Form Boe-392 - Power Of Attorney Page 2
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2BOE-392 (BACK) REV. 9 (3-11)
To represent the taxpayer for changes to their mailing address for any and all Payroll Tax Law, Benefit Reporting, both
Payroll Tax Law and Benefit Reporting.
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To execute settlement agreements under section 1236 of the California Unemployment Insurance Code.
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To delegate authority or to substitute another representative.
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Other acts (specify):
Franchise Tax Board (FTB) will send you and your first representative listed a copy of FTB computer generated notices as they
become available.
Check this box if you do not want FTB to send copies of available FTB computer generated notices to your first
representative listed.
(Note: Not all FTB processing systems are capable of generating representative copies at this time.)
This Power of Attorney revokes all earlier Power(s) of Attorney on file with the California State Board of Equalization,
the Employment Development Department, or the Franchise Tax Board as identified above for the same matters and years or
periods covered by this form, except for the following: [specify to whom granted, date and address, or refer to attached copies of
earlier power(s)]
NAME
DATE POWER OF ATTORNEY GRANTED
ADDRESS (Number and Street, City, State, ZIP Code)
Unless limited, this Power of Attorney will remain in effect until the final resolution of all tax matters specified herein.
[specify expiration date if limited term]
TIME LIMIT/ExPIRATION DATE (for Board of Equalization and Franchise Tax Board purposes)
Signature of Taxpayer(s)—If a tax matter concerns a joint return, both spouses must sign if joint representation is requested. If you
are a corporate officer, partner, guardian, tax matters partner/person, executor, receiver, registered domestic partner, administrator,
or trustee on behalf of the taxpayer, by signing this Power of Attorney you are certifying that you have the authority to execute this
form on behalf of the taxpayer.
IF THIS POWER OF ATTORNEY IS NOT SIGNED AND DATED BY AN AUTHORIZED INDIVIDUAL, IT WILL BE RETURNED AS INVALID.
SIGNATURE
TITLE (If applicable)
DATE
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PRINT NAME
TELEPHONE
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)
SIGNATURE
TITLE (If applicable)
DATE
-
PRINT NAME
TELEPHONE
(
)
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