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                                                                                                                                                   DR-835
                                                     Florida Department of Revenue                                                                 R. 10/11
                                                     POWER OF ATTORNEY                                                                                            TC
                                                                                                                                                   Rule 12-6.0015
                                                     and Declaration of Representative                                                      Florida Administrative Code
                                                                                                                                                   Effective 01/12
                                                     See Instructions for additional information
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)
                                                                                                               (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:
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 firm if applicable)
                                                                                                               Telephone number  (               )

                                                                                                               Fax number  (               )

E-mail address:                                                                                                Cell phone number  (               )
Name and address (include name of firm if applicable)
                                                                                                               Telephone number  (               )
                                                                                                               Fax number  (               )

E-mail address:                                                                                                Cell phone number  (               )
Name and address (include name of firm if applicable)
                                                                                                               Telephone number  (               )

                                                                                                               Fax number  (               )

E-mail address:                                                                                                Cell phone number  (               )
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 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 name                                                                                                     Agent number (required)
Firm name                                                                                                      Federal I.D. No.  (required)
Address (if different from above)                                                                              Telephone number  (               )

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 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  ........................u ___________________________________________________________________________ ❑
List any specific limitations or deletions to the acts otherwise authorized in this Power of Attorney.
______________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________

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DR-835
R. 10/11
Page 2
Florida Tax Registration Number:
Taxpayer Name(s): Federal Identification Number:
• 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 ............................... u ❑
b. If you want notices or communications sent to you and not your representative, check this box .................................... u ❑
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 ............................................................................................................................................. 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 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
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 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:
a. Attorney - a member in good standing of the bar of the highest court of the jurisdiction shown below.
b. Certified Public Accountant - duly qualified to practice as a certified 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 Qualified 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 Date
Letter from Above (a -f) Enrollment Card No. (if any)

