Form M-5008-R - Appointment Of Taxpayer Representative Page 2
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2M-5008-R (11-16)
Page 2 of 2
5. Notices and Communications. The Division will send original notices and other written communications to you and a
copy (other than automated computer notices) to the first representative listed in Section 2 unless you check one or more
of the boxes below.
I/We do not want the Division to send any notices or communications to my representative(s)
I/We want the Division to send a copy of notices and/or communications (other than automated computer
notices) to both representatives listed in Section 2.
6. Retention/Revocation of Prior Appointment(s) or Power(s). Unless you check the box below, the filing of this Ap-
pointment of Taxpayer Representative automatically revokes all earlier Appointment(s) of Taxpayer Representative and/or
Power(s) of Attorney on file with the Division of Taxation for the tax matters and years or periods listed in Section 3.
I/We do not want to revoke any prior Appointment(s) of Taxpayer Representative and/or Power(s) of
Attorney.
If you check the above box, you must attach copies of the previous Appointment(s) and/or Power(s) that you do not want
to revoke.
7. Signature of Taxpayer(s). If the tax matters covered by this appointment concern a joint gross income tax return and
the representative(s) is/are being appointed to represent both spouses/CU partners, both must sign below.
If a corporate officer, partner, guardian, tax matter partner, executor, administrator, or trustee signs the appointment on be-
half of the taxpayer, the signature below certifies that they have the authority to execute this form on behalf of the tax-
payer(s).
THIS APPOINTMENT OF TAXPAYER REPRESENTATIVE IS VOID IF NOT SIGNED AND DATED
________________________________
_______________
________________________________
Taxpayer Signature
Date
Title (if applicable)
______________________________________________________
Print Name
________________________________
_______________
________________________________
Taxpayer Signature
Date
Title (if applicable)
______________________________________________________
Print Name
8. Acceptance of Representation and Signature
I/We hereby accept appointment as representatives(s) for taxpayer(s) who has/have executed this Appointment of
Taxpayer Representative.
________________________________
_______________
________________________________
Representative Signature
Date
Title (if applicable)
______________________________________________________
Print Name
________________________________
_______________
________________________________
Representative Signature
Date
Title (if applicable)
______________________________________________________
Print Name
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