California Power of Attorney (CA Department of Tax and Fee Administration)

Power of Attorney (CA Department of Tax and Fee Administration)
CDTFA-392, Power of Attorney
Information Update
You may request Power of Attorney using our online services at onlineservices.cdtfa.ca.gov. To submit a request, log in
with your username and password, and select the account for which you want to represent. The request is located under
the I Want To section. Choose More, then Request Power of Attorney, and follow the prompts. The account owner will
then be able to approve or deny your request.

CDTFA-392 (S1F) REV. 16 (6-23)

STATE OF CALIFORNIA

POWER OF ATTORNEY

CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION

TAXPAYER’S NAME

BUSINESS OR CORPORATION NAME

SOCIAL SECURITY NUMBER

FEDERAL EMPLOYER IDENTIFICATION NUMBER

CDTFA ACCOUNT/PERMIT(S)

TELEPHONE NUMBER

FAX NUMBER

CALIFORNIA SECRETARY OF STATE NUMBER(S)

EMAIL ADDRESS

MAILING ADDRESS (number and street, city, state, and ZIP Code)

Individual

Partnership

Corporation

Limited Liability Company

Other

As owner, officer, receiver, administrator, or trustee for the taxpayer, or as a party to the tax or fee matter before the California
Department of Tax and Fee Administration (CDTFA), I hereby appoint (Enter below the name[s] of the individual appointee[s], their
address[es] including ZIP Code, their telephone number[s], and their fax number[s]. Do not enter names of accounting or law firms,
partnerships, or corporations as the appointee name.):
APPOINTEE NAME

APPOINTEE NAME

APPOINTEE BUSINESS NAME (if applicable)

APPOINTEE BUSINESS NAME (if applicable)

APPOINTEE ADDRESS (number and street)

APPOINTEE ADDRESS (number and street)

CITY

STATE

ZIP CODE

EMAIL ADDRESS

TELEPHONE NUMBER

CITY

STATE

ZIP CODE

EMAIL ADDRESS

FAX NUMBER

TELEPHONE NUMBER

CPA NUMBER/CA BAR NUMBER/PTIN/ENROLLED AGENT NUMBER
(One is required. Use Driver License or SSN if no CPA/CA BAR/PTIN/Enrolled Agent Number.)

FAX NUMBER

CPA NUMBER/CA BAR NUMBER/PTIN/ENROLLED AGENT NUMBER
(One is required. Use Driver License or SSN if no CPA/CA BAR/PTIN/Enrolled Agent Number.)

As attorney(s)-in-fact to represent the taxpayer(s) for the tax or fee program(s) administered by CDTFA, as indicated for the
following tax year(s) or period(s):
Select Program

Indicate Tax Year(s) or Period(s)

Sales and Use Taxes
Special Taxes
(The back of this form must be completed.)

CDTFA-392 (S1B) REV. 16 (6-23)

Confidential tax information may be received by the attorney(s)-in-fact (or any of them), subject to revocation, and the
attorney(s)-in-fact (or any of them) may perform on behalf of the taxpayer(s) the following act(s) for the tax or fee matter(s)
described on the previous page. (check the boxes for the powers granted):
General authorization (including all acts described below).
Specific authorization (selected acts described below).
To confer and resolve any assessment, claim, or collection of a deficiency or other tax or fee matter pending before the
identified agency and attend any meetings or hearings for the specified law identified above.
To receive, but not to endorse and collect, checks in payment of any refund of taxes, penalties, or interest.
To execute petitions, claims for refund, and/or amendments.
To execute consents extending the statutory period for assessment or determination of taxes.
To delegate authority or to substitute another representative.
Other (specify):
Does this power of attorney revoke all earlier power(s) of attorney on file with CDTFA as identified above for the same matters
and tax years or periods covered by this form? (check the box for either yes or no):
Yes
No, this power of attorney does not revoke all earlier power(s) of attorney on file with CDTFA as specified for the following:
(specify to whom power of attorney is granted, date and address, or refer to attached copies of earlier powers)
NAME

DATE POWER OF ATTORNEY GRANTED

ADDRESS (number and street, city, state, and ZIP Code)

Unless limited, this power of attorney will remain in effect for six years from the date this form is signed, or on the date a
power of attorney is revoked, whichever occurs first. (specify expiration date if limited term):
TIME LIMIT/EXPIRATION DATE (for CDTFA purposes)

Signature of taxpayer(s):
If a tax or fee matter concerns a joint return, both spouses must sign if joint representation is requested. If you are a corporate
officer, partner, guardian, tax or fee matters partner/person, executor, receiver, registered domestic partner, administrator, or trustee
on behalf of the taxpayer, by signing this power of attorney, you are certifying that you have the authority to execute this form on
behalf of that taxpayer.
If this power of attorney is not signed and dated by an authorized individual, it will be returned as invalid.
SIGNATURE

TITLE (if applicable)

PRINT NAME

SIGNATURE

PRINT NAME

DATE

TELEPHONE NUMBER

TITLE (if applicable)

DATE

TELEPHONE NUMBER