DTF-280 (5/05) New York State Department of Taxation and Finance Tax Information Authorization This is not a Power of Attorney. Read the instructions in Form DTF-280-I. 1. Taxpayer information (please print or type) Taxpayer name(s) (if joint income tax return, enter both names) Taxpayer SSN or EIN Mailing address Spouse’s SSN (if applicable) City, Village, town, or post office State ZIP code State of incorporation (if applicable) 2. Appointee information Appointee’s name Mailing address (include firm name, if applicable) Telephone number ( ) ( ) ( ) 3. Tax matter(s) The appointee is authorized to receive your confidential information (not including copies of tax returns) from the Tax Department for the tax matter(s) listed below. Type(s) of tax (income, sales, corporation, etc.) Tax year(s), period(s), or transaction(s) 4. Retention/revocation of prior tax information authorization(s) The filing of this tax information authorization automatically revokes all prior authorizations on file with the New York State Department of Taxation and Finance for the same tax matters you listed above in section 3. If you do not want to revoke a prior tax information authorization, mark an X in this box. Attach a copy of any tax information authorization you want to remain fully in effect. ................. The filing of Form DTF-280, Tax Information Authorization, does not revoke any power of attorney that is currently in effect for the same tax matters you listed above. 5. Taxpayer signature (Taxpayer(s) must sign and date this form below.) Either husband or wife must sign below if a joint income tax return was filed. If the taxpayer named in section 1 above is other than an individual: I certify that I am acting in the capacity of a corporate officer, partner (except a limited partner), member or manager of a limited liability company, or fiduciary on behalf of the taxpayer, and that I have the authority to execute this tax information authorization on behalf of the taxpayer. Signature Title, if applicable Date Type or print name of person signing this form if not the taxpayer(s) named in section 1 above. Signature Title, if applicable Date Type or print name of person signing this form if not the taxpayer(s) named in section 1 above. Mail to: NYS TAX DEPARTMENT TCC - ACCOUNT SERVICES SECTION WA HARRIMAN CAMPUS ALBANY NY 12227-0140 Fax number: (518) 435-8406 American LegalNet, Inc. www.FormsWorkflow.com