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AUTHORIZED REPRESENTATIVE DESIGNATION You may have someone else act on your behalf in an appeal or grievance/complaint. The person you list below will be accepted as your representative. We cannot
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Fill out the authorized representative's full name, address, phone number, and relationship to the individual.
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Indicate whether the authorized representative has the authority to act on behalf of the individual.
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Sign and date the form.

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The NC - Authorized Representative is a designated person or entity who is authorized to act on behalf of a taxpayer for the purpose of tax compliance and related matters.
Any taxpayer who wishes to designate an authorized representative to handle their tax matters or communications with the tax authority is required to file the NC - Authorized Representative form.
To fill out the NC - Authorized Representative form, provide the taxpayer's information, the authorized representative's details, and specify the scope of authorization, ensuring to sign and date the form.
The purpose of the NC - Authorized Representative form is to legally grant another individual or organization the authority to represent the taxpayer in tax-related matters.
The form requires reporting the taxpayer's name, address, identification number, the authorized representative's details, and the specific powers being granted to the representative.
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