GRANT OF SIGNATURE AUTHORITY
for
Preparation and Electronic Filing of IRS Forms 1099
I (we); ___________________________________
With taxpayer ID #; ________________________
Located at; _______________________________________________
Do hereby grant Conlon and Company, CPA’s, PLLC (you) the following:
1) I (we) ask you to prepare for us our required information returns such as form 1099. I
(we) agree to provide you with full, complete and accurate information.
2) I (we) ask you to electronically file any information returns that I (we) have hired you to
prepare, therefore I (we) grant you signature authority to sign on our behalf any form
1096 or similar form used to transmit information returns to the Internal Revenue
Service such as form 1099 based on the information that I (we) will provide you. I (we)
understand that we are ultimately responsible for the information filed and I (we) agree
to check the information before I (we) authorize filing.
3) I (we) grant you the right to receive confidential information form the IRS concerning
the processing of the electronically filed information returns.
4) I (we) do NOT grant you the authority to sign on our behalf any other type of returns
including income tax returns such as forms 1040, 1065, 1120 or 1120S.
I (we) do NOT grant you Power of Attorney in any matter not related to the filing of
information returns.
5) I (we) understand that I (we) must provide you with any corrections before February
th
15
in order for the corrections to be included on the originally filed return. I (we)
understand that any corrections that do not result from the error of Conlon and
Company, CPS’s, PLLC may incur additional charges. I (we) understand that any
th
corrections received after February 15
may require an amended return for an
additional fee.
I, the undersigned, certify that I am authorized to sign IRS form 1096 as an owner or
authorized officer, partner, or trustee of this company and that I have authority to grant you
the powers contained in this document.
___________________________________
Print Name
X ___________________________________ Date _____________
Authorized Signature
____________________________________
Title