DR-486poa Power of Attorney for Representation Before the VABDR-486POA
E N. 01/17
w POWER OF ATTORNEY FOR REPRESENTATION Rule 12D-16.002
BEFORE THE VALUE ADJUSTMENT BOARD Eff.0117
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 COLLIER 0 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
State of Florida
County of D
The foregoing instrument was acknowledged before me this
by
the presence of these witnesses:
Witness signature
Personally known OR produced identification
Type of identification produced
Print name
day of
Date
, 20
(name), who signed in
Witness signature
Signature of Notary Public
Print, type, or stamp commissioned name of Notary Public