Home > Legal > Legal > Power of Attorney Template > Indiana Power of Attorney Form > Indiana Tax Power of Attorney Form 2

Indiana Tax Power of Attorney Form 2

At Speedy Template, You can download Indiana Tax Power of Attorney Form 2 . There are a few ways to find the forms or templates you need. You can choose forms in your state, use search feature to find the related forms. At the end of each page, there is "Download" button for the forms you are looking form if the forms don't display properly on the page, the Word or Excel or PDF files should give you a better reivew of the page.

Indiana Tax Power of Attorney Form 2 Page 2
Indiana Tax Power of Attorney Form 2
If rm or vendor, list representative(s) name, telephone number and email.
Representative(s) Name Telephone Number Email
5. General Authorization
I authorize the listed representative(s), in addition to anything otherwise authorized on this form, to represent me regarding any
matters with the Indiana Department of Revenue regardless of tax years or income periods. I understand that this authority will expire 5
years from the date this POA is signed or a written and signed notice is filed revoking this authorization.
6. Tax Type(s) (Not applicable if box is checked in question 5 above)
Type of Tax Year(s)/Period(s)
(Income, Withholding, Sales, etc.) Current Year Specify
_______________________________________ ___________________________________
_______________________________________ ___________________________________
_______________________________________ ___________________________________
I acknowledge that the designated representative has the authority to receive condential information and full power to perform on behalf of
the taxpayer in tax matters related to this Power of Attorney. This authority does not include the power to receive refund checks.
I acknowledge that actions taken by the designated representative are binding, even if the representative is not an attorney. Proceedings
cannot later be declared legally defective because the representative was not an attorney.
If I am a corporate ofcer, partner, or duciary acting on behalf of the taxpayer, I certify that I have authority to execute this Power of Attorney
on behalf of the taxpayer.
7. Authorizing Signature
Signature _______________________________________________ Date _______________________________
Printed Name ____________________________________________ Title _______________________________
Telephone Number ________________________________________ Email ______________________________
Required elds - if not complete, this form will be returned to sender.
Indiana Tax Power of Attorney Form 2