Submit the completed form to the Texas Comptroller of Public Accounts as follows: Email: [email protected], Fax: 512-463-2184, Mail: Texas Comptroller of Public Accounts, P.O. Box 13528, Capitol Station, Austin, TX 78711-3528. Make sure all required information is provided and the form is signed before submission. It is advisable to keep a copy of the form for your records.

The form is effective immediately upon signing and remains valid until the specified expiration date or until revoked in writing.

The purpose of this form is to provide a legally binding document that designates an agent to act on behalf of a taxpayer in matters related to the Texas Comptroller of Public Accounts. Taxpayers can grant authority for various purposes, such as handling tax filings, accessing account data, and representing them in disputes. This helps ensure that tax-related matters are managed efficiently and in compliance with Texas Tax Code Section 111.023.

• 1. Taxpayer legal name: Provide the legal name of the taxpayer granting the power of attorney.
• 2. 11-digit Texas taxpayer number: Enter the taxpayer's 11-digit Texas taxpayer number.
• 3. Agent legal name: Provide the legal name of the agent appointed to act on behalf of the taxpayer.
• 4. Relationship to taxpayer: Specify the relationship of the agent to the taxpayer (e.g., Attorney, CPA).
• 5. Contact name: Enter the contact name for the agent.
• 6. Street, City, state and ZIP code: Provide the complete address of the agent.
• 7. Tax type(s)/Subtype(s)/Fee(s): Specify the tax types, subtypes, or fees applicable.
• 8. Email address: Enter the email address of the agent.
• 9. Phone (Area code and number): Provide the contact phone number of the agent.
• 10. Period(s)/Report year(s): Specify the applicable periods or report years.
• 11. Purposes: Select and indicate the purposes for granting authority.
• 12. Effective dates: Specify the effective dates for the power of attorney.
• 13. Signature: The taxpayer must sign the form.

Failing to submit this form means the taxpayer cannot designate an agent to handle tax-related matters.

• No Representation: The taxpayer will not have an authorized representative before the Texas Comptroller of Public Accounts.
• Missed Deadlines: Tax filings and other required actions may be delayed or missed without an appointed agent.
• Limited Access: The taxpayer may not grant access to their tax account data to a representative.

• 1. Tax Filing: When an agent needs authority to file tax returns on your behalf.
• 2. Refund Claims: When an agent needs to file claims for tax refunds.
• 3. Audit Representation: When an agent will represent you in a tax audit or examination.
• 4. Access to Data: When an agent needs access to your tax account data.
• 5. Dispute Resolution: When an agent will handle tax disputes and hearings on your behalf.