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                     AKRON  CITY  INCOME  TAX 

                                          POWER  OF  ATTORNEY 
                    (This form also valid for use with Akron-JEDDs) 
 
        Business name & Tax account #___________________________________ 
 
        I, ___________________________________, hereby grant Power of Attorney to  
 
        ________________________________________________________________ 
        concerning my         Akron         Akron-JEDD  income tax matters.  This Power of 
        Attorney   will  remain  in  effect  until revoked by me, and covers all pertinent  tax 
        information unless limited by the specific items listed below. 
         
         I wish to limit this Power of Attorney to the following income tax items or years: 
         
        The original of this form, along with original signatures, must be submitted to the 
        tax office.   We will not accept fax copies or scanned, emailed copies. 
         
         TAXPAYER   SIGNATURE                                                                             TITLE (IF FOR BUSINESS)                                                                                               DATE 

           SPOUSE   SIGNATURE  (IF JOINT ACCOUNT)                                                                                                                                                                                      DATE 
         
          PREPARER   SIGNATURE    -  REQUIRED                                                              TITLE                                                                                                       PREPARER PHONE # 
         
           PREPARER  MAILING  ADDRESS                                                                                                        CITY                                                              STATE                         ZIP 
         
                  TAX  OFFICE  USE         Approved by ____________    Date ___________ 

         TYPE ALL REQUIRED INFORMATION AND PRINT FORM PRIOR TO OBTAINING SIGNATURES.

         Mail Form To: Income Tax Division * 1 Cascade Plaza - Suite 100 * Akron, OH 44308

                                                                                          11/2009






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