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3. 3. 3. 3. 3. ACTS AUTHORIZED

ACTS AUTHORIZED

The representative is authorized, subject to revocation, to receive confidential tax information. If you want to give the

representative general authority to perform any and all acts on your behalf with regard to your state tax matters, you must

check the box General Authorization below. If you want to give the representative limited authority with regard to your state

tax matters, indicate the specific acts you are authorizing under Specific Declaration below. (Check the box(es) indicating

the acts authorized):

General Authorization

General Authorization – (All acts described below)

Specific Declaration

Specific Declaration – I authorize the representative to perform only selected acts described below:

Specific Declaration

To represent the taxpayer for any and all matters relating to the income year or period indicated above except:

(Describe specifically) ____________________________________________________________________.

To receive, but not to endorse and collect checks in payment of any refund of taxes, penalties or interest.

Please provide the name of the individual you are authorizing: __________________________________.

To execute petitions, claims for refund and/or amendments thereto.

To execute consents extending the statutory period for assessment or determination of taxes.

To execute closing agreements under Section 19441 of the California Revenue & Taxation Code.

To delegate authority or substitute another representative.

To execute settlement agreements under Section 19442 of the California Revenue & Taxation Code.

Other acts: (Describe specifically) ______________________________________________________.

4. 4. 4. 4. 4. RETENTION/REVOCA

RETENTION/REVOCA

RETENTION/REVOCATION OF PRIOR POWER OF A

TION OF PRIOR POWER OF A

TION OF PRIOR POWER OF ATT

TTORNEY DECLARA

ORNEY DECLARA

ORNEY DECLARATIONS

ORNEY DECLARA

TIONS

RETENTION/REVOCA

TION OF PRIOR POWER OF A

ORNEY DECLARA

TIONS

This Power of Attorney Declaration automatically revokes all earlier Power of Attorney Declarations on file with the

California Franchise Tax Board as identified above for the same matters and years or periods covered by this docu-

ment unless you specify otherwise below.

Check here if you do not want to revoke a prior Power of Attorney Declaration for the same matters and tax years

or income years. You MUST attach a copy of each prior Power of Attorney Declaration you want to remain in

effect.

5. 5. 5. 5. 5. RETENTION OF THIS POWER OF A

RETENTION OF THIS POWER OF A

RETENTION OF THIS POWER OF ATT

TTORNEY DECLARA

ORNEY DECLARA

ORNEY DECLARATION

TION

This Power of Attorney Declaration will remain in effect until the final resolution of all tax matters specified herein unless

the term is limited. If the term is limited, specify the expiration date: ______________________

6. 6. 6. 6. 6. SIGNA

SIGNA

SIGNATURE(S) AUTHORIZING POWER OF A

TURE(S) AUTHORIZING POWER OF A

TURE(S) AUTHORIZING POWER OF ATT

TTORNEY

ORNEY

Signatures of the taxpayers or owner

Signatures of the taxpayers or owner, officer

, officer

, officer, receiver

, receiver

, receiver, administrator

, administrator

, administrator, or trustee for the taxpayer –

, or trustee for the taxpayer –

, or trustee for the taxpayer – If the tax matter

Signatures of the taxpayers or owner

, officer

, receiver

, administrator

, or trustee for the taxpayer –

concerns a joint return and joint representation is declared, both husband and wife must sign. If you are a corporate

officer, partner, guardian, tax matters partner/person, executor, receiver, administrator, or trustee on behalf of the tax-

payer, you are certifying that you have the authority to execute this form on behalf of the taxpayer(s) by signing this Power

of Attorney Declaration.

If this Power of Attorney Declaration is not signed and dated, it will be returned as invalid.

_______________________________________________________________

________________________

_______________________

Signature

Date

Title (if applicable)

_______________________________________________________________

Print Name

_______________________________________________________________

________________________

_______________________

Signature

Date

Title (if applicable)

_______________________________________________________________

Print Name

_______________________________________________________________

________________________

_______________________

Signature

Date

Title (if applicable)

_______________________________________________________________

Print Name

FTB 3520 (REV 06-1999) PAGE 2

Form Ftb 3520 - Power Of Attorney - Declaration Of Administration Of Tax Matters - 1999 Page 2

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