Form Boe-892 - Statement Of Authorization
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1BOE-892 REV. 10 (12-04)
STATE OF CALIFORNIA
STATEMENT OF AUTHORIZATION
BOARD OF EQUALIZATION
2005
Please return completed form to the Valuation Division, Board of Equalization, P.O. Box 942879, Sacramento, CA 94279-0061.
If you have any questions, you may reach us at 916-322-2323.
SBE NO.
COMPANY NAME
ADDRESS (including zip code)
CITY
STATE
ZIP
DESIGNATED REPRESENTATIVE
E-MAIL ADDRESS
ADDRESS (including zip code)
CITY
STATE
ZIP
TELEPHONE NUMBER
FAX NUMBER
(
)
(
)
Please be advised that the person listed above is authorized to act as our designated representative before the California State
Board of Equalization in connection with the assessment of our property. Our designated representative may inspect or copy all
information, documents, and records, including narrations and workpapers relating to the appraisal and the assessment of our
property during the period January 1, 2005 through December 31, 2005, for the lien date 2005. I understand that this form must
be filed annually in order for the representative status to remain current.
OWNER, PARTNER OR OFFICER’S SIGNATURE
DATE
✍
SIGNATORY’S PRINTED NAME
TITLE
CLEAR
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