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Home My WebLink AboutPower of Attorney & Declaration of RepresentativeRESOLUTION 2011-274 ADOPTED DOC ID: 6758 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2011-274 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON MARCH 29, 2011: RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs Supervisor Scott A. Russell to execute the Power of Attorney and Declaration of Renr~en_!~tive form appointing two Certified Public Accountants of the firm Aibrecht~ Vio~iano~ Zureck and Co.~ P.C. to represent the Town of Southold before the Internal Revenue Service regarding, tax matters pertaining to Tax Form 941 for the year ended December 31~ 2008, subject to the approval of the Town Attorney. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED '[UNANIMOUS] MOVER: Christopher Talbot, Councilman SECONDER: Louisa P. Evans, Justice AVES: Ruland, Orlando, Talbot, Kmpski Jr., Evans, Russell 2848 (Rev. June Power of Attorney and Declaration of Representative · Type or print. · See the separate Inetruotlons. ~ Power of Attorney Ceutlom Form 2848 will not be honored for any purpose other than repre~antat/on before the IRS. I Taxpayer Information. Taxpayer(8) must sl~n and date this form on pa~e 2, line 9. Taxpayer name{s) and address / ~nolal eeourity number{s) Town of Southold P.O. Box 1179 Southold, NY 11971-0959 Daytime t~lephoce number / / Employer identification number 11-6001939 Plan number (if applicable) hereby appoint(s) the fo]lowing representaUve{s) as attomey(s)-In-fact: 2 Reprssontotive(a) must sign and date this form on page 2, part II. Name and address Kenneth B. Laks, CPA Albrecht,Viggiano,Zureck & Co., P.C. 25 Suffolk Court, Hauppauge, NY 11788 Name and address Robert S. Posner, CPA Albrecht,Viggiano,Zureck & Co. P.C. 25 Suffolk Court, Hauppauge, NY 11788 Name and address cAF No..0..!.0..0.~.9.~0..R .................... Talo.~ona No..6..~.1.~.4=.9.~.Q ............ Fax No..6..3..1.~ .9..5..1.8. .................... Check if new;, Address [] Telephone No. I--I Fax No. [] cAF.o. 2.0Q~...!~.~.<~.O..R .................... Tehephona No..6. _3..1.."~_. ~ '..9. _5..0.0. ............ Fax No..6..3..1. ~ ~: .9..5..1.8. ................... Check if new: Address [] Telephone NO. [] Fax No. [] CAF No .......................................... Telephone NO.. ................................. Fax No .......................................... Check if new:, Address [] Telephone No. [] Fax No, [] to represent the taxpayer(s) before the Intemal Revenue Sen, ice for the following tax mattem: 3 Tax matters Type of Tm< (Income, Employment, Exctss, etc.) or Civil Penalty (see the instructions for line 3) Income Tax Form Number 0040, 941, 720, etc.) 941 yeer(s) or Period(s) (see the lnstmctione for line 3) December 31, 2008 4 Spnolflo use not reoorded on Centmtized Author',.aGon File {CAF). ff the power of attorney is for a speoifio use not recorded on CAF, check this box. See the inebucflons for Un® 4. $paofflo Um Not Re~orded on CAF .............. · [] 5 Acts nut~orizad. The reprasantstives am authndzed to receive and inspect confldanfial tax information and to perform any and all acts that I (we) can preform with respect to the tax mettom dcecdbed on line 3, for example, the authority to sign any agreements, consents, or ct~er documents. The authority does not include the power to receive refund checks (see line 6 below), the power to substitute another representative or add additional rag~e~ontaflves, the power to sign caftein returns, o~ the power to execute a request for dleclceure of tax returns or return information to a thild party. See tf~ line 5 in~a'uctlons for more information. Exonptfone. An ucemollad rstum preparer cannot sign any document for a taxpayer and may only represent taxpayers In flmltod situations. See Unors'olled Rotum Preparer on page 1 of the instmctior~. An enrolled actuary may only represent taxpayers to the extent provided in section 10.3(o') of Treasury Department Circular No. 230 (Circular 230). An enrolled retirement plan administrator may only represent taxpayers to the extant provided in section 10.3(e) of Circular 230. ~on the line 5 inetm~ons for restrictions on tax matters partners. In most cases, the student practitioner's (levels k and I) authority is limltsd (for example, they may only practice under the supewlslon of another practitioner}. List any specific additions or deletions to the ac~ otherwise authorized in this power of