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Home My WebLink AboutPOWER OF ATTORNEY AND DECLARATION OF REPGRESENTATIVE FORM 2848 Form . 2848 Power of Attorney and Declaration of Representative ~ Type or prlnl ~ See the separate instructions. OMS No.' 154S.Q150 For IRS Use Only Received by: Name Telephone Funclion (Rev. June 2008) 0eparlmenI alllle TI83Sllr)' Intemal Revenue SeMce Power of Attorney Caution: Form 2848 will not be honored for an pu se other than representation before the IRS. 1 Tax ayer Information. Tax yer(s) must si n and date this form on page 2, line 9. Taxpayer name(s) and address Social security number(s) AUGUSTA RICHMOND COUNTY PENSION PLAN 530 GREENE STREET AUGUSTA, GA 30911 Date I I Employer Identification number Daytime telephone number ( 706) 724-4557 58 : 2204274 Plan number Vf applicable) hereby appoint(s) the following representative(s) as altorney(s)-in-fact: 2 Representative(s) must sign and date this form on page 2. Part II. Name and address CI>F No. ..... .......~_~Q~:~9.~~~ ..._........_ Telephone No. ........ !.~~:~~~:~~.~1.......... Fax No. ..H.......?~~~.~Q:'~?~.4D........... 0 Check if new: Address w Telephone No. Fax No. CI>F No. .. _ . . . . .. .. . .. .. . . . . . . .. . .. _ . . .. .. . .. . . . . Telephone No. ........... _..... ... ._....._ _" ... Check if ne:~~~~s~"tj'''''';:~i~Ph~~~'N~:D''''''F~~-NO. 0 CI>F No. .... ........... _...... ............. ...... Telephone No. .. _ ..... ... ... .... _. . . ..... .. _.... Check if ne::~:~~s~'D""";:~i~Ph~~~'N~.-rr""'F~'X"NO. 0 to represent the taxpayer(s) before the Intemal Revenue Service for the following tax matters: JAMES W BURROUGHS CPA 4468 COLUMBIA ROAD MAR G 30907 Name and address Name and address 3 Tax matters Type of Tax Oncome. Employment, Excise. etc.) or Civil Penalty (see the instructions for line 3) Tax Form Number (1040,941,720. etc.) Vear(s) or Period(s) (see the instructions for line 3) INCOME, EMPLOYMENT FORM 945 2008-2010 4 Specific use not recorded on Centralized Authorization File (CAF).lf the power of aUorney is for a specific use not recorded on CAF. 0 check this box. See the instructions for Line 4. Specific Uses Not Recorded on CAF . . . . . . . . . . . . . . ~ Acts authorized. The representatives are authorized to receive and inspect confidential tax information and to perform any and all acts that I (we) can perform with respect to the tax matters described on line 3. for example. the authority to sign any agreements, consents, or other documents. The authority does not include the power to receive refund checks (see line 6 below), the power to substitute another representative or add additional representatives. the power to sign certain returns, or the power to execute a request for disclosure of tax retums or return information to a third party. See the line 5 instructions ror more information. exceptions, An unenrolled return preparer cannot sign any document for a taxpayer and may only represent taxpayers in limited situations. See Unenrolled Return Pre parer on page 1 of the instructions. An enrolled actuary may only represent taxpayers to the extent provided in section 10.3(d) of Treasury Department Circular No. 230 (Circular 230). An enrolled retirement plan administrator may only represent taxpayers to the extent provided in section 10.3(e) of Circular 230. See the line 5 instructions for restrictions on tax matters partners. In most cases, the student practitioner's (levels k and I) authority is limited (for example, they may only practice under the supervision of another practitioner). 5 Ust any specific additions or deletions to the acts olherwise authorized in this power of attorney: . . .. . . _ . . . . . _ . . . . . ... . . . . . . . . _ _ . . . .. . . . . . . .................................................................................................................................................................... ..............................................................--............................................................................................................ ...................................................................................................................................................................... 