Rev. 6/94
                                                                   Form A-37                                                           Massachusetts
                                                  Consent Extending the Time                                                           Department of
                                                                                                                                       Revenue
                                                  for Assessment of Taxes

See instructions. Please print or type.
Name of taxpayer(s)                                                                                       Social Security number(s)

Street address (including apartment number or rural route)                                                Federal Identification number

City/Town                                                                                                 StateZip

Pursuant to G.L. c. 62C, § 27 the above-named taxpayer and the Commissioner of Revenue hereby consent and agree as follows:
1.The Commissioner may assess the full amount of any tax or excise due from the above-named taxpayer(s) under the applicable
  provisions of General Laws, chapter _______________, for the taxable period(s)                               _________________       on or before
  __________________________                              .
2.During the extended period, the Commissioner of Revenue or an authorized agent may examine the books, papers, records, and
  other data of the above-named taxpayer(s).
3.This agreement will not reduce the period of time otherwise provided by law for making the assessment.
4.The period so extended by the Commissioner of Revenue and the above-named taxpayer(s) may be further extended by subsequent
  agreements in writing made before the expiration date of the time last extended.
5.Executing this agreement will extend the statute of limitations with respect to abatement claims where the abatement period has not
  expired before July 1, 1993.
Signature of taxpayer or authorized representative                 Title and capacity as agent (see below)     Date

Spouse’s signature, if filing jointly                                                                          Date

Signature of authorized DOR official                                                                           Date

Send three copies of this form with original signatures on each to:

Once the DOR authorized official has signed this form, a copy will be mailed to you.

Instructions
This consent may be executed by the taxpayer’s attorney or         • C.P.A. or L.P.A. (duly qualified to practice as a certified or li-
agent, provided such action is authorized by a written Power of    censed public accountant in the jurisdiction indicated);
Attorney (Form M-2848). This consent may be executed by an
                                                                   • enrolled agent (enrolled as an agent under the requirements of
officer of the taxpayer organization without a power of attorney
                                                                   Treasury Department Circular No. 230);
provided he/she is empowered under state law to sign for the
taxpayer. If a power of attorney form has not previously been      • officer (a bona fide officer of the taxpayer organization);
filed, attach a completed Form M-2848, Power of Attorney. If a     • a full-time employee of the taxpayer;
power of attorney form has been filed, you do not have to file an-
other copy with the consent unless you are specifically asked to   • family member (a member of the taxpayer’s immediate family,
provide an additional copy.                                        e.g., spouse, parent, child, brother or sister);
If this consent is executed by the taxpayer’s attorney or agent,   • type of fiduciary; or
such person must indicate next to his or her signature the capac-  • other (attach statement).
ity in which he or she represents the taxpayer:
                                                                   If this consent is executed with respect to a year for which a joint
• attorney (a member in good standing of the bar of the highest    return of a husband and wife was filed, it must be signed by
  court of the jurisdiction indicated);                            both spouses unless one spouse, acting under a power of attor-
                                                                   ney, signs as an agent for the other.