06 - Authorize TML to Engage Legal Representation in IRS matter

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Forrn2848 Power of Attorney (Rev. January 2018) and Declaration of Representative Department of the Treasury Internal Revenue Service ► Go to wwwJrs.gov/Form2848 for instructions and the latest information. Power of Attorney Caution: A separate Form 2848 must be completed for each taxpayer. Form 2848 will not be honored for any purpose other than representation before the IRS. 1 Taxpayer information. Taxpayer must sign and date this form on page 2, line 7. Taxpayer name and address I Taxpayer identification number(s) hereby appoints the following representative(s) as attorneys) -in -fact: 2 Representative(s) must sign and date this form on page 2, Part II. Name and address CAF No. ------ 4206 "t lig QM V.u��;„"krolll PTIN ----------• it G �1 ::r L .A IIL l llLui'L ID11 iiV11), ”»Jte 200 Telephone No. 4101',lem, AR 72758 Fax No. Check if to be sent copies of notices and communications ❑✓ Check if new: Address ❑✓ OMB No. 1545-0150 For IRS Use Only Received by: Name Telephone Function .............. Date / / number (if applicable) 03d' 118 ..l°606r II "tl Ill!!Z - 4-19-461-56E3. 1 179 878..69 68 Fax No. ✓❑ Name and address CAF No.________________ 0305392M - 05 VFW aM---------------- tl'.on L. ,Janti PTIN tl26 VV C..opfto. VVva*m e, Suite 111800 Telephone No. 0 L688 888 I lvI e IlZauclk, AIR V "?01 Fax No. hM 9u 13 1888 Check if to be sent copies of notices and communications 13 Check if new: Address ❑ Telephone No. ❑ Fax No. El._ _ ..._..___... Name and address CAF No. PTIN ----------------------------------------------------- Telephone No. Fax No. (Note: IRS sends notices and communications to only two representatives.) Check if new: Address ❑ Telephone No. ❑ Fax No. ❑ Name and address CAF No. PTIN----------- - - -- - Telephone No. Fax No. Note: IRS sends notices and communications to only two representatives.) Check if new: Address ❑ Telephone No. ❑ Fax No. ❑ to represent the taxpayer before the Internal Revenue Service and perform the following acts: 3 Acts authorized (you are required to complete this line 3). With the exception of the acts described in line 5b, I authorize my representative(s) to receive and inspect my confidential tax information and to perform acts that I can perform with respect to the tax matters described below. For example, my representative(s) shall have the authority to sign any agreements, consents, or similar documents (see instructions for line 5a for authorizing a representative to sign a return). Description of Matter (Income, Employment, Payroll, Excise, Estate, Gift, Whistleblower, Tax Form Number Year(s) or Periods) (if applicable) Practitioner Discipline, PLR, FOIA, Civil Penalty, Sec. 5000A Shared Responsibility 1040, 941, 720, etc. if applicable) ( ) ( pp ) (see instructions) Payment, Sec. 4980H Shared Responsibility Payment, etc.) (see instructions) 2016 ?M 4 Specific use not recorded on Centralized Authorization File (CAF). If the power of attorney is for a specific use not recorded on CAF, check this box. See the instructions for Line 4. Specific Use Not Recorded on CAF _ ► El ^ 5a Additional acts authorized. In addition to the acts listed on line 3 above, I authorize my representative(s) to perform the following acts (see instructions for line 5a for more information): ❑ Access my IRS records via an Intermediate Service Provider; ❑ Authorize disclosure to third parties; ❑ Substitute or add representative(s); ❑ Sign a return; ❑ Other acts authorized: For Privacy Act and Paperwork Reduction Act Notice, see the instructions. Cat. No. 11980J Form 2848 (Rev.1-2018)