Power Of Attorney Form

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POWER OF ATTORNEY
Know all men by these present that I, __________________________________, in the County of
(Owner or officer of corporation)
________________________, in the City of ___________________, in the State of _________________,
do hereby make, constitute and appoint ______________________________________, my true and lawful
attorney in fact to appear for me and represent me before the Board of County Commissioners or the Board
of Equalization and Review in the County of Burke in connection with any matter involving the ad valorem
taxation of the property described below. I grant unto said attorney in fact the full power and authority to
appeal the property tax value assigned by the County to the described property, and the power to make full
and complete settlement or other disposition of the matter. I hereby authorize the said County to disclose to
my attorney in fact all information used by the County in connection with the listings, appraisal, or
assessment of the said property, including specifically information of a confidential nature.
I understand that the property tax value of any property appealed to this board may be lowered, left
unchanged, or increased as a result of the appeal.
I also understand that my attorney in fact, unless he is an attorney at law authorized to practice in the State
of North Carolina, will not be allowed to file a notice of appeal with the Property Tax Commission and
will not be allowed to represent me at any hearing to be held before the North Carolina Property Tax
Commission, for such representation would constitute the unauthorized practice of law.
The specific property which my attorney in fact is authorized to appeal is described as follows:
_____________________________________________________________________________________
_____________________________________________________________________________________
NOTE: PLEASE USE THE PROPERTY TAX PARCEL IDENTIFICATION NUMBER(S)
FOR REAL PROPERTY; PERSONAL PROPERTY SHOULD BE DESCRIBED AS CLEARLY
AS POSSIBLE. ATTACH ADDITIONAL INFORMATION SHEETS IF NECESSARY.
I am the record owner of the property described above. YES NO (Circle One), if No, please identify the
record owner and state the relationship between the record owner and the person executing the power of
attorney. _____________________________________________________________________________
Witness my hand this ________ day of _______________, _______.
___________________________________
Signature of owner or officer of corporation
___________________________________
Name (please print)
___________________________________
Full title of officer of corporation
STATE OF ________________________
COUNTY OF ______________________
The foregoing instrument was duly acknowledged before me by __________________________________
for the uses and purposes therein expressed.
Witness by hand and Notarial Seal, this
_____ day of ________________, ______.
___________________________________
Revised 1/10/06
Notary Public
My Commission Expires: ______________

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