Form N-848 - Power Of Attorney
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FORM
STATE OF HAWAII - DEPARTMENT OF TAXATION
N-848
POWER OF ATTORNEY
(REV. 2012)
(NOTE: References to “married”, “unmarried”, and “spouse” also means
“in a civil union”, “not in a civil union”, and “civil union partner”, respectively.)
PART I
POWER OF ATTORNEY (Please type or print.)
1 Taxpayer Information. Taxpayer(s) must sign and date this form on page 2, line 6.
Taxpayer name(s) and address (Please type or print.)
Social security number(s)
Federal employer
identification number
Daytime telephone number
Fax number
(
)
(
)
E-mail address
hereby appoint(s) the following representative(s) as attorney(s)-in-fact:
2 Representative(s) must sign and date this form on page 2, Part II.
Individual name and address
Telephone No. (
)
Fax No. (
)
E-mail address
Check if new: Address
Telephone
Fax
E-mail
Individual name and address
Telephone No. (
)
Fax No. (
)
E-mail address
Check if new: Address
Telephone
Fax
E-mail
Individual name and address
Telephone No. (
)
Fax No. (
)
E-mail address
Check if new: Address
Telephone
Fax
E-mail
Individual name and address
Telephone No. (
)
Fax No. (
)
E-mail address
Check if new: Address
Telephone
Fax
E-mail
to represent the taxpayer(s) before the Department of Taxation, State of Hawaii, for the following tax matters:
3 Tax Matters
Hawaii Tax I.D. Number
Type of Tax
Tax Form Number
Year(s) or Period(s)
(Income, General Excise, etc.)
(N-11, N-13, G-49, etc.)
W __ __ __ __ __ __ __ __ - __ __
W __ __ __ __ __ __ __ __ - __ __
W __ __ __ __ __ __ __ __ - __ __
W __ __ __ __ __ __ __ __ - __ __
4 Acts Authorized.—The representatives are authorized to receive and inspect confidential tax information and to perform any and all acts that
I (we) can perform with respect to the tax matters described on line 3, for example, the authority to sign any agreements, consents, tax clearance
applications, or other documents. The authority does not include the power to receive refund checks, the power to substitute another representative,
the power to sign certain returns, or the power to execute a request for disclosure of tax returns or return information to a third party.
List any specific additions or deletions to the acts otherwise authorized in this power of attorney:
FORM N-848
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