This document is a power of attorney form for the New York City Department of Finance. It allows taxpayers to appoint one or more representatives to handle specified tax matters on their behalf. The form provides sections to enter taxpayer and representative information, specify the tax matters and years involved, and includes instructions on limitations of the power of attorney and how to complete the form.

1. N E W Y O R K C I T Y D E PA R T M E N T O F F I N A N C E
P OW E R O F AT TO R N E Y
TM
Finance
Please read the instructions for this form before completing. These instructions explain how the
information entered on this power of attorney will be interpreted and the extent of the powers granted.
1 - TAXPAYER INFORMATION (Taxpayer must sign and date this form - please print or type)
Taxpayer’s name Taxpayer’s EIN or SSN
Mailing address
State of incorporation (if applicable)
City, village, town, or post office State ZIP code
The taxpayer named above appoints the person(s) named below as his/her/its attorney(s)-in-fact:
2 - REPRESENTATIVE(S) INFORMATION (Representative(s) must sign and date this form on back)
Representative’s name Mailing address (include firm name, if any) Telephone and fax numbers
to represent the taxpayer in connection with the following tax matter(s):
3 - TAX MATTER(S)
Type(s) of tax(es) (may enter more than one) Tax year(s), period(s), or transaction(s) Notice/assessment number(s)
with full power to receive confidential information and to perform any and all acts that the taxpayer can perform
with respect to the above specified tax matter(s), except for signing tax returns or delegating his or her authority
(unless authorized below). If you do not want any of the above representative(s) to have full power as described above,
check this box and attach a signed and dated explanation..................................................................................................................... K
I authorize the above representative(s) to sign tax returns for tax matters indicated above (see instr.) (sign here): _______________________________
NOTE: This authorization is not valid unless the Commissioner of Finance has granted written permission for a
representative to sign tax returns for the taxpayer and a copy of that written permission is attached hereto.
I authorize the above representative(s) to delegate his or her authority to another (see instructions) (sign here): ________________________________
If this Power of Attorney DOES NOT APPLY with respect to appearances before the New York City Tax Appeals
Tribunal, check this box .......................................................................................................................................................................... K
4 - RETENTION/REVOCATION OF PRIOR POWER(S) OF ATTORNEY
The filing of this power of attorney automatically revokes all earlier powers of attorney on file for the same tax matter(s)
and year(s), period(s), or transaction(s) covered by this document. If you do not want to revoke a prior power of attorney,
check this box and attach a copy of any power of attorney you want to remain fully in effect ................................................................ K
5 - NOTICES AND CERTAIN OTHER COMMUNICATIONS
Where statutory notices and certain other communications involving the above tax matter(s) are sent to a representative, these docu-
ments will be sent to the first representative named above. If you do not want notices and certain other communications sent to the
first representative named above, enter the name of the representative designated above (or on the attached power of attorney previ-
ously filed and remaining in effect) that you want to receive notices, etc. __________________________________________________________________________
6 - TAXPAYER SIGNATURE
If the taxpayer named 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 power of attorney on behalf of the taxpayer.
Signature Taxpayer’s telephone and fax numbers Date
Type or print name of person signing this form if not the taxpayer named above Title, if applicable
AFFIX CORPORATE SEAL, IF APPLICABLE

2. Form NYC-PA NAME: _______________________________________ EIN/SSN: ________________________ Page 2
7 - ACKNOWLEDGMENT OR WITNESSING THE POWER OF ATTORNEY
This Power of Attorney must be acknowledged before a notary public or witnessed by one disinterested individual, unless the ap-
pointed representative is licensed to practice in New York State as an attorney-at-law, certified public accountant, or public accountant,
or is a New York State resident enrolled as an agent to practice before the Internal Revenue Service.
The person(s) signing as the above taxpayer appeared before me and executed this power of attorney.
Name of witness (print and sign) Date
Mailing address of witness (please type or print)
ACKNOWLEDGMENT - INDIVIDUAL ACKNOWLEDGMENT - CORPORATE
STATE OF STATE OF
SS: SS:
COUNTY OF COUNTY OF
On this _____________________________ day of _____________________________________________, ___________________,
On this day of
_____________________________ ________________________________________________, ___________________,
before me personally came, ______________________________________________________________________________,
before me personally came, ________________________________________________________________, to me known
to me known, who, being by me duly sworn, did say that he/she resides at
to be the person described in the foregoing Power of Attorney; and he/she acknowledged
that he/she executed the same.
______________________________________________________________________________________________________________________
INSERT ADDRESS
that he/she is the ______________________________________ of ____________________________________________________,
the corporation described in the foregoing Power of Attorney; and that he/she signed
his/her name thereto by authority of the board of directors of said corporation.
