, include the EIN of the business (or Phoenix, AZ 85038-9086 the SSN associated with the business if the business does not Who Can Use Form 285? have an EIN). Any of the following may file Form 285: Section 2 - Appointee Information • An individual The Appointee must be an individual. Enter the first and last • Individuals that file joint returns name and current address of the person the taxpayer is appointing to receive confidential information and/or to act on • A sole proprietorship the taxpayer’s behalf. If the Appointee has a foreign address, • A corporation enter the information in the following order: city, province or • A group of consolidated or combined corporations state, and country. Follow the country’s practice for entering • A partnership the postal code. Do not abbreviate the country name. • A limited liability company (LLC) |
Arizona Form 285 Enter the ID number of the individual (Appointee). This may • The taxpayer is a legal entity, such as a corporation, a be an SSN, ITIN, Certified Public Accountant (CPA) number, formal partnership, a limited liability company, or a State Bar number, Alternative Preparer Tax ID number or trust. other government issued ID number that is unique to the • Representation of the entity is not the Appointee’s Appointee (for example: a passport or driver’s license primary duty to the legal entity, but secondary or number). If the taxpayer wants to name more than one incidental to other duties relating to the management or Appointee, please attach an additional sheet that contains the operation of the legal entity. required information for each Appointee. • The person is not receiving separate or additional NOTE: The number used must be different for each compensation (other than reimbursement for costs) for individual Appointee designated. For identification purposes, representation. the Appointee will be required to provide that number when If either 1 or 2 do not apply, then only the following contacting the Department. individuals can represent a taxpayer when the taxpayer authorizes: Section 3 - Tax Matters 1. An active member of the State Bar of Arizona; 1. You may use this form for more than one tax type. Please 2. An Arizona Certified Public Accountant; or check the box or boxes to specify the tax type covered by 3. A “Federally Authorized Tax Practitioner” within the this authorization. meaning of Arizona Revised Statutes (A.R.S.) Check the box marked “Other” for any of the following §42-2069(D)(1). This includes: taxes and be sure to indicate the tax type in the space under • An enrolled agent authorized to practice before the IRS. the box. • An out-of-state attorney or out-of-state certified public • Tobacco tax accountant, if the person is not currently under • Liquor tax suspension or disbarment from practice before the IRS, • Bingo tax and if the person has filed with the IRS, a written 2. Specify the tax year(s) or tax period(s). declaration that he or she is currently qualified as an 3. Check the box that properly describes the form of attorney or a CPA. ownership of the Taxpayer. (See GTP 15-2 for guidance). • An individual practicing with a federally authorized tax practitioner and who is subject to the same standards of NOTE: When you sign this form, you are authorizing the practice and ethics requirements of that person. department to release confidential information to the named Section 5 - Power of Attorney Appointee. If you would like to grant additional authority to the By checking the box on line 5, the taxpayer grants the Appointee, complete Section 4 of this form. If you want to grant Appointee power of attorney. A power of attorney authorizes a power of attorney, skip Section 4 and complete Section 5. the Appointee to perform any and all acts that the taxpayer can Section 4 - Additional Authorization perform with regard to the tax matters and tax year(s) or period(s) specified. This includes, but is not limited to, the This section is only required if additional authorization is powers listed in items 4a through 4h. Any limitation to this required. power of attorney must be specified. The use of a power of Items 4a through 4h allow the Taxpayer to grant additional attorney must be in accordance with Rule 31 of the Arizona authorization to the Appointee. Please check all boxes that Rules of the Supreme Court. (See Section 4) apply. Items 4a through 4f are administrative matters with the department. Any other authorization that involves negotiating Section 6 - Revocation of Earlier Authorization(s) legal rights or responsibilities or filing documents on the By checking the box in Section 6, you are revoking all prior taxpayer’s behalf is also an administrative matter. authorizations filed with the Arizona Department of Revenue. The revocation will be effective as to all earlier authorizations In order to represent a Taxpayer in an administrative matter, and Powers of Attorney on file with the Arizona Department the Appointee must be an Arizona attorney or must meet the of Revenue except those specified on the form in Section 