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RESET FORM PRINT FORM
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 - 11th FL * Akron, OH 44308
11/2009
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