PARTNERSHIP
CORPORATION
LIMITED LIABILITY COMPANY
Employment Development Department
BOE-392 (FRONT) REV. 9 (3-11)
STATE OF CALIFORNIA
POWER OF ATTORNEY
BOARD OF EQUALIZATION
FRANCHISE TAX BOARD
EMPLOYMENT DEVELOPMENT DEPARTMENT
Check below to indicate the appropriate agency. Please note that a separate form must be completed and provided to each agency checked.
STATE BOARD OF EQUALIZATION
FRANCHISE TAx BOARD
EMPLOYMENT DEVELOPMENT DEPARTMENT
PO BOx 942879
PO BOx 2828 MS F283
PO BOx 826880 MIC 28
SACRAMENTO CA 94279-0001
RANCHO CORDOVA CA 95741-2828
SACRAMENTO CA 94280-0001
800-400-7115
FAx 916-843-5440
916-654-7263 • FAx 916-654-9211
TAXPAYER’S NAME
BUSINESS OR CORPORATION NAME
TELEPHONE NUMBER
FAX NUMBER
(
)
(
)
SOCIAL SECURITY NUMBER
FEDERAL EMPLOYER IDENTIFICATION NUMBER(S)
CALIFORNIA SECRETARY OF STATE NUMBER(S)
BOARD OF EQUALIZATION ACCOUNT/PERMIT(S)
EDD EMPLOYER ACCOUNT NUMBER
MAILING ADDRESS (Number and Street, City, State, ZIP Code)
INDIVIDUAL
OTHER
As owner, officer, receiver, administrator, or trustee for the taxpayer, or as a party to the tax or fee matter before the:
State Board of Equalization
Franchise Tax Board
I hereby appoint: [enter below the individual appointee(s) name(s), address(es) (including ZIP Code), telephone number(s) and fax number(s)
– do not enter names of accounting or law firms, partnerships, corporations, etc., as the appointee name]
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APPOINTEE NAME
APPOINTEE NAME
APPOINTEE BUSINESS NAME (If applicable)
APPOINTEE BUSINESS NAME (If applicable)
APPOINTEE ADDRESS (Number and Street)
APPOINTEE ADDRESS (Number and Street)
(City)
(State)
(ZIP Code)
(City)
(State)
(ZIP Code)
TELEPHONE NUMBER
FAX NUMBER
TELEPHONE NUMBER
FAX NUMBER
(
)
(
)
(
)
(
)
As attorney(s)-in-fact to represent the taxpayer(s) for the following tax or fee matters: [specify type(s) of tax]
Franchise and Income Tax Law
Payroll Tax Law
Sales and Use Tax Law
Benefit Reporting
Use Fuel Tax Law
Other:
SPECIFY THE TAx OR FEE YEAR(S) OR PERIOD(S) [IF ESTATE TAx, INDICATE DATE OF DEATH] (for Board of Equalization and Franchise Tax Board purposes)
The attorney(s)-in-fact (or any of them) are authorized, subject to revocation, to receive confidential tax information and to
perform on behalf of the taxpayer(s) the following acts for the tax or fee matters described above: [check the box(es) for the
powers granted]
General Authorization (including all acts described below).
Specific Authorization (selected acts described below).
To confer and resolve any assessment, claim or collection of a deficiency or other tax or fee matter pending before the
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identified agency and attend any meetings or hearings thereto for the specified law identified above.
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To receive, but not to endorse and collect, checks in payment of any refund of taxes, penalties or interest.
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To execute petitions, claims for refund and/or amendments thereto.
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To execute consents extending the statutory period for assessment or determination of taxes.
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To execute closing agreements under section 19441 of the California Revenue and Taxation Code.
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To execute settlement agreements under section 19442 of the California Revenue and Taxation Code.
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(The back of this form must be completed)