6. requirements of Rule 31.3(c)(5)(b) of the Arizona Rules of the Supreme Court. The following individuals are authorized If you wish to revoke only some prior authorizations and/or pursuant to Rule 31.3(c)(5)(b) to represent taxpayers in powers of attorney, please check the box in Section 6 and list, administrative matters, authorized by the taxpayer: in the space provided, those authorizations and powers of 1. Any individual, if the total amount in dispute, including attorney that you wish to remain in effect. tax, penalties, and interest, is less than $5,000.00. Section 7 - Corporations Having Controlled 2. A full-time officer, partner, member or manager of a Subsidiaries limited liability company, or employee, if all of the If you list names in this section, you must check one of the boxes following apply: to indicate if names listed are to be “included in the disclosure authorization” or “excluded in the disclosure authorization”. 2 |
Arizona Form 285 DO NOT use this section to list multiple Appointees. Instead, Limited Liability • Member in a member-managed use a separate sheet. Company (LLC) (if LLC The department may disclose confidential information relating taxation is at the entity • Manager in a manager-managed to a corporate taxpayer to a designee of the taxpayer who is level) LLC authorized in writing by the taxpayer. See Individual if LLC • Designee of member or A principal corporate officer of a parent corporation may elected to be treated as manager. execute a written authorization for a controlled subsidiary. a disregarded entity or A principal corporate officer of a parent corporation that wants where tax relates to to designate a person to receive confidential information flow through items on regarding the corporation’s controlled subsidiaries must either: individual return 1. Attach a list of each controlled subsidiary that the parent Estates • Personal representative wants to include in the disclosure authorization (federal • Any heir, next of kin, or Form 851 may be used for this purpose); or beneficiary, only if he has a 2. Complete Section 7 of Form 285. material interest that will be affected by the confidential Section 8 - Signature of or for Taxpayer information. Trusts (table continued on next column) • Any trustee Who may sign an • A beneficiary or grantor only if Taxpayer authorization the beneficiary or grantor has a Individual - Single • Individual material interest that will be affected by the confidential Individual - Joint • Both sign same document for information. the same representative. • Each signs separate document Government Entity • Head of the entity or a member for two representatives. of the governing board of the entity, or any employee of the Sole Proprietorship • The individual owner of entity who has been delegated Business (Federal Form business. the authorization in writing by 1040 Schedules C, E, F the head of the entity or the income) This includes governing board of the entity. where there is no entity or where entity is Bankruptcy • Refer to court document disregarded for income estate/receivership appointing bankruptcy trustee to tax purposes (e.g. ensure disclosure is authorized. disregarded LLC) NOTE FOR CORPORATIONS: An Officer holding a Corporations • A principal corporate officer corporate title other than one of those listed, should check the (chief executive officer, box above the signature line in Section 8 to certify that they SEE NOTE FOR president, secretary, treasurer, are a principal officer of the corporation. For example; a CORPORATIONS vice president of tax, chief Vice President of Finance or an Assistant Treasurer is not LOCATED AT THE financial officer, chief operating listed and therefore would be required to certify that the END OF THIS officer or chief tax officer or officer is a principal officer by checking the box in Section 8. TABLE any other corporate officer who has the authority to bind the For more information, see the department’s General Tax taxpayer on matters related to Procedure, GTP 15-2, Procedure for Submitting an state taxes). Authorization for Disclosure of Confidential Information and Powers of Attorney. Partnerships (general or • Any general partner of the limited partnerships) partnership; designee of general Section 9 - Declaration of Appointee partner. If the Appointee has been given authority under any of Section 4a through 4h or Section 5 or is otherwise authorized to practice law as defined in Rule 31(a) of the Arizona Rules of the Supreme Court, the Appointee must sign and date this declaration and enter a designation from 9a through 9e. The persons who are authorized to practice law before the Department of Revenue include active Arizona attorneys and those authorized under Rule 31.3(c)(5)(b) of the Arizona 3 |
Arizona Form 285 Rules of the Supreme Court. An Appointee indicating authorization under 9d who is engaged in practice with a federally authorized tax practitioner, must provide the name of the practitioner with whom he or she works and that person's CAF number in the place provided. 4 |