Taxpayer(s) name, identifying number, and address including PIN code: ____________________________
____________________________
____________________________
____________________________
hereby appoints (names(s), CAF number(s), address (es), including PIN code(s), and telephone numbers:
____________________________
____________________________
____________________________
____________________________
____________________________
as attorney(s)-in-fact to represent the taxpayer(s) before any office of the Revenue office 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: _________________
Central tax number: __________
Year(s) or period(s) _________
Date of death if estate tax: _____
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. Send copies of notice and other written communications addressed to the taxpayer(s) in proceedings involving the tax matters to: the appointee first named above….
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