Ets Form 150 - Excise Tax Division, State Of Wyoming - Limited Power Of Attorney
Download a blank fillable Ets Form 150 - Excise Tax Division, State Of Wyoming - Limited Power Of Attorney in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Ets Form 150 - Excise Tax Division, State Of Wyoming - Limited Power Of Attorney with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2State of Wyoming
D
R
EPARTMENT OF
EVENUE
D
F
, Governor
122 West 25th Street, 2-West, Cheyenne, Wyoming 82002-0110
AVE
REUDENTHAL
E
J. S
, Director
Telephone: (307) 777-7961
Web:
E-mail:dor@wy.gov
DMUND
CHMIDT
Administration Fax (307)777-7722
Ad Valorem Division Fax (307)777-7722
Excise Division Fax (307)777-3632
Mineral Division Fax (307)777-7849
Liquor Division Fax (307)777-6255
Excise Tax Division
Limited Power of Attorney
Sales/Use Tax License Number:
Revenue Identification Number:
Business’’/Owner’’s/Taxpayer’’s Name:
Mailing Address:
TO WHOM IT MAY CONCERN: I/We have appointed
as our agent to represent the above mentioned taxpayer before the Wyoming Excise Tax
Department for the following excise tax matters until further notice:
Tax Type (Sales, Use, Estate,
Document Requested (Tax returns - specify
Year(s) or
Cigarette, etc.)
form #, written determinations, notices, etc.)
Period(s)
I declare under penalty of perjury that I have the authority to sign this limited power of attorney
for the above mentioned taxpayer:
Authorized by:
Title:
(Individual Business –– Owner; Corporation –– Major Officer;
Partnership –– Partner; LLC or LLP –– Member or Manager)
Phone Number:
Date:
The foregoing document was acknowledged before me by
this
day of
, 20
.
Witness my hand and official seal,
(Notary Public). My commission expires
.
Return signed original to: Wyoming Department of Revenue
For questions, please call:
Excise Tax Division, Herschler Bldg.
307-777-5200
th
nd
122 W. 25
St., 2
Floor West
Cheyenne, WY 82002-0110
Effective 09/23/04
ETS Form 150
ADVERTISEMENT
0 votes
Related Articles
Related forms
Ets Form 120 - Subcontractor Information Report - State Of Wyoming - The Department Of Revenue - Excise Tax Division
Financial
Form Rv-f1303601 - Application For Franchise, Excise Tax Registration - State Of Tennessee
Financial
Related Categories
Parent category: Legal