attomeT. .......................................... ................................................................................................................................................ ................................................................................................................................................ ................................................................................................................................................ Receipt of mfond oheok~. If you want to authorize a repmsantative named on line 2 to receive, BUT NOT TO ENDORSE OR CA~.I, refund checks, initial here and list the name of that repreeectaflvs below. Name of representathre to receive re[und check(e) · For Privacy AOt and Paperwork Rednoflon AOt Notice, eec page 4 of the btstrnofloce. Form 2848 (Rev. 6-2008) STt= DQXWI001.1 Form 2848 (Rev. 6-2~) Page 2 ? Notlm~ eed eommunle~tlone. Original co~ end ~ w~ ~mmunl~i~s wlfl ~ ~ to yco end a copy to ~ fi~ mp~ I~ on Ii~ 2. a ff y~ a~ w~ ~e ~nd mp~ I~ ~ ~e a ~py of no~ ~d c~m~o~, ch~k ~ ~x ..... k ~ b If ~u do cot ~ any no~ or ~m~ as~ ~ your mp~s), ch~k ~is ~ .......... k ~ 8 R~n~n of p~r p~s) ~ ~m~. ~e ~ing of ~b ~r ~ a~mw au~ly r~ ~1 ea~r ~w~s) of ~y ~ fi~ ~ ~e I~1 R~ce ~e ~r ~ a~ t~ m~ and ~m or ~s oove~ by ~is ~cu~. If ~u do not w~ ~ ~ke a ~ ~ ~ ~, ~k hem ........................ k ~ YOU MU~ A~ACH A CO~ OF A~ POWER OF A~ORN~ YOU WA~ TO REM~N IN EF~. 9 ~m ~ ~a~e}. If a ~ ma~ ~s a J~ m~m, ~ hus~ ~ w~ mu~ si~ ff joint mpm~n~n is mquastsd, offi~, s~ ~e ~. ff Ngn~ by a ~ ~r, ~r, g~l~, ~ maim ~, ~or, r~el~r, admini~or, or ~ ~ be~ ~ ~ ~ayer, I ~ ~ I ~e t~ au~ to ex~ ~ ~ on ~haff ~ ~e ~pay~. ~ IF NOT~I~NED AND DATED, ~18 POWER OF A~ORN~ WILL BE RETURNED. ..... ..... Print Name [ ] ....................... i,o..w...n_,o..f..S..o..u..t.h..o. Ld. ....................... PIN Number Print name of taxpayer from line 1 If other than individual Signature Date Title (if applicable) Print Name I PIN Number I'.C~illl De=laratlon of Representative Ceu~on: Studen~ with a special order to represent taxpa~rs in qualified Low Income Taxpayer Clln~s or the Student Tax Clinic Program gevet$ k and l~ cee the ins~uctions for Part ll. Under paaalbes of perjury, I declare that: · I am not cun~ntly under suspension or d~ban-cent from practice before the intsmal Revenue Garvine; · I am aware of regulations contained in Circuler 230 (31 CFR, Part 10), as emended, concerning the pmctfce of attomeye, certified public accountants, enrolled agents, enrolled actuates, and others; · I am authorized to represent the taxpayer(e) Identified In Part I for the tax matter(s) specified them; and · I am one of the following: a Attomey--a member In good standing of the bar of the highest court of the Ju~sdinflon shown below. b Certified Public Accountant--duly qualBed to practice es a cartffled public accountant in the Jurisdiction shown below. ¢ Enrolled Age~t---anmlled as an agent under the requirements of Circular 230. d Offlcar--e bona fide officer of the tsxp~6~er's organization. · Full-Time Ernployee--a fulI-Ume employee of the taxpayer. f Family Member--~ member of the taxpayer's Immediate family (for example, spouse, parent, child, brother, o~ sister). g Enrolled Actuaty--emolled es an actuary by the Joint Board for the Enrollment of Actuaries under 29 U.S.C. 1242 (the authority to practice before the Internal Revenue Se~ice is limited by seoflon 10.3(d) of Clmuler 230). h Unenro#ed Return Prepmer--the euthorRy to prectlce before the IntemN Reveoue ,Service is limited by Circular 230, section 10.7(oX1)(vll0. You must have prepared the rstum in question end the return must be under examination by the IRS. See Unenmlled Retom Preparer on page 1 of the instructions. k Student Attome~dent who receives permleslon to prentice before the IRS by virtue of their status as a law student under section 10.?(d) of Circoler 230. I Student CPA--student who receives ben~laslon to practice bofom fie IRS by virtue of their status as a CPA student under Sen~on 10.7(c0 of Clrculer 230. r Enrolled Retirement Plan Agent---enrolled as a retirement plan agent under fie requirements of Circular 230 (the authority to practice before fie Intemei Revenue Sen~ce is Ilrnlt~d by section 10.3(e)). · IF THIS DEOLARATION OF REPRESENTATIVE 18 NOT 81GNED AND DATED, THE POWER OF ATTORNEY WILL BE RETURNED. See the Part II instructions, Designation--Insert Jurisdiction (state) or Signature Date above leffer Ia-r) identification b NY b NY Fom~ ~ (Rev. s~ ~ oo~.2