Power Of Attorney {N-848}

1 þ Taxpayer Information. Taxpayer(s) must sign and date this form on page 2, line 6. Taxpayer name(s) and address þ þ Social security number(s) þ Federal employer þ identi037cation number en Daytime telephone number þ Fax numberen ( þ ) þ ( þ ) E-mail addresshereby appoint(s) the following representative(s) as attorney(s)-in-fact: 2 þ Representative(s) must be an individual and must sign and date this form on page 2, Part II. Individual name and address þ VPID or TMRID þ þ Social Security No. þ þ Telephone No. þ ( þ ) þ þ Fax No. þ ( þ ) þ þ E-mail address þ þ Check if new: þ Address þ þ Telephone þ þ Fax þ þ E-mail þ Individual name and address þ VPID or TMRID þ þ Social Security No. þ þ Telephone No. þ ( þ ) þ þ Fax No. þ ( þ ) þ þ E-mail address þ þ Check if new: þ Address þ þ Telephone þ þ Fax þ þ E-mail Individual name and address þ VPID or TMRID þ þ Social Security No. þ þ Telephone No. þ ( þ ) þ þ Fax No. þ ( þ ) þ þ E-mail address þ þ Check if new: þ Address þ þ Telephone þ þ Fax þ þ E-mail Individual name and address þ VPID or TMRID þ þ Social Security No. þ þ Telephone No. þ ( þ ) þ þ Fax No. þ ( þ ) þ þ E-mail address þ þ Check if new: þ Address þ þ Telephone þ þ Fax þ þ E-mail to represent the taxpayer(s) before the Department of Taxation, State of Hawaii, for the following acts: 3 þ Acts authorized (you are required to complete this line 3). (Stating 223All Taxes224, 223All Forms224, or 223All Periods224 on line 3 is NOT acceptable.) With the exception of the acts described in line 4b, I (we) authorize my (our) representative(s) to receive and inspect my (our) con037dential tax information and to perform acts that I (we) can perform with respect to the tax matters described below. For example, my (our) representative(s) shall have the authority to sign any agreements, consents, tax clearance applications, or similar documents (but see instructions for authorizing a representative to sign a return). Please note that the tax year(s) or period(s) on line 3 can extend only 3 years after the current year. For example, if Form N-848 is submitted at any time in 2018, the tax year or period on line 3 cannot be extended beyond December 31, 2021. þ Hawaii Tax I.D. Number þ Type of Tax þ Tax Form Number þ Year(s) or Period(s) þ (Income, General Excise, etc.) þ (N-11, G-49, etc.)FORMN-848(REV. 2017)STATE OF HAWAII - DEPARTMENT OF TAXATIONen POWER OF ATTORNEY (NOTE: References to 223married224 and 223spouse224 are also references to 223in a civil union224 and 223civil union partner,224 respectively.) PART I POWER OF ATTORNEY (Please type or print.) þ FORM N-848 American LegalNet, Inc. www.FormsWorkFlow.com þ FORM N-848 PAGE 2 þ (REV. 2017) 4a þ Additional acts authorized. In addition to the acts listed on line 3 above, I (we) authorize my (our) representative(s) to perform the following acts (see instructions): þ Authorize disclosure to third parties; þ Substitute or add representative(s); þ Sign a return; þ þ þ þ þ Other acts authorized: þ þ þ þ 4b þ Speci037c acts not authorized. My (our) representative(s) is (are) not authorized to endorse or otherwise negotiate any check (including directing or accepting payment by any means, electronic or otherwise, into an account owned or controlled by the representative(s) or any 037rm or other entity with whom the representative(s) is (are) associated) issued by the government in respect of a Hawaii tax liability. þ List any speci037c deletions to the acts otherwise authorized in this power of attorney (see instructions): þ þ þ 5 þ Signature of Taxpayer(s). If a tax matter concerns a year in which a joint return was 037led, both spouses must sign if joint representation is requested. If signed by a corporate of037cer, partner, guardian, tax matters partner/person, executor, receiver, administrator, or trustee on behalf of the taxpayer, I certify that I have the authority to execute this form on behalf of the taxpayer. þ þ IF NOT SIGNED AND DATED, THIS POWER OF ATTORNEY WILL BE RETURNED TO THE TAXPAYER. þ þ þ þ þ þ Signature þ Date þ Title (if applicable) þ þ þ þ Print Name þ Print name of taxpayer from line 1 if other than individual þ þ þ þ þ þ Signature þ Date þ Title (if applicable) þ þ Print Name þ IF NOT COMPLETED, SIGNED AND DATED, THIS POWER OF ATTORNEY WILL BE RETURNED TO THE TAXPAYER. REPRESENTATIVES MUST SIGN IN THE ORDER LISTED IN PART I, LINE 2. Type or Print NameSignatureDateFiling the Power of AttorneyFile the original, photocopy, or facsimile transmission (fax) with each letter, request, form, or other document for which the power of attorney is required. For example, if you wish to designate an individual to represent you in obtaining tax clearance certi037cates, a copy of Form N-848 must be 037led each time you submit Tax Clearance Applications. The Department does not maintain a permanent, centralized 037le of powers of attorney. Unless you are provided with contact instructions by a representative from the Department of Taxation, mail the completed Form N-848 to: Hawaii Department of Taxation, P.O. Box 259, Honolulu, HI 96809-0259, or send it by FAX to (808) 587-1488. PART IISIGNATURE OF REPRESENTATIVE(S) American LegalNet, Inc. www.FormsWorkFlow.com