Fillable POWER OF ATTORNEY THAT D elaware Division of (ADP)

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POWER OF ATTORNEY THAT D elaware Division of (ADP)

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POWER OF ATTORNEY
THAT
:
Employer Name
a corporation, sole proprietorship, partnership, LLC, LLP, trust
Account #
FEIN #
(circle one)
with address:
does hereby constitute and appoint
it’s true and lawful attorney in fact with full power and authority to represent the said business entity before the:
D
elaware Division of Unemployment Insurance
until further notice in the following matters, to wit:
☐
The presenting of completed forms, including claims for refund or adjustment of account, employer’s protest of benefit claims,
and information relative hereto.
☐ The payment of contributions.
☐ The obtaining of such information as is permissible.
☐ All matters affecting merit rating.
☐ Participates in SIDES.
☐ Access to file reports electronically.
☐
Change of the official mailing address to:
☐ The personal discussion of any or all of the foregoing with proper officials of:
Delaware Division of Unemployment Insurance
THIS AUTHORIZATION CANCELS AND SUPERSEDES ALL PRIOR POWERS OF ATTORNEY. THIS POWER OF ATTORNEY
CAN BE CANCELLED BY THE BUSINESS ENTITY AT ANY TIME BY WRITTEN NOTICE TO THE DIVISION OF UNEMPLOYMENT
INSURANCE.
AFFIDAVIT:
I, (Name of Authorized Citizen), being duly sworn depose and say that I hold the office
, in the , Employer Registration Number having
its principal office at and am fully authorized on behalf of such company
to grant the powers stated in said Power of Attorney to (Party Granted Power of Attorney) as the
true and lawful attorney in fact with power and authority to represent (business entity)
before the DELAWARE DIVISION OF UNEMPLOYMENT INSURANCE without first obtaining the direction and approval of the Board
of Directors of (business entity).
(Signature of Authorized Officer)
Sworn and subscribed before me this ______________ day of _______________________, 20__________.
(NOTARY SEAL)
Notary Public
Notary Expiration:
ADP, LLC, and its subsidiaries and Corporate Cost Control, LLC.
ADP Unemployment Claims - NH
PO BOX 1390
LONDONDERRY, NH 03053-1390
AFFIX NOTARY SEAL IN THIS AREA.
THIS MESSAGE WILL NOT PRINT
PO BOX 1390, LONDONDERRY, NH 03053-1390
ADP Unemployment Claims - NH
SIDES: BR000000022
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Power-of-Attorney Delaware Division of Unemployment Insurance Revised 2016
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POWER OF ATTORNEY THAT D elaware Division of (ADP)

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Completed 8 February 2021

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