Power Of Attorney Form

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POWER OF ATTORNEY
Know all men by these presents that _________________________________, (Taxpayer) in the County of
____________________________, State of _____________________, City of ____________________, do hereby
make, constitute, appoint, and authorize the representative(s) listed below as my true and lawful attorney in fact to
appear for me and represent me before the board of county commissioners or the county board of equalization
and review in the County of _________________________, in connection with any matter involving the ad valorem
taxation of the property described below; I grant unto said attorney in fact the full power and authority to appeal the
property tax value assigned by the County to the described property, and the power to make full and complete
settlement or other disposition of the matter; I hereby authorize the said County to disclose to my attorney in fact all
information used by the County in connection with the listing, appraisal, or assessment of the said property, including
specifically information of a confidential nature.
I understand that in the event of an adverse decision by either County Board, that if this matter is appealed to
the North Carolina Property Tax Commission, the property tax value may be lowered, left unchanged, or increased as
a result of the appeal. I also understand that representation of business entities before the Property Tax Commission
is subject to the provisions of G.S. 105-290(d2).
The specific property which my attorney in fact is authorized to appeal is described as follows:
NOTE: PLEASE USE THE PROPERTY TAX PARCEL IDENTIFICATION NUMBER(S) FOR REAL
PROPERTY; PERSONAL PROPERTY SHOULD BE DESCRIBED AS CLEARLY AS POSSIBLE.
ATTACH ADDITIONAL INFORMATION SHEETS IF NECESSARY.
Taxpayer(s) must sign and date this Power of Attorney before a Notary Public.
Taxpayer's name and address:
Telephone Number:
Fax Number:
Email:
Witness my hand this the _______day of __________________, 20___.
____________________________________
TAXPAYER
STATE OF _____________________
COUNTY OF ___________________
The foregoing instrument was duly acknowledged before me by __________________________ for the uses
and purposes therein expressed.
Witness my hand and seal this the ___________day of __________________, 20___.
(seal)
My commission expires :_________________
____________________________
Notary Public
Representative(s) name and address:
Telephone Number:
Fax Number:
Email:

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