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        State of Rhode Island and Providence Plantations
        Form RI-2848
        Power of Attorney

Taxpayer name                                                                               Social security or federal identification number

Address                                                           City, town or post office                                State ZIP code

Taxpayer name                                                                               Social security or federal identification number

Address                                                           City, town or post office                                State ZIP code

hereby appoints:
Power of Attorney name                                                                      Telephone number

Address                                                           City, town or post office                                State ZIP code

Power of Attorney name                                                                      Telephone number

Address                                                           City, town or post office                                State ZIP code

as attorney(s)-in-fact to represent the taxpayer(s) before the office of the State of Rhode island, Division of Taxation, for the following state
matters (specify the type(s) of tax and year(s) or period(s) (date of death if this is for estate tax)):

The attorney (s)-in-fact (or either of them) are authorized, subject to revocation, to receive confidential information and to perform on behalf
of the taxpayer (s) the following acts for the above tax matters: 
Check off any of the following which are NOT granted.
        To receive, but not to endorse and collect, checks in payment of any refund of state taxes, penalties or interest. 
        To execute waivers (including offers of waivers) of restrictions on assessment or collection of deficiencies in tax and waivers of no-
        tice of disallowance of a claim for credit or refund. 
        To execute consents extending the statutory period for assessment or collection of taxes. To execute closing 
        agreements. 
        To represent taxpayer (s) at preliminary reviews and administrative hearings. (Must be an attorney, person authorized by law to prac-
        tice accountancy, or partner or corporate officer of taxpayer as provided by the Administrative Hearing Procedures.) 
        Other acts (specify) ______________________________________________________________________
Notices and other written communications in proceedings involving the above matters shall be sent to the above named attorney (s) so long
as this power of attorney remains in effect. 
Copies to be sent to the taxpayer (s). 
This power of attorney revokes all earlier powers of attorney and tax information authorizations on file with the Division of Taxation office for
the same matters and years or periods covered by this form, except the following (Specify to whom granted, date granted, and address in-
cluding ZIP code; or refer to attached copies of earlier powers and authorizations):

                       If signed by corporate officer, partner, or fiduciary on behalf of the taxpayer,
                       I certify that I have authority to execute this power of attorney on behalf of the taxpayer.
Taxpayer signature                                   Print name                     Title (if applicable)                  Date

Taxpayer signature                                   Print name                     Title (if applicable)                  Date

        Mailing address: RI Division of Taxation, One Capitol Hill, Providence, RI 02908-5806           Revised 11/2014



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State of Rhode Island and Providence Plantations
Form RI-2848
Power of Attorney

This declaration must be completed by the attorney, certified public accountant, licensed public accountant, or enrolled agent. 
I declare that I am not currently under suspension or disbarment from practice before the Division of Taxation and that: 

                  I am a member in good standing of the bar of the highest court of the jurisdiction indicated below; or 
                  
                  I am duly qualified to practice as a certified public accountant in the jurisdiction indicated below; or 

                  I am a licensed public accountant in the jurisdiction indicated below. 

                  I am actively enrolled to practice before the Internal Revenue Service. 

Designation                            Jurisdiction Signature                                                                                      Date
(Attorney, CPA, LPA or enrolled agent) (State, etc)

If the power of attorney is granted to a person other than an attorney, certified public accountant, or licensed public accountant, or enrolled
agent, it must be witnessed or notarized below. 
                            The person (s) signing as or for the taxpayer (s): (Check and complete ONE.) 
                  is/are known to and signed in the presence of the two disinterested witnesses whose signatures appear here: 

                            Signature of witness                                                                                              Date

                            Signature of witness                                                                                              Date
                  
                  appeared this day before a notary public and acknowledged this power of attorney as a voluntary act and deed 

                            Signature of notary                                                                                                Date

                                                                                                                                                   NOTARIAL SEAL 






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