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South Dakota Tax Power of Attorney Form

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The South Dakota tax power of attorney is a legal document used by the grantor to authorize the attorney-in-fact to act on his/her behalf in his/her tax related matters.

South Dakota Tax Power of Attorney Form Page 2
South Dakota Tax Power of Attorney Form
The Power of Attorney shall be effective upon receipt thereof by the Department of Revenue
and shallcontinue until cancelled by ling with the department an instrument properly executed and reciting
such cancellation.
IN WITNESS WHERE OF, the undersigned has caused these present to be execute, for benet of the
principal namebelow.
Please check the following licenses which you hold or are applying for:
Business Tax License(s) Tax License Number(s) if previously assigned
Sales/Use Tax License
Manufacturers License
Wholesalers License
Contractors’ Excise Tax License
Special Licenses
Alcohol Wholesalers License
Tobacco Distributor License
Accounting or Reporting Firm By: Principle and Licensee By:
Company Name Company Name
FEIN or SS# FEIN or SS#
Signature of Owner/Legal Rep. Signature of Owner/Legal Rep.
Title Title
Address-Mailing Address-Mailing
City/State City/State
Phone Number Phone Number
State of:
County of:
On this day of , before the undersigned, a Notary of the Public for the
State of personally appeared known to
be the person whose name is subscribed to the within instrument, and acknowledge to me that he
executed the same in capacity as shown.
IN WITNESS WHEREOF, I have set my hand and seal this day
of ,this certicate above written.
Notary Public
My commission expires:
PRINT FOR MAILING
CLEAR FORM
South Dakota Tax Power of Attorney Form
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