STATE OF TEXAS COUNTY OF __________________ § § § LIMITED POWER OF ATTORNEY I, __________________________________________ , ________________________________ , hereby appoint TITLE Name: _____________________________________________________________________ Address: ___________________________________________________________________ City, State and ZIP code: ___________________________________________________________________ Phone (Area code & number): ___________________________ E-mail address: ________________________________ as Agent and attorney acting on behalf of ____________________________________________________ , Texas Taxpayer No. __________________________ for the tax type _________________________________________ covering the periods ____________________________________ for the following limited and special purposes: To provide information as requested for the purpose of my tax audit(s). To discuss relevant issues pertaining to my tax audit(s). To receive mail from the Comptroller regarding my tax audit(s) and/or contested case(s). To enter into a written agreement extending the period of limitation during which the tax may be assessed, accept a notification of the 60 day requirement to obtain records and/or certificates, and accept a notification of sampling procedure. (This would normally be an officer of a corporation, a partner, or owner.) To provide representation and make oral and written presentations of fact or argument related to my contested case(s). I grant the above named AGENT full power to substitute one or more attorneys or other representatives to carry out the powers and duties specified above. Entity name: _________________________________________ Authorized Representative: _______________________________________ PRINT Title ________________________________________________ ___________________________________________________ Date ____________________________ Form 86-113 (11-07) American LegalNet, Inc. www.FormsWorkflow.com