6 Receipt of refund checks. If you want to authorize a representative named on line 2 to receive. BUT NOT TO ENDORSE OR CASH. refund checks, initial here and list the name of that representative below. Name of representative to receive refund check(s) ~ For Privacy Act and Paperwork Reduction Act Notice, see page 4 of the Instructions. Cat. No. 11980J Form 2848 (Rev. 6-2008) Form 2&l8 lRllv..u.2001.11 7 Notices and oommullica~ions. Original notices and other written communicationswiHbe Spn! to YOll and>acopy to the first representative listed on line 2. a If you also vlantthesecondJepresentative listecltomceivea copy of notices and communications. checkthts box. b ILyou do not want any notices or communicutionssent to your mpresentativc(s}, ch~Ck:this box 8 Retention/revocation ofprior.power(s) of attorney. The mingof this power of attomeyatJtomalicafly revokes .ailearfier power(s)of attorney on flle with the intemal Revenue Service for the same tax matters and years Or periods covered by this document If you do not 0 wanlto revoke uprlor power oLaUorney. check here. 1>0. YOU MUST ATTACH A COpy OF ANY POWER OF ATTORNEY YOU WANT TO REMAIN IN EFFECT. Page 2 1>00 1>00 9 Signature of taxpayer(s). ILa tax matter concerns a loint return, both h\Jsbund and wile must sign if joint represent.il1on is requested. othenuise, see the instrucllons. Ifsigned by a. corporate officer, partner,guardian. tax mutters partner,executor. receiver, administrator. or trustee on behalf of the taxpayer, I certify that I have. the authorlly to..execute this form Of) behalf of the taxpayer. ... IF NOT SIGNED AND DATED, THIS POWER OF ATTORNEY WILL BE RETURNED. Ul0~A h - - - - - - - - '"j~~ha~r;- - - - - - - .- - ~~:'::~1:~~~~,\",.,,~. ~~y,~~..~.:..~~.~.:~~.~~$.\~l~.~'?.~:;~~~h~, 0 [] 0 ~printN~ ~.." a...,,,.... .0. '\'~, PIN Number I:'"~ c, {!)e$ ~"4'1~ G;t~ 'tl) '/)1:,', . .,' ..1A.t~)'~.~\~, .m.. .k!:f#,,-...r4.1(f[~~..~._...-........u Lena J. BoJi \ JJ:"~c!JirL) ~ D D D 0 - .....-- --.... ...-......."'... -'* .._......"'fff.jf~"'.-... !~........ -..... .~~......." --;;,'>> .~ Print amo...."c., ",,0"" ..:: PIN Number h -q,~'o.of) 4'7 '4~" (~~. r<~ IDIII Oeclaration~of'Rapre'irentative Caution:Studentswitll a special order to represent tuxpayersin qualified Low Income Taxpayer Clinicsodlle Student Tax Clinic Program (levels k andQ. sea the. instructions. for Part II. Under penalties of perjury. I declaratha!: · I am not currently ullder suspension Qrdisbarment from practice before the Internal R\!Venue Service: · I am aware of wgulatiofls contained in Circular 230(31 CFR, Part 10). as amended, concerning the practice of attorneys, certified pubhc accountants. enrolled agents. enrolled actuaries, and otherS; · lam authorized to represent the taxpayer(s) identified in Part I lor Ihe tax malterls) specified there; and . I am one of the following: a Attorney-a member in good standing of Ihe bar of the highest court of thejurisdk;fion shown below, b Certified PubliC Accountant-duly qualified to practice as a certified puoHc accountant in the Jurisdiction shown below. c Enrolled Agent-enrolled as an agent under the requirements of Circular 230, d Officer-a bona fide omcero! the taxpayer's organization. e Full.Time Employc(J:--QfulHimeemploYOtl of tho taxpayer. f Family Member-a member ofthe taxpayer's immediate family (lor example. spouse. parent. child. brother. or sister), 9 Enrolled Actuary-emolled as. an actuary by the JOint Board for the EmoHmentofActuaries under29 U,S,C, 1242 (the authority to practice before tl1elntemal Revenue Service is limited by section 1O.3(d) of Circular 230). h Un enrolled Retum Preparer-the authority topmctice before the Internal Revenue Service is limited by Circu!ar230, section 10,7(c)(1)(vW). You must have prepared the return in question and the return must be under examination by the IRS. SeeUnenrolled Return Pre parer on page 1 of the instructions, k Student Attorney-student who receives pemlission to practice before the IRS by virtue of their status as a Imv stueiont under seclion 10. 7(d). of Circular 230. Student CPA-student who receives permission to prat.:tice before the IRS by vlrtueoftheir status asa CPA studentunclersectiol1 10.7(d) at Circular 230. r Enrolred Retirement Plan Agent-enrolled as a reliremeht plan agent under the requirements of Circular 230 (Ihe authorityJo practice before the Internal Revenue Service is limited by section 1O.3(ej), ... IF THIS DECLARATION OF REPRESENTATIVE IS NOT SIGNEOANDDATED,THEPOWER OF ATTORNEY WILL BliRETURNEO. See.the Part II instructions. Designation-Insert Jurisdiction (state) or above letter (a-r) identification .r;._I.