OES-190T (Rev.4-07) 
 
                      OKLAHOMA EMPLOYMENT SECURITY COMMISSION 
                                     POWER OF ATTORNEY – TAX 
                                             
I, ___________________________________, am the owner or officer  with authority to contract for 
__________________________________________________________________________________________, 
Oklahoma Account #_____________________________, Federal ID #_________________________________. 
                                             
I hereby appoint: 
 
 Name:                       ____________________________________ 
 Address:                    ____________________________________ 
 City, State, and Zip:       ____________________________________ 
 Telephone No.:              ____________________________________ 
 Fax No.:                    ____________________________________ 
 
As attorney-in-fact to represent the above-named taxpayer before the Oklahoma  Employment Security 
Commission with respect to all unemployment insurance tax matters and issues arising pursuant to Article III of 
the Employment Security Act of 1980.  This Power of Attorney shall be effective immediately and shall remain in 
effect until the Oklahoma  Employment  Security Commission  receives notice  of its revocation.  A notice of a 
revocation of a Power of Attorney or a notice of change of address must be in a separate writing and mailed to the 
Oklahoma Employment Security Commission at P.O. Box 52003, Oklahoma City, OK  73152-2003.  The attorney-
in-fact is authorized to receive all confidential information pertaining to the taxpayer’s unemployment insurance 
tax account.  This Power of Attorney removes all earlier Powers of Attorney previously granted by the taxpayer for 
unemployment insurance tax purposes. 
 
____________________________________        ________________________________________
Date       Signature 
                                            ________________________________________
       Printed Name 
                                            ________________________________________
       Title 
 
                                     ACKNOWLEDGMENT 
                                             
State of __________________) 
     )   SS. 
County of ________________) 
 
 Before me, the undersigned, a notary public in and for this county and state, personally appeared 
___________________________ and acknowledged to me that he/she executed the above instrument in his/her 
official capacity as the free and voluntary act and deed of himself/herself and the taxpayer. 
 In witness of this  fact, I signed this  document  and  affixed my official seal on 
________________________________, ________. 
 
Official Seal with Commission Number 
And Expiration Date:          
                                            _____________________________________________
               Notary Public 

 RESET FORM

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