Signature of notary public M Date Signature of notary public M Date
Notary public: L affix stamp L (or other indication of notaryʼs authority). Notary public: L affix stamp L (or other indication of notaryʼs authority).
ACKNOWLEDGMENT - LIMITED LIABILITY COMPANY ACKNOWLEDGMENT - PARTNERSHIP/LLP
STATE OF
STATE OF
SS:
SS:
COUNTY OF
COUNTY OF
On this ____________________________ day of ________________________________________________, _________________,
On this _____________________________ day of _________________________________________________, __________________,
before me personally came, _________________________________________________________, to me known,
before me personally came, ____________________________________________________________, to me known,
who, being by me duly sworn, did say that he/she/they/it reside(s) at
who, being by me duly sworn, did say that he/she/they/it reside(s) at
_______________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
INSERT ADDRESS
INSERT ADDRESS
that he/she/they/it is (are) a partner(s) of ______________________________________________________________
that he/she/they/it is (are) a member(s) or manager(s) of __________________________________________
the partnership described in the foregoing Power of Attorney; and that he/she/they/it is
the limited liability company described in the foregoing Power of Attorney; and that
(are) empowered to and did execute the same.
he/she/they/it is (are) empowered to and did execute the same.
Signature of notary public M Date Signature of notary public M Date
Notary public: L affix stamp L (or other indication of notaryʼs authority). Notary public: L affix stamp L (or other indication of notaryʼs authority).
8 - DECLARATION OF REPRESENTATIVE (to be completed by representative)
I agree to represent the above-named taxpayer in accordance with this power of attorney. I affirm that my representation will not violate the
provisions of section 2604 of the New York City Charter restricting appearances by current employees or former government employees. I
have read a summary of these restrictions reproduced in the instructions to this form.
I am (indicate all that apply):
4. a New York State resident enrolled as an agent to practice before the IRS
1. an attorney-at-law licensed to practice in New York State.
5. an employee, not a corporate officer (if the taxpayer is a corporation)
2. a certified public accountant duly qualified to practice in New York State
6. other. _______________________________________________________________________________
3. a public accountant enrolled with the New York State Education Department
Designation
(use number(s) Signature Date
from above list)
NYC-PA

3. N E W Y O R K C I T Y D E PA R T M E N T O F F I N A N C E
Instructions for Form NYC-PA
TM
Finance
POWER OF ATTORNEY
GENERAL INSTRUCTIONS Real Property Transfer Tax, etc.). You may enter more than one tax type.
Purpose of form. Use this Power of Attorney form as evidence that the in- Next, enter the tax year(s) or tax period(s), or transaction(s) covered by this
dividual(s) named as representative(s) has the authority to obligate, bind, or Power of Attorney. If applicable, enter the notice or assessment number(s)
appear on your behalf with respect to the tax matters listed in section 3, Tax in the last column.
matters. This form is used for all New York City administered taxes.
If you designate only a specific tax and no tax year or period, the power of
The individual(s) named as representative(s) may receive confidential in- attorney will apply to all tax years and periods for the designated tax. If you
formation concerning your taxes. Unless you indicate otherwise, he or she designate only a specific tax year or period and not a specific tax type, the
may also perform any and all acts you can perform, including consenting to power of attorney will apply to all tax types for the designated tax year or pe-
extend the time to assess tax, or executing consents that agree to a tax ad- riod. If you do not designate either a tax type or a tax period, the power of
justment. Representatives may sign returns or delegate authority only if attorney will apply to all taxes and all periods.
specifically authorized on the power of attorney. See Limitations below.
Please note: Authorizing someone to represent you by a power of attorney Certain taxes, such as the Real Property Transfer Tax, do not have a tax
does not relieve you of your tax obligations. period or year, but are based on a specific transaction. In that situation,
enter the date of conveyance in the box specified for tax year(s), period(s),
This Power of Attorney form will not be required when an individual appears or transaction(s).
with the taxpayer or an individual who is authorized to act on behalf of the
Examples:
taxpayer. For example, this form would not be required for an individual
who appears on behalf of a corporate taxpayer with an authorized corporate 1. You want your representative to handle the tax matters for your unin-
officer. corporated business in New York City for tax year 1999.
