03-25-13 Agenda & Packet - Laserfiche WebLink

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• 7.Signature of Taxpayer: If signed by a corporate officer,partner,guardian,tax matters partner/person,executor,receiver,administrator or trustee on behalf of the taxpayer,I certify that I have the authority to execute this form on behalf of the taxpayer. The following applies if the authorized representative is a Certified Property Tax Representative pursuant to 50 IAC 15-5-5: I understand that by authorizing JEFFREY M MCGOWAN as my Certified Property Tax Representative,I am aware of and accept the possibility that the property value may increase as a result of filing an administrative appeal with the Property Tax Assessment Board of Appeals,and that I may be compelled to appear at a hearing before the Property Tax Assessment Board of Appeals or the Department of Local Government Finance. I further understand that the Certified Property Tax Representative is not an attorney and may not present arguments of a legal nature on my behalf. If this power of attorney is not signed,dated and notarized,it will be returned. natur f taxpay / Date of si nature(monnth,ld7a/y,year) r' ted name of tax.ayer / Title(if applicable) OHN AXELBERG PRESIDENT-GENERAL SHEET METAL WORKS, INC. /Signature of taxpayer Date of signature(month,day,year) Printed name of taxpayer Title(if applicable) 8.Notarization STATE OF Ji\ 1 fX k..fA EMAf _ 1 JENNIFER A.GUDEMAf ` ``- �. ` t " Elkhart County COUNTY OF (G1 tL -!.'lv�- SS: - wor j g.,s :•rIly Commission Expires I .,-... ':'!' ? August 15,2014 __ Before me,a notary public in and for said state and county,personally appeared,this I al —.`nF ,,. ` 2L /3 the taxpayer(s)or a person duly authorized to sign for and on behalf of the taxpayer(s),who a.:i o'Nledged�l'ttiie eixecution- this Power of Attorney as the voluntary act and deed of the taxpayer(s). 2 `4. nature of notarypublic C.to 0 County of residence y u , T p or printed It of nota publi to _ Y� Date comTry�fission expires(Month;:.44V4 j'r ��v\t V• vel-e w i �11511� }i',- ...• PART II-DECLARATION OF REPRESENTATIVE ^R 1.,..:, ',,1 Under penalties of perjury,I declare that: ' 1 I am aware of the statutes,rules and regulations applicable to the matters specified in line 3; I am authorized to represent the taxpayer(s)identified in Part I for the tax matter(s)specified there;and I am one of the following: a. Certified Public Accountant-duly qualified to practice as a certified public accountant in the jurisdiction shown below. b. Certified Tax Representative pursuant to 50 IAC 15-5. c. Other(specify) If this declaration of representative is not signed and dated,the power of attorney will be returned. DESIGNATION JURISDICTION(state,etc.)OR _ (insert above letter-a,b,or c) ENROLLMENT CARD NUMBER SIG T i DATE(month,day,year) a.b. INDIANA , /�‘:1 hillij �:• 2-18-13 iii me 0 I tiii Page 2 of 2