Please complete the following information:
- the top portion regarding your business information
- The employer will need to sign at the bottom of the form
If you have any questions please call (877)-328-6505, and ask for Tax and Compliance.
You may send completed power of attorney forms by scan and email through a help desk ticket to firstname.lastname@example.org.
**Please complete and fax/scan/email a completed power of attorney form for each state that your company currently has a tax obligation for. Ex: If you are located in both Florida and Georgia, please completed and return a power of attorney for each state.**