Fiduciaries. A fiduciary (trustee, receiver, or guardian) stands in the posi- 2. You want your representative to handle the transfer of real estate in New
tion of a taxpayer and acts as the taxpayer. Therefore, a fiduciary does not York City which occurred on July 10, 1999
act as a representative and should not file a power of attorney. If a fiduci-
ary wants to authorize an individual to represent or act on behalf of the en-
TYPE(S) OF TAX TAX YEAR(S), PERIOD(S) NOTICE/ASSESSMENT
tity, a power of attorney must be filed and signed by the fiduciary acting in
OR TRANSACTION(S) NUMBER
___________________________________________________________________
the position of the taxpayer. 1 NYC unincorporated 1999
business tax
___________________________________________________________________
Filing the Power of Attorney. File the form with the office in which a mat-
ter is pending. A photocopy or facsimile transmission (fax) is also acceptable, 2 NYC real property transfer tax July 10, 1999
although the Department reserves the right to require an original power of at-
torney or proof of the existence and validity of the original power of attorney. Limitations. This power of attorney authorizes the representative(s) you ap-
If this power of attorney covers more than one tax matter, a copy of this power pointed to act for you for the tax matters indicated with the exception of sign-
should be submitted to each office in which a matter is pending. The Power ing returns or delegating authority. For a taxpayerʼs representative to have
of Attorney form should be filed in a conspicuous manner. It should not be the authority to sign tax returns on behalf of the taxpayer, the taxpayer or the
attached to or incorporated in any return, report, or other document that is taxpayerʼs court-appointed representative must request permission in writ-
routinely filed, unless the return, report or other document specifically pro- ing from the Commissioner of Finance. Such permission may be granted
vides for such attachment or incorporation. Sign and date all copies of doc- upon the determination that good cause exists for the granting of such per-
uments attached to this form. mission. A properly executed Power of Attorney form is also required on
which the line on the Power of Attorney form granting specific author-
ization for the representative to sign the tax return has been signed by
SPECIFIC INSTRUCTIONS the taxpayer or the taxpayerʼs court-appointed representative. You
must sign the specific authorization line if you want your representative to
1. Taxpayer Information have the authority to delegate his or her authority to someone else. In order
Individuals. Print or type your name, social security number and mailing for such authority to be delegated, the recognized representative under
address in the space provided. a power of attorney must file a statement signed by him or her con-
taining the name and mailing address of the new representative in the
Corporations, partnerships, limited liability companies or associations. office in which the matter is pending. A representative does not need
Enter the name, employer identification number (EIN), and business ad- the consent of any other representative to make a delegation.
dress.
If you intend to limit the authority in any other way, check the box and attach
Trusts. Enter the name and EIN of the trust, and the name, title and address a complete explanation (signed and dated), stating the specific restrictions.
of the trustee.
4. Retention/Revocation of prior power(s) of attorney
2. Representative information The filing of this power of attorney automatically revokes all earlier power(s)
Enter your representativeʼs name, mailing address (including firm name, if of attorney on file for the same tax matters and year(s), period(s), or trans-
applicable), telephone number and fax number, if applicable. Only individ- action(s) covered by this form. If there is an existing power of attorney that
uals may be named as representatives. You may not appoint a firm to rep- you do not want to revoke, check the box on this line and attach a signed and
resent you. dated copy of each power of attorney you want to remain in effect.
All representatives appointed will be deemed to be acting severally, You may not partially revoke a previously filed power of attorney. If a pre-
unless this form clearly indicates that all representatives are required viously filed power of attorney has more than one representative and you do
to act jointly. not want to retain all the representatives on that previously filed power of at-
torney, you must indicate on the new power of attorney the representative(s)
3. Tax matters you want to retain.
Enter the tax type (General Corporation Tax, Unincorporated Business Tax,

4. Instructions for Form NYC-PA Page 2
Exception. Acknowledgement or witnessing will not be required if the ap-
If you want to revoke an existing power of attorney and do not want to name
a new representative, send a copy of the previously executed power of at- pointed representative is licensed to practice in New York State as an at-
torney to the office in which a matter is pending. Write revoked across the torney-at-law, certified public accountant. public accountant, or is a New
copy of the power of attorney, and sign and date the form. If you do not York State resident enrolled as an agent to practice before the Internal Rev-
have a copy of the power of attorney you want to revoke, send a statement enue Service (IRS).
to the office where you filed the power of attorney. The statement of revo-
8. Declaration of representative (to be completed by representative)
cation must indicate that the authority of the power of attorney is revoked,
and must be signed and dated by the taxpayer. Also, the name and ad- In the first column, each representative must enter the number describing his
dress of each recognized representative whose authority is revoked must be or her profession or capacity to represent the taxpayer listed on the front of
the Power of Attorney form. If the representative enters number 6, for other,
listed.
that representative must indicate in the space provided at number 6, his or
A representative can withdraw from representation by filing a statement with her relationship or capacity to represent the taxpayer. For example, if the
the office where the power of attorney was filed. The statement must be representative is a family member, he or she must enter his or her relation-
signed and dated by the representative and must identify the name and ad- ship, such as father. If the representative is a professional not licensed to
dress of the taxpayer(s) and tax matters from which the representative is practice in New York State, indicate in the space provided at number 6 the
withdrawing. representativeʼs professional designation and the state in which he or she
is licensed, such as Florida Attorney. If more than one representative is listed
Remember: Making any changes to the power of attorney form filed with as other, indicate the relationship or capacity for each representative by
one office does not make changes to the power of attorney filed with any name. Each representative must sign and date the declaration.
other office. If your power of attorney form covers more than one tax mat-
ter, you must notify each office separately of any and all changes to a power For additional information relating to representation before:
of attorney and representatives.
