Purpose
Allows outside organizations or individuals to represent employers (or employing entities) in matters affecting unemployment and disability insurance before the Division of Employer Accounts. (See Form)

Use
Enables us to properly identify organizations or individuals who are authorized to receive employer documents and information, in order to maintain employer documents and information, and to maintain employer confidentiality.

Use by Employer
All Power of Attorney forms must be filled out completely by the employing company or corporation.

1. Provide legal corporate/company name, address and N.J. Taxpayer I.D. Number.

2. Original signature of authorized officer or owner of employing entity and completion of affidavit attesting to position in corporation or company.

3. Completion of notary portion; including signature, seal and expiration date.

4. Provide corporate Seal.  If no seal is available, please indicate this on the Power of Attorney.

5. Acceptance signature by qualified officer of organization or individual for whom Power of Attorney is being granted.