Spouse #1 Form 2848 (Revised 10–2011) Page 2
Summary: This is an example of Form 2848 (Revised October 2011), page 2, filed to provide power of attorney information regarding a third party involved with a taxpayer's matters with items included as described in the text. Additionally, these line items are
completed:
- Under
Part II: Declaration of Representative
: -
-
Designation--Insert above letter (a-h)
field contains c (I am one of the following: Enrolled Agent--enrolled as an
agent under the requirements of Treasury Department Circular Number 230.) -
Jurisdiction (state) or Enrollment Card Number
field contains 90-99999 -
Signature
field contains Jim Smith -
Date
field contains 7/21/2011
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