BOE-392 - California Power of Attorney Form

BOE-392 (FRONT) REV. 9 (3-11)
POWER OF ATTORNEY
STATE OF CALIFORNIA
BOARD OF EQUALIZATION
FRANCHISE TAX BOARD
EMPLOYMENT DEVELOPMENT DEPARTMENT
Check below to indicate the appropriate agency. Please note that a separate form must be completed and provided to each agency checked.
STATE BOARD OF EQUALIZATION 
PO BOx 942879
SACRAMENTO CA 94279-0001
800-400-7115
FRANCHISE TAx BOARD
PO BOx 2828 MS F283
RANCHO CORDOVACA 95741-2828
FAx 916-843-5440
EMPLOYMENT DEVELOPMENT DEPARTMENT
PO BOx 826880 MIC 28
SACRAMENTO CA 94280-0001
916-654-7263  •  FAx 916-654-9211
TAXPAYER’S NAME
BUSINESS OR CORPORATION NAME
TELEPHONE NUMBER
( )
FAX NUMBER
( )
SOCIAL SECURITY NUMBER FEDERAL EMPLOYER IDENTIFICATION NUMBER(S) CALIFORNIA SECRETARY OF STATE NUMBER(S)
BOARD OF EQUALIZATION ACCOUNT/PERMIT(S) EDD EMPLOYER ACCOUNT NUMBER
MAILING ADDRESS (Number and Street, City, State, ZIP Code)
INDIVIDUAL PARTNERSHIP CORPORATION LIMITED LIABILITY COMPANY
OTHER
As owner, officer, receiver, administrator, or trustee for the taxpayer, or as a party to the tax or fee matter before the:
State Boardof Equalization FranchiseTax Board Employment Development Department
Ihereby appoint: [enter below the individual appointee(s) name(s), address(es) (including ZIP Code), telephone number(s) and fax number(s)
– do not enter names of accounting or law firms, partnerships, corporations, etc., as the appointee name]
APPOINTEE NAME
APPOINTEE BUSINESS NAME (If applicable)
APPOINTEE ADDRESS (Number and Street)
(City) (State) (ZIP Code)
TELEPHONE NUMBER
( )
FAX NUMBER
( )
APPOINTEE NAME
APPOINTEE BUSINESS NAME (If applicable)
APPOINTEE ADDRESS (Number and Street)
(City) (State) (ZIP Code)
TELEPHONE NUMBER
( )
FAX NUMBER
( )
As attorney(s)-in-facttorepresentthe taxpayer(s)forthe followingtaxorfee matters: [specify type(s) of tax]
Franchise and Income Tax Law
Sales and Use Tax Law
Use Fuel Tax Law
Payroll Tax Law
Benefit Reporting
Other
:
SPECIFY THE TAx OR FEE YEAR(S) OR PERIOD(S)[IF ESTATE TAx, INDICATE DATE OF DEATH](for Boardof Equalization and FranchiseTax Boardpurposes)
The attorney(s)-in-fact (or any of them) are authorized, subject to revocation, to receive confidential tax information and to
perform on behalf of the taxpayer(s) the following acts for the tax or fee matters described above: [check the box(es) for the
powers granted]
General Authorization (including all acts described below).
Specific Authorization (selected acts described below).
To confer and resolve any assessment, claim or collection of a deficiency or other tax or fee matter pending before the
identified agency and attend any meetings or hearings thereto for the specified law identified above.
To receive, but not to endorse and collect, checks in payment of any refund of taxes, penalties or interest.
To execute petitions, claims for refund and/or amendments thereto.
To execute consents extending the statutory period for assessment or determination of taxes.
To execute closing agreements under section 19441 of the California Revenue and Taxation Code.
To execute settlement agreements under section 19442 of the California Revenue and Taxation Code.
(The back of this form must be completed)
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BOE-392 - California Power of Attorney Form PDF

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