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Limited Power Of Attorney Form. This is a Connecticut form and can be use in Department Of Revenue Services Statewide.
Tags: Limited Power Of Attorney, LGL-003, Connecticut Statewide, Department Of Revenue Services
State of ConnecticutDepartment of Revenue Services450 Columbus Blvd Ste1Hartford CT 06103-1837Limited Power of AttorneyLGL-003LGL-003 gives another person authority to receive blank tax returns, return information and refund checks for a taxpayer.Who is Giving a Limited Power of Attorney to Another Person? Taxpayer222s name � Social Security Number Spouse222s name � Social Security Number Street address � CT Tax Registration Number � � � � Taxpayer is: � � � � � � � � � � � � � � � � � � � � � � � � � � � � Corporation � Partnership � Sole Proprietorship � � � � � � Estate � Business Trust � Limited Liability Company � � To Whom is a Limited Power of Attorney Given? � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � taxpayer and that would otherwise be mailed directly to the taxpayer. Name � Address � Telephone Number Type of Tax (Corporation Business Tax, Admissions Tax, etc.) � Year(s) or Period(s) � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � Who May Execute This Limited Power of Attorney? � � Any individual, if the request pertains to an income or individual use tax � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � that is not managed by managers, or a manager, if the taxpayer is an LLCthat is managed by managers The sole proprietor, if the taxpayer is a sole proprietorship A general partner, if the taxpayer is a partnership or a limited partnership The administrator or executor, if the taxpayer is an estate The trustee, if the taxpayer is a trust � � � � � � � � The successor, receiver, guarantor or assignee of the taxpayer � � � � � � � Declaration � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � have appointed in this limited power of attorney.I declare under the penalty of false statement that I have examined this document and, to the best of my knowledge and belief it is true, correct and � � � � � � � � � � � � � � � � � � � � � Print your name � Print your title Signature Date American LegalNet, Inc. www.FormsWorkFlow.com