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District of Columbia Tax Power of Attorney Form 1

District of Columbia Tax Power of Attorney Form 1
District of Columbia Tax Power of Attorney Form 1
Government of the
District of Columbia
D-2848 Power of Attorney and
Declaration of Representation
Personal information
Your first name, M.I., Last name for individual or Business name for business
Spouses first name, M.I., Last name for individual
Your SSN or EIN for business Spouse’s SSN Your daytime phone number
Home address (number and street) or business address Apartment number
City State Zip code
Revised 11/2005
OFFICIAL USE ONLY
Representative(s) This Power of Attorney will not be valid unless the Representative(s) complete the Declaration of Represen-
tative, sign and date this form on page 2.
hereby appoint(s) the following representative(s) as attorney(s)-in-fact:
Name and address EIN/SSN
Telephone No.
Fax No.
Name and address EIN/SSN
Telephone No.
Fax No.
E-mail address
Tax matters
Type of Tax Income, Sales, etc Tax Form Years or Periods
Acts authorized The representatives are authorized to represent the taxpayer(s) before the Office of Tax and Revenue
for the tax matters listed above, to receive and inspect confidential tax information and to perform any and all acts
that I (we) can perform (for example, the authority to sign any agreements, consents, or other documents). This
authority does not include the power to receive or cash refund checks. If you wish to grant this authority to your
authorized representative, please state this below. List any specific additions or deletions to the acts otherwise
authorized by this power of attorney:
D-2848 Page 1
E-mail address
Notices and communications Original notices and other written communications will be sent to you and a copy to
the first representative listed unless you check the oval below.
If you do not want any notices or communications sent to your first representative, check here:
District of Columbia Tax Power of Attorney Form 1
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