DR-486POA Power of Attorney for RepresentationDR-486POA
R. 12/20
Rule 12D-16.002
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POWER OF ATTORNEY FOR REPRESENTATION F.A.C.
BEFORE THE VALUE ADJUSTMENT BOARD Eff.12/20
FLORIDA Section 194.034(1)(b), Florida Statutes
You may use this form to grant power of attorney for representation in value adjustment board proceedings.
This form or other power of attorney accompanies the petition at the time of filing.
COMPLETED BY PETITIONER
I, (name), appoint (name) as my attorney -in -fact to present
evidence and testimony and act on my behalf in any lawful way before the Select County County Value
Adjustment Board.
This power of attorney is effective immediately and is valid only for one assessment year.
This power of attorney is limited to the 20_ assessment year concerning the parcel(s) or account(s) below.
❑ I authorize the person I appointed above to have access to confidential information related to the following
parcel(s) or account(s).
Parcel ID/Account #
Parcel ID/Account #
Parcel ID/Account #
Parcel ID/Account #
Parcel ID/Account #
Parcel ID/Account #
Parcel ID/Account #
Parcel ID/Account #
This power of attorney is further limited as follows:
Signature of taxpayer/owner
Witness signature
State of Florida
County of Select County
Print name
Witness signature
Date
The foregoing instrument was acknowledged before me by means of physical presence or online
notarization on this day of (year), by (name),
who signed in the presence of the witnesses.
Personally known
Produced identification
Type of identification produced
Signature of Notary Public
Print, Type, or Stamp Commissioned Name of Notary Public