(.r:.{~L Date - P:1!'!..~.~ ~__. _._ ___.__........m....__ Title (if applicable) Id.YGils1JJ...I!./r;/lmp.JY.Q. daJlY.ti.~l4/'L.pl.lJ j.) .".... Printnameoftaxpayer from line 1 ifotherlhan individual .?l~9.{g2..m.. Date Clerk of Commission ............ ..."'........_... ...._.....no-..... ..............~'.-.. ........~......"" ........... ...... _........... Title (if applicable) Signature Dale B GA r:J:...... ,>-4 "":t:l "-=~~~~~ ~ . ,- ""S--2.87P 7' Form 2848 .James\'!. Burroughs, CPA, P.c. Certified Public Accountant May 28, 2009 Dept of the Treasury Internal Revenue Service Cincinnati, OH 45999-(){)42 Dear Sir or Madam: Re: Augusta Richmond County Pension Plan 58-2204274 PleascJlnd enclosed form 945 lor 2008. [am assistingQutlliJled Plan Admillistrators,Inc. in Augusta, Georgia with the admih.istrationofthe Augusta Richmond County Pension Plan5.1n this capacity I would like to explaitlthe pwblcm we haveencolllltered. Qualifled Pltm Administrators, Inc. assumed the responsibility ofadministcringthe plan effectiveJanuury J, 2008. We were operating under the assumption that the county personnel were making tax PllJ'ments as required onalllonthly basis. We were providing thepertinentinformatiem to them to make these payments. During the year we<becameawarc that the deposits were not being made as required. At that time we required alldep()sits in arrears to be</lladc and future deposits made em as:'l"stcmatic timely basis. The county personnel assumed that wcwerc nmkingthesepayments on their behalf. We understand theAugustH Richmond County Pension fllndhas had an excellent history of making the tax payments timely. We ask that ynuconsiderthat fjlct and \Va/veall penalties and interest arising from the late tax deposits. Should YOll need further explanation or assistance please contact me immediately. Sincerely, ..",,^. f7 C' "", /''} _..::?":::~?7?--::;;:J'~~'" . . ""- .Hil1le~ \V. Burroughs L- V \tnninC'z Executive SuitCs' 446>; Columbia Road' \lartim'z. CiA 30IJ07' 701\.860.5251 . Fax 706"li60-5794' jan OePllflme(lt elthe T'e.?s;uly into,nal Rownue: SllnMll 7 Annual Retum of Withheld Federallncom.e Tax . Fat withholding roportud on forms 1tl9911nd W-2G. . S.. ..puatlllnllruelion.. ro,1'I\01'O Inlo'tlUIlion anlncomlllAx wlthholdlng.lln P"b. 15 (Cr..c. E) llnd Pllbd5-A. Please type or print, OMS No. 1S45.143\l Form 945 2008 Enter slate code for slale in which deposits wore made only if different from stille in address 10 Ihe right (see t.he instructions). . r NAttlo (Ill cll$lIll~uls""cll'anl tladll nema) AUGUSTA RICHMOND COUNTY PENSIO T'lldO'l\llmo. Illlny CIlIOl\dll' Yon' ---, If address is different from prior retum.. check here ..H..... . 0 Emllleye, tdonliliealllll'l1lO Address (numbu, Me! ShUlll) 58-2204274 011, SIDI.., andZU' code 530 GREENE STREET IGA I LAUGUSTA, GA 30911 ~ A II you do not have to ale returns in the future, check hore.. "" D.and enter datefinatpaymentsmade"" Fedoral income tax wilhheldlrom pensions, annuilios, IRAs. gambling winnings,ele ... .".. <.' ......c,..'.. 502905.19 2 Backup withholding 2 3 Adjustment to correct admlnislrative errors (see Ihe instructions). . . . . . . . . . . . . . . . . . 3 4 Total taxes. If $2,500 or more, this must equallin~ aM be.low or line M of Form 945-A. . . . 4 502905.19 5 Total deposits for2008 from your records. including overpayment appliedfrom200Veturn........ ..... 5 502905.19 6 Balance due (subtraellinc 5 from line 4) (see the instructions) 6 7 Overpayment. II line 4 is less Ihan line 5. enler overpayment here. . . .. . . ... $ and check if 10 be: o Applied 10 nexl relurn or 0 Refunded. · Allflfors: If Une4 is less than $2,500, do not complete !ineaOt Form 945.A. · Semiweekly schedulo depositors: CompleleFotnl 945-A and check here.. ., . ... .. .. . . ..... ..........., ......,........ · Monthly schedule doposltors: Complete line 8, entries A through M, and check here. . . . . . . . . . . . . . . . . .. .... ............. :@ 8 K November....... . L December.;...... Tax liabili . for month 41955.29 41955.29 A January.......... B February........ C Marcll........... o April............. E Ma ............. M No. Third Party Designte Phone Sign Here Paid Preparer's UseOnfy '3/16/2009 istrators Inc Chnclllf snll.omp!ayo4 30901 EL'l Phone no. 58-2133279 706-724-4557 Form (2008)