Business Heaven/Business Heaven.iso/office/lguide1/8414.bld

Text File | 1993-01-06 | 5KB | 232 lines

#8414
@841 Enter the name of the taxpayer(s):
@842 Enter the EIN or SS# of taxpayer(s):
@843 Enter the street address of the taxpayer:
@844 Enter the city, state of the taxpayer:
@845 Enter the name of the attorney(s):
@846 Enter the street address of the attorney(s):
@847 Enter the city, state of the attorney(s):
@848 Enter CAF number of attorney(s):
@888 Telephone number of attorney(s):
@849/@849/@849/@849 Enter type of tax:
Individual
Corporate
FICA/Withholding
KEY IN VALUE
@850 End years or periods or date of death if estate tax:
@851/@851 Notices are to be sent to:
the appointee first named above
KEY IN VALUE
#8415 Are refund checks to be sent to the representative?
#if#8415
@852/@852 Power is granted to:
the appointee first named above
KEY IN VALUE
#8416
@853/@853 If earlier powers remain effective, list them:
Not applicable
KEY IN VALUE
#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: @850

Year(s) or period(s)

Date of death if estate tax: @850


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)


PART II


I declare that I am not currently under suspension or disbarment
form 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