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Eral Employer Identification Number(s) Address Permit Number (s) City State Zip Code Hereby appoints: Telephone Number Name Address City State Name Zip Code Telephone Number Address City State Zip Code Note: If you appoint an organization, firm or partnership, you must also name an individual within the organization to act on your behalf. As attorney(s)-in-fact to represent taxpayer before the Oklahoma Tax Commission and/or acquire any tax form(s) and/or documents that taxpayer.

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