___________________________________________________
STATE OF TEXAS §
§
COUNTY OF __________________ §
LIMITED POWER OF ATTORNEY
I, __________________________________________ , ________________________________ , hereby appoint
TITLE
Name: _____________________________________________________________________
Address: ___________________________________________________________________
City, State and
ZIP code: ___________________________________________________________________
Phone E-mail
(Area code & number): ___________________________ address: ________________________________
as Agent and attorney acting on behalf of ____________________________________________________ , Texas
Taxpayer No. __________________________ for the tax type _________________________________________
covering the periods ____________________________________ for the following limited and special purposes:
To provide information as requested for the purpose of my tax audit(s).
To discuss relevant issues pertaining to my tax audit(s).
To receive mail from the Comptroller regarding my tax audit(s) and/or contested case(s).
To enter into a written agreement extending the period of limitation during which the tax may be assessed,
accept a notification of the 60 day requirement to obtain records and/or certificates, and accept a notification
of sampling procedure. (This would normally be an officer of a corporation, a partner, or owner.)
To provide representation and make oral and written presentations of fact or argument related to my contested
case(s).
I grant the above named AGENT full power to substitute one or more attorneys or other representatives to
carry out the powers and duties specified above.
Entity name: _________________________________________
Authorized
Representative: _______________________________________
PRINT
Title ________________________________________________
Date ____________________________
Form 86-113 (11-07)