G the New York City Department of Finance, see Title 19 of the Rules of
Notices and certain other communications the City of New York, Chapter 27.
Where statutory notices and certain other communications involving tax mat-
ters are sent to a representative, those documents will be sent to only one G the New York City Department of Finance Conciliation Bureau, see
representative. The statutory notices and certain other communications will Title 19 of the Rules of the City of New York, Chapter 38.
be sent to the first representative listed unless you indicate a different rep-
resentative on the form. If you do not want notices and certain other com- G the New York City Tax Appeals Tribunal, see Title 20 of the Rules of
munications to go to any of your representatives, write none.
the City of New York, Chapter 1.
6. Taxpayerʼs signature
Representation by former government employees
The Power of Attorney form must be signed by the taxpayer or by an indi-
Section 2604 (d) of the New York City Charter bars a former government
vidual who is authorized to execute the power of attorney on behalf of the
employee from appearing or practicing before his or her former agency for
taxpayer.
one year after leaving public service, and prohibits for life his or her partici-
pation in any matter that he or she was substantially and personally involved
Include acknowledgement or witnessing, if required. The taxpayer, or his,
with while a government employee.
her, or its representative may be required to provide identification and evi-
dence of authority to sign this power of attorney.
Representation by current public servants
Section 2604 of the New York City Charter contains restrictions on the ac-
Individuals. You must sign and date the Power of Attorney form.
tivities of current public servants. For example, Section 2604(b)(6) provides
that no public servant shall, for compensation, represent private interests
Corporations. The president, vice-president, treasurer, assistant treasurer
before any city agency or appear directly or indirectly on behalf of private in-
or any other officer of the corporation having authority to bind the corpora-
terests in matters involving the city. For a public servant who is not a regu-
tion must sign the Power of Attorney form.
lar employee, this prohibition applies only to the agency served by the public
servant. Other restrictions also apply. For further information, see section
Partnerships. All partners must sign the Power of Attorney form or it must
2604 of the New York City Charter and Conflicts of Interest Board Advisory
be signed in the name of the partnership by a partner authorized to act for
Opinion No. 2001-3 and the New York City Conflicts of Interest Board web-
the partnership. A partner is authorized to act in the name of the partnership
site (http://nyc.gov/ethics).
if, under state law, the partner has authority to bind the partnership.
Privacy act notification
Limited liability companies. Every member and manager must sign the
The Federal Privacy Act of 1974, as amended, requires agencies re-
Power of Attorney, or it must be signed in the name of the limited liability
questing Social Security Numbers to inform individuals from whom they
company by a member or manager duly authorized to act for the limited li-
seek this information as to whether compliance with the request is vol-
ability company who must certify that he or she has such authority.
untary or mandatory, why the request is being made and how the infor-
mation will be used. The disclosure of Social Security Numbers by
Fiduciaries. In matters involving fiduciaries under agreements, declara-
taxpayers is mandatory and is required by section 11-102.1 of the Ad-
tions, or appointments, this form must be signed by all of the fiduciaries, un-
ministrative Code of the City of New York. Disclosure by appointed rep-
less it can be established that fewer than all fiduciaries have the authority to
resentatives is voluntary. Such numbers disclosed on any report or return
act in the matter under consideration. Include evidence of the authority of
are requested for tax administration purposes and will be used to facili-
the fiduciaries to act when filing the Power of Attorney form.
tate the processing of tax returns and to establish and maintain a uniform
Others. The Power of Attorney form must be signed by the taxpayer or by system for identifying taxpayers who are or may be subject to taxes ad-
ministered and collected by the Department of Finance. Such numbers
an individual having the authority to act in the interest of the taxpayer.
may also be disclosed as part of information contained in the taxpayerʼs
You must indicate the date of execution on this Power of Attorney. return to another department, person, agency or entity as may be re-
quired by law, or if the taxpayer gives written authorization to the De-
7. Acknowledgement or witnessing the power of attorney partment of Finance.
The Power of Attorney form must be acknowledged by a notary public or
witnessed by a disinterested individual who must also sign and date this
form. Notary public: affix stamp (or other indication of notaryʼs au-
thority).