Iowa Unemployment Insurance And Tax Power of Attorney Form
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The Iowa unemployment insurance and tax power of attorney is a legal document used by the employer to authorize the attorney-in-fact to act on his/her behalf in the company's unemployment insurance, claims/benefits and tax related matters.
DOCUMENT CONTROL DATE
IOWA WORKFORCE DEVELOPMENT UNEMPLOYMENT INSURANCE (UI) TAX BUREAU
Declaration of Power of Attorney or Authorized Representative - 68-0092 (05-07)
1. Provide Employer/Company Information
Legal Name of Business or Last Name of Sole Proprietor
First Name of Sole ProprietorInitial
Social Security Number
Iowa UI Tax Account Number
Current Mailing Address
Zip Code + 4
Employer's E-Mail Address
Federal Identification Number
2. Provide Power of Attorney or Authorized Representative Information
Name of Firm or Company's Legal Name
Name (if Firm is not designated)
Telephone NumberFax Number
Employer's E-Mail Address of Power of Attorney or Authorized Representative
Check appropriate box. Refer to instructions for explanation of privileges.
Power of AttorneyAuthorized Representative
As the true and lawful agent, with limited power and authority to represent the said employer before Iowa Workforce Development, until further notice, in only
the matters selected below: (Please check all pertinent boxes)
All Unemployment Insurance matters All Tax related matters
All Claims/Benefits related matters.
Filing - Unemployment Insurance Reports and payments
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