BOE-392 (FRONT) REV. 6 (11-01)
STATE OF CALIFORNIA
POWER OF ATTORNEY
BOARD OF EQUALIZATION
FRANCHISE TAX BOARD
Check below to indicate the appropriate agency. Please note that a separate form must be completed and provided to each agency checked. For Franchise
Tax Board purposes, this form or Form FTB 3520 (REV. 07-2001) is used to designate a representative.
STATE BOARD OF EQUALIZATION
FRANCHISE TAX BOARD
PO BOX 942879
PO BOX 2828
SACRAMENTO CA 94279-0001
RANCHO CORDOVA CA 95741-2828
FAX (916) 845-0523
TAXPAYER’S NAME
TELEPHONE NUMBER
SOCIAL SECURITY OR FEDERAL EMPLOYER IDENTIFICATION NUMBERS
CALIFORNIA SECRETARY OF STATE NUMBERS
(See Form BOE-324-A, for SS Number disclosure information.)
BOARD OF EQUALIZATION ACCOUNT/PERMITS
MAILING ADDRESS
(Street & Number)
(City)
(State)
(Zip Code)
INDIVIDUAL
PARTNERSHIP
CORPORATION
_____________________________________________
OTHER
As owner, officer, receiver, administrator, or trustee for the taxpayer, or as a party to the tax or fee matter before the
State Board of Equalization
Franchise Tax Board
I hereby appoint: [enter below the names, addresses (including zip codes), telephone numbers and FAX numbers of
individual appointees. Do not enter names of accounting or law firms, partnerships, corporations, etc.]
APPOINTEE NAMES
APPOINTEE NAMES
APPOINTEE ADDRESS (Street & Number)
APPOINTEE ADDRESS (Street & Number)
(City)
(State)
(Zip Code)
(City)
(State)
(Zip Code)
TELEPHONE NUMBER
FAX NUMBER
TELEPHONE NUMBER
FAX NUMBER
As attorneys-in-fact to represent the taxpayers
SPECIFY THE TAX OR FEE YEARS OR PERIODS [IF ESTATE TAX, INDICATE DATE OF DEATH]:
The attorneys-in-fact (or any of them) are authorized, subject to revocation, to receive confidential tax information and
to perform on behalf of the taxpayers the following acts for the tax or fee matters described above: [Check the box(es)
for the powers granted.]
General Authorization (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 of the California Revenue & Taxation Code under section 19441
To delegate authority or to substitute another representative
Other acts (specify): ___________________________________________________________________________
(The back of this form must be completed.)