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2003-253K
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Entry Properties
Last modified
11/22/2016 12:13:28 PM
Creation date
9/30/2015 6:52:53 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
09/23/2003
Control Number
2003-253K.
Agenda Item Number
7.D.
Entity Name
Cultural Council of Indian River
Subject
Summer Cultural Camp Program
Children's Services Advisory Committee Grant Contract
Archived Roll/Disk#
3207
Supplemental fields
SmeadsoftID
3419
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7154 11 /07/2002 8:47 AM <br /> Form 2848 Power of Attorney <br /> (Rev. January 2002) OMB No. 1545-0150 <br /> Department of the Treasury and Declaration of Representative For IRS Use Only <br /> Internal Revenue Service See the searate instructions . <br /> • • Received by. <br /> P 't Power of Attorney (Type or print. ) Name <br /> Telephone <br /> 1 Taxpayer information. Taxpa er s must sign and date this form on a e 2, line 9. Function <br /> Date <br /> Taxpayer name (s) and address Social security number(s) Employer identification <br /> CULTURAL COUNCIL OF INDIAN RIVER number <br /> COUNTY , INC . 59 - 3299133 <br /> 2145 14TH AVENUE 1 Daytime telephone number Plan number (if applicable) <br /> VERO BEACH FL 32960 177211111, 7701111114857 <br /> hereby appoint(s) the following representative(s) as attomey(s)-in-fact: <br /> 2 Representative(s) must sign and date this form on a e 2, Part II . <br /> Name and address CAF No. 6 5 0 5 - 6 8 5 6 6 R <br /> SCOTT A . NUTTALL <br /> Telephone No. 7721111112311111116902 <br /> 3111 CARDINAL DRIVE . . . . . . . . . . . . . . . . . . . . 4 . . . 4 . . . . . . . . . . <br /> . . . . . . . <br /> Fax No. 72 - 231 - 4099 <br /> 7 <br /> VERO BEACH FL 32963 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . <br /> Check if new. Address Telephone No. <br /> Name and address <br /> CAF No. <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . <br /> Telephone No. <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br />. . . . . . . . <br /> Fax No. <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . <br /> Check if new: Address Telephone No. <br /> Name and address CAF No. <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . <br /> Telephone No. <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . <br /> Fax No. <br /> Check if new: Address Tele hone No. <br /> to represent the taxpayer(s) before the Internal Revenue Service for the following tax matters: <br /> 3 Tax matters <br /> Type of Tax (Income, Employment, Excise, etc.) Tax Form Number Year(s) or <br /> or Civil Penal See the instructions for line 3 . 1040, 941 , 720 , etc. Period(s) <br /> PENALTY 990 9 / 30 / 01 <br /> 4 Specific use not recorded on Centralized Authorization File (CAF). If the power of attomey is for a specific use not recorded <br /> on CAF, check this box. See theinstructions for Line 4. Specific uses not recorded on CAF. . , , • • , , . • . , • • . <br /> . . . . . . . . . . . <br /> 5 Acts authorized. The representatives are authorized to receive and inspect confidential tax information and to perform any <br /> and all acts that I (we) can perform with respect to the tax matters described on line 3 , for example, the authority to sign any <br /> agreements, consents, or other documents . The authority does not include the power to receive refund checks (see line 6 <br /> below), the power to substitute another representative , the authority to execute a request for a tax return , or a consent to <br /> disclose tax information unless specifically added below, or the power to sign certain returns. See the instructions for Line <br /> 5. Acts authorized. <br /> List any specific additions or deletions to the acts otherwise authorized in this power of attorney: <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br />. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . I. . . . . . . . . . . . . . <br /> Note: In general , an unen rolled preparer of tax retums ca. . . <br /> nnot sign any docu. . . <br /> ment for a taxpayer.. . <br /> See Revenue. . . . <br /> Procedure 81 -38, : . . . . . . . . . . . . . . . . . . . . . . . . . <br /> printed as Pub. 470, for more information . <br /> Note : The tax matters partner of a partnership is not permitted to authorize representatives to perform certain acts. See the separate <br /> instructions for more information . <br /> 6 Receipt of refund checks . If you want to authorize a representative named on line 2 to receive , BUT NOT TO ENDORSE <br /> OR CASH, refund checks , initial here and list the name of that representative below. <br /> Name of representative to receive refund check(s) C <br /> For Paperwork Reduction and Privacy Act Notice, see the separate instructions. Form 2848 (Rev. 1 -2002) <br /> DAA � yr <br />
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