Fillable Printable Department of Taxation Power of Attorney - Nevada

Department of Taxation Power of Attorney - Nevada

TP0019 7/12

 Taxpay

copy

 State copy

 Client copy

Nevada Department of Taxation

(MBT) Power of Attorney

Know all men by these presents:

That , having its principal

office at

, does hereby constitute and appoint

Paychex, Inc.

1175 John Street

West Henrietta, NY 14586

its true and lawful attorney in fact with full power and authority to represent the said

before Nevada Department of Taxation until further notice in the following matters:

1. The presenting of completed forms for the filing and payment.

2. The obtaining of such account information as is permissible.

The legal mailing address of the undersigned shall remain the same. The undersigned will

continue to receive all correspondence and remain record of address.

This authorization cancels and supersedes all prior authorizations.

Signature of authorized officer(s):

Print Name

Date / /

Signature

Notary Public:

Date / /

(Witness)