Power of Attorney: WWW - Ftb.ca - Gov
Power of Attorney: WWW - Ftb.ca - Gov
Power of Attorney: WWW - Ftb.ca - Gov
STATE OF CALIFORNIA
FRANCHISE TAX BOARD POWER OF ATTORNEY
PO BOX 2828 DECLARATION FOR THE FRANCHISE TAX BOARD
RANCHO CORDOVA CA 95741-2828
FAX NUMBER: (916) 845-0523
This Power of Attorney Declaration remains in effect until you resolve the matters specified on it, or until you
revoke it.
We provide instructions for completing this form on pages 3 and 4. For more information about a power of attorney, visit
www.ftb.ca.gov, then type POA in the Search field. Or see publication Power of Attorney (FTB 1144).
- - SOS #:
Check if new Daytime Telephone #:
address FEIN:
Spouse/RDP’s address, if different ( ) -
Note: You must complete and attach page 5 if this power of attorney applies to the combined reporting of
multiple corporations.
Telephone #: ( ) -
Fax #: ( ) -
Telephone # ( ) -
Fax #: ( ) -
5. Acts authorized
You authorize your representative as an attorney-in-fact to:
• Receive and inspect your confidential tax information.
• Perform any actions you might perform to resolve your issues with us – such as signing agreements, consents, or
other documents.
The authority granted does not include the power to receive refund checks, the power to substitute another
representative, or the power to sign certain tax returns – unless you specify otherwise in section 6.
1
RDP refers to a registered domestic partner or partnership.
Print Name
Print Name
Print Name
Important Information
• Power of Attorney Declarations do not need to be notarized.
• It is illegal to forge another person’s signature.
• We will return this Power of Attorney Declaration to you if it is not signed and dated.
• Retain a copy of this Power of Attorney Declaration for your files.
• Mail or fax this declaration to the respective address or fax number listed on top of page 1 on this form.
You must complete this authorization schedule and attach it to FTB 3520 if this power of attorney applies to the combined
reporting of multiple corporations. Provide information for each corporation that this Power of Attorney Declaration is
executed on behalf of.
List the individual who signs the Power of Attorney Declaration as a common corporate officer, receiver, administrator, or
trustee for each of the taxpayers listed below.
SOS #:
FEIN:
Telephone #: ( ) -
Name of Grantor’s Authorized Individual – Required
Title of Signatory
SOS #:
FEIN:
Telephone #: ( ) -
Name of Grantor’s Authorized Individual – Required
Title of Signatory
SOS #:
FEIN:
Telephone #: ( ) -
Name of Grantor’s Authorized Individual – Required
Title of Signatory
SOS #:
FEIN:
Telephone #: ( ) -
Name of Grantor’s Authorized Individual – Required
Title of Signatory