Fillable Printable Form DP-2848 Power of Attorney - New Hampshire
Fillable Printable Form DP-2848 Power of Attorney - New Hampshire
Form DP-2848 Power of Attorney - New Hampshire
[pg 33]
FORM
DP-2848
NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
POWER OF ATTORNEY (POA)
SECTION 1 Name, address including ZIP code+4 and identifying number of taxpayer(s):
SECTION 2 I/We hereby appoint [name, address including ZIP code+4 and telephone number of appointee(s)]:
SECTION 3 As attorney(s)-in-fact to represent the taxpayer(s) before the Department of Revenue Administration of the State of New Hampshire with
respect to:
SECTION 6, PART A SIGNATURE (IN INK) OF THE TAXPAYER(S): If signed by a corporate offi cer or fi duciary on behalf of the taxpayer, I certify
that I have the authority to execute this power of attorney on behalf of the taxpayer.
SECTION 6, PART B IF THE POWER OF ATTORNEY IS GRANTED T O A PERSON OTHER THAN AN ATT ORNEY, CERTIFIED
PUBLIC ACCOUNTANT OR THE PREPARER OF SUBJECT TAX RETURN(S), IT MUST BE WITNESSED BELOW.
SECTION 5 This power of attorney revokes all prior powers of attorney relating to the above taxable period except:
Said attorney(s)-in-fact shall, subject to revocation, have authority to receive confi dential information and full power to perform on behalf of the
taxpayer(s) all acts necessary with respect to above tax matters.
DP-2848
Rev 09/2010
The person signing as or for the taxpayer(s) is known to and signed (in ink) in the presence of the two disinterested witnesses
whose signatures appear here:
Witness Signature (in ink) Date Witness Signature (in Ink) Date
Said attorney(s)-in-fact shall, subject to revocation, have authority to receive or inspect confi dential tax information only.
SECTION 4 - MUST BE CHECKED
Signature (in ink) Title Date
x
Mail To: NH DRA, Audit Division, PO Box 457, Concord, NH 03302-0457
FOR DRA USE ONLY
NOTE
All applicable items must be fi lled in to properly complete Form DP-2848
New Hampshire Power of Attorney. An incomplete form will prohibit direct
communication between the Department and the appointee.
SECTION 1
Enter the complete taxpayer's name, address including ZIP code+4,
and federal identifi cation number, social security number or Department
identifi cation number if appropriate. Any DRA issued license or registration
number of the taxpayer should also be included in this section.
SECTION 2
Enter the name, address, including ZIP code+4 and telephone number
of the appointee. If the name of a fi rm is indicated, then the Department
will be authorized to correspond directly with anyone in that fi rm. If an
individual(s) is indicated, the Department will be authorized to correspond
directly with the individual(s) named only. A fi rm name that is part of an
individual's address does not mean that the employees of the fi rm can
represent the taxpayer.
SECTION 3
A brief description or listing of the returns and/or tax matters at issue.
Example: 2006 and 2007 New Hampshire Corporation Business Tax
Returns, 2007 New Hampshire Interest & Dividends Tax Return, or All
New Hampshire tax matters, etc.
SECTION 4
One of the two boxes MUST BE CHECKED. The fi rst box should be
checked if the taxpayer wants the representative to be able to receive
confi dential information as well as perform on behalf of the taxpayer for
all acts necessary for the tax matters at issue. The second box should
be checked if the taxpayer wants the representative to be able to receive
confi dential information only.
SECTION 5
This Power of Attorney form will revoke all prior power of attorney
authorizations relating to the specifi c tax matters referenced in section
3 above, unless prior appointees are excepted here. If a prior POA was
completed for a CPA and the taxpayer completes a second POA to add
an attorney, the prior POA will automatically be revoked unless the CPA's
name is again entered in this section.
SECTION 6 PART A
The taxpayer is required to sign, in ink, and date the POA. The original
signed form POA must be sent to the Department at the address below.
SECTION 6 PART B
If the appointee is someone other than a CP A, an attorney, or the preparer
of the subject tax returns, the form needs to be signed, in ink, and dated by
two witnesses. The original signed POA should be mailed to the address
below.
NEED HELP?
Any questions regarding completion of Form DP-2848 Power of Attorney should be directed to: Central Taxpayer Services at: (603) 271-2191. Individuals
with hearing or speech impairments may call TDD Access: Relay NH 1-800-735-2964.
