Bta.wa.gov
Representative Authorization I am the taxpayer in this appeal to the Washington State Board of Tax Appeals (WSBTA). I authorize the person or firm identified below to act on my behalf in all matters related to this appeal. I understand that if I fail to timely notify the WSBTA of any change in representation, I could be barred from seeking to extend a submission or other filing deadline. BOE or DOR Petition Number(s):______________________________________________________________________Assessment Year(s) or Audit Period:______________________________________________________________________Representative Name and Firm:______________________________________________________________________Representative Mailing Address:______________________________________________________________________Representative Telephone Number:______________________________________________________________________Representative Email:______________________________________________________________________Taxpayer Name:______________________________________________________________________Taxpayer Mailing Address:______________________________________________________________________Taxpayer Telephone Number:______________________________________________________________________Taxpayer Email:______________________________________________________________________Signature: ______________________________________ Date: __________________ ................
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