home *** CD-ROM | disk | FTP | other *** search
- #8414
- @841 Enter the name of the taxpayer(s):
- ~Enter the name of the taxpayer. Should match, if possible, the
- ~name on the returns in question.
- @842 Enter the EIN or SS# of taxpayer(s):
- ~Enter the taxpayer's identification number for the taxpayer.
- ~This is either a social security number or an employer
- ~identification number.
- @843 Enter the street address of the taxpayer:
- ~Enter the taxpayers street address.
- @844 Enter the city, state of the taxpayer:
- ~Enter the city and state where the taxpayer resides.
- @845 Enter the name of the attorney(s):
- ~Enter the name of the attorney or attorney(s). Note that this
- ~does not imply that the person must be an attorney at law. In
- ~the case of an individual, a family member may act for them, and
- ~CPA's, Enrolled Agents and other tax advisors can also represent
- ~someone before the IRS. Note that more than one person (such as
- ~partners at a firm) can be named.
- @846 Enter the street address of the attorney(s):
- ~Enter the street address where the attorneys conduct business.
- @847 Enter the city, state of the attorney(s):
- ~Enter the city and state where the attorney's conduct business.
- @848 Enter CAF number of attorney(s):
- ~Enter the CAF number of the attorneys. This is a number which is
- ~given to each person who has represented others before the IRS.
- @888 Telephone number of attorney(s):
- ~Enter the telephone number of the attorneys.
- @849/@849/@849/@849 Enter type of tax:
- ~Select the type of tax.
- Individual
- Corporate
- FICA/Withholding
- KEY IN VALUE
- @850 End years or periods of tax:
- ~Enter the years when the representative will act for the person.
- ~Note that this must be specific years. The IRS will not accept
- "all years."
- @111/@111 If estate, enter year of death:
- ~If this is an estate, enter the year that the decedent died.
- Not applicable
- KEY IN VALUE
- @851/@851 Notices are to be sent to:
- ~Select who will get notices of IRS hearings, etc.
- the appointee first named above
- KEY IN VALUE
- #8415 Are refund checks to be sent to the representative?
- ~Select if refund checks are to be sent to the representative.
- ~Normally this is "no."
- #if#8415
- @852/@852 Power is granted to:
- ~Select to whom the power is granted.
- the appointee first named above
- KEY IN VALUE
- #8416
- @853/@853 If earlier powers remain effective, list them:
- ~A power of attorney will revoke older powers of attorney unless
- ~they are mentioned in this prompt.
- Not applicable
- KEY IN VALUE
- #endif
- #8777
- #end control section
- #8414
- /* IRS POA FORM: Para. 8414 */
-
-
- POWER OF ATTORNEY AND DECLARATION OF REPRESENTATIVE
-
-
- Taxpayer(s) name, identifying number, and address including ZIP
- code:
-
-
- @841
-
- @842
-
- @843
-
- @844
-
-
- hereby appoints (names(s), CAF number(s), address(es), including
- ZIP code(s), and telephone numbers:
-
-
- @845
-
- @846
-
- @847
-
- @848
-
- @888
-
- as attorney(s)-in-fact to represent the taxpayer(s) before any
- office of the Internal Revenue Service for the following tax
- matter(s) (specify the type(s) of tax and year(s) or period(s)
- (date of death if estate tax):
-
-
- Type of tax: @849
-
- Federal tax number: @842
-
- Year(s) or period(s): @850
-
- Date of death if estate tax: @111
-
-
- The attorney(s)-in-fact (or either of them) are authorized,
- subject to revocation, to receive confidential information and to
- perform and any all acts that the principal(s) can perform with
- respect to the above specified tax matters (excluding the power
- to receive refund checks, and the power to sign the return (see
- regulations section 1.6012-1(a)(5), Returns made by agents),
- unless specifically granted below.)
-
-
- Send copies of notice and other written communications addressed
- to the taxpayer(s) in proceedings involving the tax matters to:
-
-
- @851
-
-
- #8415
- /* Para. 8415: Refund checks)
-
-
- Taxpayer initial here: _________________ if you are granting the
- power to receive, but not to endorse or cash, refund checks for
- the above tax matters to:
-
-
- @852
-
-
- #8416
- /* Para. 8416: Addl. stuff */
-
- This power of attorney revokes all earlier powers of attorney and
- tax information authorizations on file with the Internal Revenue
- Service for the same tax matters and years or periods covered by
- this power of attorney, except the following:
-
-
- @853
-
-
- Signature of or for taxpayer(s):
-
-
- (If signed by a corporate officer, partner, or fiduciary on
- behalf of the taxpayer, I certify that I have the authority to
- execute this power of attorney on behalf of the taxpayer.)
-
-
-
- ________________________________________________
-
- Signature
-
-
-
-
- ________________________________________________
-
- Title
-
-
- Date: ___________________________
-
-
- If the power of attorney is granted to a person other than an
- attorney, certified public accountant, enrolled agent, or
- enrolled actuary, the taxpayer(s) signature must be witnesses or
- notarized below. (The representative must complete Part II. Only
- representative listed there are recognized to practice before the
- Internal Revenue Service.
-
-
- The persons signing as or for the taxpayer(s): (Check and complete
- one)
-
-
- ______ is/are known to and signed in the presence of the two
- disinterested witnesses whose signatures appear here:
-
-
-
-
- _______________________________________________
-
- Signature of Witness
-
-
- Date: ___________________
-
-
-
- _______________________________________________
-
- Signature of Witness
-
-
- Date: ___________________
-
-
- __________ appeared this day before a notary public and
- acknowledged this power of attorney as a voluntary act and deed.
-
-
-
-
- _______________________________________________
-
- Witness (Signature of notary)
-
- #8777
- /* Para. 8777*/
- PART II
-
-
- I declare that I am not currently under suspension or disbarment
- from practice before the Internal Revenue Service, that I am
- aware of Treasury Department Circular No. 230 as amended (31
- C.F.R. Part 10), Regulations governing the practice of attorneys,
- certified public accountants, enrolled agents, enrolled
- actuaries, and others, and that I am one of the following:
-
-
- 1 a member in good standing of the bar of the highest court of
- the jurisdiction indicated below;
-
- 2 duly qualified to practice as a certified public accountant in
- the jurisdiction indicated below;
-
- 3 enrolled as an agent pursuant to the requirements of Treasury
- Department Circular No. 230;
-
- 4 a bona fide officer of the taxpayer organization;
-
- 5 a full-time employee of the taxpayer;
-
- 6 a member of the taxpayer's immediate family (spouse, parent,
- child, brother or sister);
-
- 7 a fiduciary for the taxpayer;
-
- 8 an enrolled actuary (the authority of an enrolled actuary to
- practice before the Service is limited by section 10.3(d)(1) of
- Treasury Department Circular No. 230);
-
- 9 Commissioners special authorization (see instructions for Part
-
- II, item 9) ___________________________________________;
-
-
- and that I am authorized to represent the taxpayer identified in
- Part I for the tax matters there specified.
-
-
- Designation Jurisdiction Signature Date