Change Of The Official Mailing Address - Delaware Division Of Unemployment Insurance
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1THAT:
_______________________________________________
(Taxpayer Name)
Account # ________________, a corporation, with address:
_______________________________________________
_______________________________________________
does hereby constitute and appoint _______________________________ at
______________________________________________________________
It’s true and lawful attorney – in – fact with full power and authority to represent the said Corporation
before the:
Delaware Division of Unemployment Insurance
Until further notice in the following matters, to-wit:
1. The presenting of completed forms, including claims for refund or adjustment of account,
employer’s protest of benefit claims, and information relative thereto.
2. The payment of contributions.
3. The obtaining of such information as is permissible.
4. All matters affecting merit rating.
5. Change the official mailing address to:
_______________________________
_______________________________
_______________________________
6. The personal discussion of any or all of the foregoing with proper officials of:
Delaware Division of Unemployment Insurance
This authorization to be effective immediately, superseding any such authority previously granted and to
continue until cancelled.
IN WITNESS WHEREOF, the said CORPORATION has caused this instrument to be duly attested by the
signature of its duly qualified officer this _____________day of _____________________A.D.________
Corporate Seal Here
Business Name
By _________________________
Title ________________________
_______________________________
Witness
Doc.No. 60 06 01 07 05 01
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