Form M-2848 - Power Of Attorney And Declaration Of Representative Page 4

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If you are signing the power of attorney for a taxpayer who is not an indi-
vidual, such as a corporation or trust, please type or print your name on
the line below the signature line at the bottom of the form.
F. Notarizing or witnessing the power of attorney. A notary public or
two individuals with no stake in the tax matter must witness a power of at-
torney unless it is granted to an attorney, certified public accountant, public
accountant or enrolled agent.
Part 2. Declaration of Representative
Your representative must complete Part 2 to make a declaration containing
the following:
1. A statement that the representative is authorized to represent you as a
certified public accountant, public accountant, attorney, enrolled agent,
member of your immediate family, etc. If entering “eight” in the “designation”
column, attach a statement indicating your relationship to the taxpayer.
2. The jurisdiction recognizing the representative, if applicable. For an attor -
ney, certified public accountant or public accountant: Enter in the “jurisdic-
tion” column the name of the state, possession, territory, commonwealth
or District of Columbia that has granted the declared professional recogni-
tion. For an enrolled agent: Enter the enrollment card number in the “juris-
diction” column.
3. The signature of the representative and the date signed.

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