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Power Of Attorney Form. This is a Official Federal Forms form and can be use in Alcohol And Tobacco Tax And Trade Bureau (TTB).
Tags: Power Of Attorney, TTB F 5000.8, Official Federal Forms Alcohol And Tobacco Tax And Trade Bureau (TTB),
OMB No. 1513-0014 (0/31/201) DEPARTMENT OF THE TREASURY ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB) POWER OF ATTORNEY (Please read instructions before completing this form) 1. PRINCIPAL (Name of Partnership, Corporation, Association, Limited Liability Company, Estate, or Individual) 2. BUSINESS IN WHICH ENGAGED 3. ADDRESS (Number, Street, City, State, ZIP Code), TELEPHONE NUMBER, AND E-MAIL ADDRESS 4. 6. 7. 8. PRINCIPAL'S EMPLOYER IDENTIFICATION NUMBER (Employer Identification Number or Social Security Number) 5. PERMIT NUMBER / REGISTRY NUMBER (If applicable) NAME, TELEPHONE NUMBER, AND E-MAIL ADDRESS OF APPOINTED ATTORNEY ADDRESS (Number, Street, City, State, and ZIP Code) The above named principal, engaged in the business shown, has appointed the above named attorney to: (See Instruction 2) (a) Execute for him/her all applications, notices, bonds, tax returns, tax information disclosure authorizations, and other instruments, claims, offers in compromise, letters, writings, and papers, and to act for him/her in dealing with the Alcohol and Tobacco Tax and Trade Bureau (TTB) in connection with matters relating to the laws and regulations administered by it. The principal authorizes the attorney named above to receive on his/her behalf any and all notices, papers, and letters from the Alcohol and Tobacco Tax and Trade Bureau in connection with all such matters, and grants him/her full power and authority to do all that is essential in and about the premises, as duly as the principal could do if personally present, with full power of substitution and revocation. The principal hereby ratifies and confirms all that the attorney must lawfully do or cause to be by virtue of this appointment. (b) Authorization limited to: 9. The power is to apply to the following. (If authority is restricted to a particular factory, plant, premises, etc., give name as: Distilled Spirits Plant, Tobacco Products Factory, Tobacco Export Warehouse, etc., and address and registry number; or, if a Wholesale Liquor Dealer, SDA, or Tax-Free Alcohol User; or if this Power of Attorney may be used for manufacturing or importing firearms or ammunition, etc., give permit number.) 10. SIGNATURE OF APPOINTED ATTORNEY EXECUTION (See Instruction 3) 11. SIGNATURE IF PRINCIPAL IS INDIVIDUAL (Signature of Principal) DATE 12. SIGNATURE IF PRINCIPAL IS PARTNERSHIP, LIMITED LIABILITY PARTNERSHIP (LLP), ESTATE, CORPORATION, LIMITED LIABILITY COMPANY (LLC), OR ASSOCIATION. Under penalties of perjury, I declare that I have the authority to execute this power of attorney on behalf of the principal. Signature Signature Signature Signature Title Title Title Title Date Date Date Date 13. Seal of Corporation, Association, or LLC (A corporation, association or LLC will impress their seal below if they have one. If there is no seal, check the "Not Applicable box". The person(s) signing in Items 11 or 12 must have been granted signing authority (other than Power of Attorney) on another document previously approved or accepted by TTB). Not Applicable TTB F 5000.8 (0/20) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 14a . ACKNOWLEDGMENT 14. ACKNOWLEDGMENT, WITNESSING, OR DECLARATION (Complete 14a, 14b, or 14c) 14b . WITNESSING This power of attorney was signed by or for the principal(s) by a person or persons known to, and in the presence of, the two disinterested witnesses whose signatures appear below: The above-named person(s) signing as or for the principal(s) appeared before me today and acknowledged this power of attorney as his/her/their voluntary act and deed. The notarial seal must be affixed unless a seal is not required under the laws of the state where the power of attorney is executed. Signature of Notary or Other Officer NOTARIAL SEAL (If required) Date Title Signature of Witness Signature of Witness Date Date 14c. DECLARATION by attorney or certified public accountant who is granted the power of attorney by this form. I declare that I am aware of the regulations of 31 CFR Part 8, that I am not currently under suspension or disbarment from practice before the Alcohol and Tobacco Tax and Trade Bureau, and that I am currently: (Check applicable box) A member in good standing of the bar of the highest court of 1 Qualified to practice as a certified public accountant in 1 Printed Name 1 Insert Name of State, Possession, or District of Columbia FOR TTB USE ONLY Signature DATE RECEIVED FOR FILING TTB OFFICE RECEIVED BY (Signature and Title) INSTRUCTIONS 1. GENERAL. This form is filed with TTB to show the appointed attorney is to represent the principal. ITEM 8. A full power of attorney is granted by paragraph 8(a). The power of attorney may be limited or restricted by deleting all of paragraph 8(a) and listing the specific powers to be conferred in section 8(b). EXECUTION. This form must be signed by or on behalf of the principal(s) as follows: (a) INDIVIDUAL by his or her completion of item 11. (b) PARTNERSHIP, LIMITED LIABILITY PARTNERSHIP (LLP) by completion of item 12 by all partners, or one partner who attaches his/her authorization to act on behalf of all the partners unless this authorization is provided by State law. (c) CORPORATION or ASSOCIATION by completion of items 12 and 13, an officer authorized by supporting corporate or organizational documents (preferably the president, vice-president, or treasurer; or LLC member or manager), must sign in item 12. (d) ESTATE by completion of item 12 by the executor or administrator and attaching other such documents as may be required by TTB. (e) LIMITED LIABILITY COMPANY (LLC) by completion of item 12 by all members or managers, or one member or manager who attaches his/her authorization to act on behalf of the LLC. 4. FILING. This form must be completed in duplicate, unless otherwise required, and submitted to the Director, National Revenue Center, 550 Main St, Ste. 8002, Cincinnati, OH 45202-5215. The original with any attachments will be retained by the Director, National Revenue Center, and all other copies will be returned to the principal. If the power of attorney is applicable to more than one business establishment, additional copies must be submitted for each. 7. The additional copies will be filed in the same manner as when the power of attorney relates to only one establishment or business. Copies reproduced by photographic process need not be certified as copies of the original. 5. ORIGINAL OF A RULING. The Alcohol and Tobacco Tax and Trade Bureau