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DR-835
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POWER OF ATTORNEY INSTRUCTIONS
Purpose of this form Section 2 – Representative(s)
A Power of Attorney (Form DR-835) signed by the taxpayer and the Enter the individual name, firm name (if applicable), address,
representative is required by the Florida Department of Revenue telephone number(s), and fax number of each individual appointed as
in order for the taxpayer’s representative to perform certain acts attorney-in-fact and representative. If the representatives have the
on behalf of the taxpayer and to receive and inspect confidential same address, simply write “same” in the appropriate box. If you wish
tax information. You and your representative must complete, sign, to appoint more than three representatives, you should attach a letter
and return Form DR-835 if you want to grant Power of Attorney to Form DR-835 listing those additional individuals.
to an attorney, certified public accountant, enrolled agent, former Section 3 – Tax Matters
Department employee, reemployment tax agent, or any other qualified Enter the type(s) of tax this Power of Attorney authorization applies to
individual. A Power of Attorney is a legal document authorizing and the years or periods for which the Power of Attorney is granted.
someone other than yourself 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
collection processes. A Power of Attorney will remain in effect until for “Tax Matters.” The Power of Attorney can be limited to specific
you revoke it. If you provide more than one Power of Attorney with reporting period(s) that can be stated in year(s), quarter(s), month(s),
respect to a tax and tax period, the Department employee handling etc., or can be granted for an indefinite period. You must indicate
your case will address notices and correspondence relative to that the tax types, periods, and/or matters for which you are authorizing
issue to the 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 Examples:
representative is, or is accompanied by: a trustee, a receiver, an Sales and Use Tax First and second quarter 2008
administrator, an executor of an estate, a corporate officer, or an Corporate Income Tax 7/1/07 – 6/30/08
authorized employee of 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 Claim for Refund 3/7/07
our Internet site (www.floridarevenue.com/forms). Section 4 – To Appoint a Reemployment Tax Agent
How to Complete Form DR-835, Power of Attorney 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
• For individuals and sole proprietorships: Enter your name, of Form DR-835.
address, social security number, and telephone number(s) in the Enter the agent’s name. It must be the same name as found in
spaces provided. Enter your federal employer identification number Section 2. Enter the firm name and address. You do not need to
(FEIN), if you have one. If a joint return is involved, and you and complete the address line if you reported that information in Section 2.
your spouse are designating the same attorney(s)-in-fact, also enter 1. Enter the agent number. The agent number is a seven-digit
your spouse’s name and social security number, and your spouse’s number assigned by the Department of Revenue.
address if different from yours.
2. Enter the federal employer identification number. The FEIN is a
• For a corporation, limited liability company, or partnership: nine-digit number assigned to the agent by the Internal Revenue
Enter the name, business address, FEIN, a contact person familiar Service.
with this matter, and telephone number(s).
3. Select the mail type.
• For a trust: Enter the name, title, address, and telephone
number(s) of the fiduciary, and name and FEIN of the trust. Primary Mail. If you select primary mail, the agent will receive
all documents from the Department of Revenue related to this
• For an estate: Enter the name, title, address, and telephone reemployment tax account, and will be authorized to receive
number(s) of the decedent’s personal representative, and the name confidential information and discuss matters related to the tax and
and identification number of the estate. The identification number wage report, benefit information, claims, and the employer’s rate.
for an estate includes both the FEIN if the estate has one and the
decedent’s social security number. Reporting Mail. If you select reporting mail, the agent will receive
the Employer’s Quarterly Report (Form RT-6), certification, and
• For any other entity: Enter the name, business address, FEIN, correspondence related to reporting. The agent will be authorized to
and telephone number(s), as well as the name of a contact person receive confidential information and discuss the tax and wage report,
familiar with this matter. certification, and correspondence with the Department.
• Identification Number: The Department may have assigned you Rate Mail. If you select rate mail, the agent will receive tax rate
a Florida tax registration number such as a sales tax number, a notices and correspondence related to the rate and will be authorized
reemployment tax account number, or a business partner number. to receive confidential information and discuss the employer’s rate
These numbers further assist the Department in identifying your notices and rate with the Department.
particular tax matter, and you should enter them in the appropriate
box. If you do not provide this information, the Department may not Claims Mail. If you select claims mail, the agent will receive the
be able to process the Power of Attorney. notice of benefits paid, and will be authorized to receive confidential
information and discuss matters related to benefits.
Note: Duplicate copies of certain computer-generated notices and
other written communications cannot be issued due to current system
constraints and therefore, these communications will be sent only to
the representative.

