Free Statement of Authorization - California

BOE-892 REV. 14 (12-08)

STATE OF CALIFORNIA

STATEMENT OF AUTHORIZATION

BOARD OF EQUALIZATION

2009
Please return completed form to the State-Assessed Properties Division, Board of Equalization, P.O. Box 942879, Sacramento, CA 94279-0061. If you have any questions, you may contact us at 916-322-2323.
SBE NO.

COMPANY NAME

ADDRESS (including zip code)

CITY

STATE

ZIP

DESIGNATED REPRESENTATIVE

E-MAIL ADDRESS

ADDRESS (including zip code)

CITY

STATE

ZIP

TELEPHONE NUMBER

FAX NUMBER

(

)

(

)

Please be advised that the person listed above is authorized to act as our designated representative before the California State Board of Equalization in connection with the assessment of our property. Our designated representative may inspect or copy all information, documents, and records, including narrations and workpapers relating to the appraisal and the assessment of our property during the period January 1, 2009, through December 31, 2009, for the lien date 2009. I understand that this form must be filed annually in order for the representative status to remain current.
OWNER, PARTNER OR OFFICER'S SIGNATURE DATE



SIGNATORY'S PRINTED NAME

TITLE

CLEAR

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