Looking for a Mississippi Tax Forms And Templates? Download it for free!

Form 63-018 - Application For International Fuel Tax Agreement (Ifta) Credentials 1997 Page 3

Account Name.

IFTA Account No.

POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS, that the under signed principal and licensee has made and appointed, and does

hereby make and appoint (reporting firm's name)

or their agents with offices at (mailing address)

(phone number)

, to act as Attorney-in-fact for the licensee, who makes this

appointment either personally or in an authorized capacity on behalf of the licensee; this power of attorney shall be for all

matters relating to IFTA fuel taxes including but not limited to licensing decal orders, fuel tax reports and discussing all

required documents with any agent or employee of the State Tax Commission.

IN WITNESS WHEREOF, I

have set my hand this

day of

Signature of Owner / Legal Representative

Title

ACKNOWLEDGEMENT

STATE OF

COUNTY OF

On this

day of

,19

,before me, the undersigned Notary Public, in and for the county

and state aforesaid personally appeared

and acknowledged to me that he

executed the same as his free and voluntary act and deed, and as the free and voluntary act and deed of said corporation,

for the uses and purposes therein set forth.

Given under my hand and seal the day and year last above written.

Notary Public

My Commission Expires

Form 63-018 - Application For International Fuel Tax Agreement (Ifta) Credentials 1997 Page 3