Form Boe-892 - Statement Of Authorization - 2013
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1BOE-892 REV. 19 (12-12)
STATE OF CALIFORNIA
STATEMENT OF AUTHORIZATION
BOARD OF EQUALIZATION
2013
Please return completed form to the State-Assessed Properties Division, Board of Equalization, P.O. Box 942879, Sacramento,
CA 94279-0061. If you have any questions, you may contact us at 1-916-274-3270
SBE NO.
COMPANY NAME
ADDRESS
CITY
STATE
ZIP
DESIGNATED REPRESENTATIVE
EMAIL ADDRESS
ADDRESS
CITY
STATE
ZIP
TELEPHONE NUMBER
FAX NUMBER
(
)
(
)
Please be advised that the person listed above is authorized to act as our designated representative before the California State
Board of Equalization in connection with the assessment of our property. Our designated representative may inspect or copy
all information, documents, and records, including narrations and workpapers relating to the appraisal and the assessment of
our property during the period January 1, 2013, through December 31, 2013, for the lien date 2013. I understand that this form
must be filed annually in order for the representative status to remain current.
OWNER, PARTNER OR OFFICER’S SIGNATURE
DATE
SIGNATORY’S PRINTED NAME
TITLE
CLEAR
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Parent category: Financial