Indiana Tax Power Of Attorney Form 49357

Information you will need

• DBA Names
• New Address
• Firm Name
• Firm Address
• Firm City
• Firm State
• Firm Phone
• Firm Email
• Taxpayer Name
• Taxpayer Address
• Taxpayer State
• Taxpayer City
• EIN
• Representative Name
• Representative Address
• Representative City
• Representative State
• Representative Phone
• Representative Email
• Firm/Vendor Representative
• Firm/Vendor Representative Phone
• Firm/Vendor Representative Email
• General Authorization
• Tax Type

…and 15 more fields in the PDF.

Completed by the employer.

The form includes 1 signature line.