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DR-835
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Note: If you wish to appoint a representative to act on your behalf in governing representation before the Department of Revenue. The
a specific and non-continuing reemployment tax matter, you should representative(s) must also declare, under penalties of perjury, that he
complete Section 3 and Section 6 and not Section 4. For example, or she has been authorized to represent the taxpayer(s) in this matter
if you hire a representative to assist you with a single matter, such as and authorized by the taxpayer(s) to receive confidential taxpayer
a reemployment tax audit or contesting the payment of a claim, and information.
wish that representative to handle just that one matter, you should The representative(s) you name must sign and date this declaration
not complete Section 4 to authorize that representation. Instead, you and enter the designation (i.e., items a-f) under which he or she is
should fill out Section 3 and specify the exact matter the representative authorized to represent you before the Department of Revenue.
is handling.
a. Attorney – Enter the two-letter abbreviation for the state (for
Section 5 – Acts Authorized example “FL” for Florida) in which admitted to practice, along with
Your signature on the back of the Power of Attorney authorizes the your bar number.
individual(s) you designate (your representative or “attorney-in-fact”)
to perform any act you can perform with respect to your tax matters, b. Certified Public Accountant – Enter the two-letter abbreviation
except that your representative may not sign certain returns for you for the state (for example “FL” for Florida) in which licensed to
nor may your representative negotiate or cash your refund warrant. practice.
This authority includes signing consents to a change in tax liability, c. Enrolled Agent – Enter the enrollment card number issued by the
consents to extend the time for assessing or collecting tax, closing Internal Revenue Service.
agreements, and compromises. You may authorize your representative
to receive, but not negotiate or cash, your refund warrant by checking d. Former Department of Revenue Employee – Former employees
the box in Section 5 and writing the name of the representative on the may not accept representation in matters in which they were
line below. If you wish to limit the authority of your representative other directly involved, and in certain cases, on any matter for a period
than in the manner previously described, you must describe those of two years following termination of employment. If a former
limits on the lines provided in Section 5. Department of Revenue employee is also an attorney or CPA,
then the additional designation, jurisdiction, and enrollment card
Section 6 – Mailing of Notices and Communications should also be entered.
If you do not check a box, the Department will send notices and other
written communications to the first representative listed in Section 2, e. Reemployment Tax Agent – A person(s) appointed under
unless you select another option. If you wish to have no documents Section 4 of the Power of Attorney to handle reemployment tax
sent to your representative, or documents sent to both you and your matters on a continuing basis. A separate Power of Attorney
representative, you should check the appropriate box in Section 6. form must be completed in order for a reemployment tax agent to
Check the second box if you wish to have notices and other written handle a specific and non-continuing matter such as a protest of a
communications sent to you and not to your representative. In reemployment tax rate.
certain instances, the Department can only send documents to the f. Other Qualified Representative – An individual may represent
taxpayer. Therefore, the taxpayer has the responsibility of keeping the a taxpayer before the Department of Revenue if training and
representative informed of tax matters. experience qualifies that person to handle a specific matter.
Note: Taxpayers completing Section 4 (To Appoint a Reemployment Rule 28-106.107, Florida Administrative Code, sets out mandatory
Tax Agent Only) should not complete Section 6. See Section 4 of these standards of conduct for all qualified representatives. A representative
instructions for information regarding notices and communications sent shall not:
to a reemployment tax agent. (a) Engage in conduct involving dishonesty, fraud, deceit, or
Section 7 – Retention/Nonrevocation of Prior Power(s) of Attorney misrepresentation.
The most recent Power of Attorney will take precedence over, but will (b) Engage in conduct that is prejudicial to the administration of
not revoke, prior Powers of Attorney. If you wish to revoke a prior justice.
Power of Attorney, you must check the box on the form and attach a
copy of the old Power of Attorney. (c) Handle a matter that the representative knows or should know
that he or she is not competent to handle.
Section 8 – Signature of Taxpayer(s)
The Power of Attorney is not valid until signed and dated by the (d) Handle a legal or factual matter without adequate preparation.
taxpayer. The individual signing the Power of Attorney is representing, *Social security numbers (SSNs) are used by the Florida
under penalties of perjury, that he or she is the taxpayer or authorized Department of Revenue as unique identifiers for the administration of
to execute the Power of Attorney on behalf of the taxpayer. Florida’s taxes. SSNs obtained for tax administration purposes are
• For a corporation, trust, estate, or any other entity: A corporate confidential under sections 213.053 and 119.071, Florida Statutes,
officer or person having authority to bind the entity must sign. and not subject to disclosure as public records. Collection of your
SSN is authorized under state and federal law. Visit our Internet
• For partnerships: All partners must sign unless one partner is site at www.floridarevenue.com and select “Privacy Notice” for
authorized to act in the name of the partnership. more information regarding the state and federal law governing the
• For a sole proprietorship: The owner of the sole proprietorship collection, use, or release of SSNs, including authorized exceptions.
must sign. Where to Mail Form DR-835
• For a joint return: Both husband and wife must sign if the If Form DR-835 is for a specific matter, mail or fax it to the office or
representative represents both. If the representative only employee handling the specific matter. You may send it with the
represents one spouse, then only that spouse should sign. document to which it relates.
PART II – DECLARATION OF REPRESENTATIVE If Form DR-835 is for a reemployment tax matter and the taxpayer has
Any party who appears before the Department of Revenue has the completed Section 4, mail it to the Florida Department of Revenue,
right, at his or her own expense, to be represented by counsel or by a P.O. Box 6510, Tallahassee FL 32314-6510, or fax it to 850-488-5997.
qualified representative. The representative(s) you name must declare,
under penalties of perjury, that he or she is qualified to represent you in
this matter and will comply with the mandatory standards of conduct

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