Indiana Limited Power of Attorney Form Instructions 2024-2025
This form grants an individual or corporation the authority to act on behalf of the permittee in matters related to the Indiana Alcohol and Tobacco Commission. It requires notarization and specific details about the permit and representative. The form remains effective until revoked in writing.
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How do I fill this out?
To fill out this form, you'll need to provide detailed information about the permit holder and the appointed attorney-in-fact. Make sure to fill out all sections legibly and complete the notarization process. Follow these initial instructions to get started.

How to fill out the Indiana Limited Power of Attorney Form Instructions 2024-2025?
1
Type or print legibly.
2
Complete all sections with the required information.
3
Sign the form before a notary public.
4
Ensure the appointed representative's details are correct.
5
Submit the notarized form to the Indiana Alcohol and Tobacco Commission.
Who needs the Indiana Limited Power of Attorney Form Instructions 2024-2025?
1
Business owners needing representation before the Indiana Alcohol and Tobacco Commission.
2
Individuals granting authority to act on their behalf for permit matters.
3
Corporations appointing a representative for confidential information handling.
4
Permit holders delegating document execution responsibilities.
5
Any party requiring a legally-binding power of attorney for specific permit-related actions.
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What are the instructions for submitting this form?
Submit the completed form to the Indiana Alcohol and Tobacco Commission via mail to 302 W Washington St, Indianapolis, IN 46204. For additional submission options or inquiries, contact their office at (317) 232-2430. Ensure the form is notarized and includes all required information. My advice is to double-check all details before submission to avoid delays or rejections.
What are the important dates for this form in 2024 and 2025?
Ensure the form is submitted before any relevant deadlines in 2024 and 2025 for your permit matters with the Indiana Alcohol and Tobacco Commission.

What is the purpose of this form?
The purpose of this form is to grant limited power of attorney to an appointed representative to act on behalf of the permittee in matters related to the Indiana Alcohol and Tobacco Commission. This includes receiving confidential information and executing documents pertaining to the specified permit number. The form ensures proper delegation of responsibilities and compliance with legal requirements.

Tell me about this form and its components and fields line-by-line.

- 1. Permittee(s) Name(s): The name of the individual or entity granting the power of attorney.
- 2. d/b/a Name(s): Any doing business as names associated with the permittee.
- 3. Permit Number: The specific permit number related to the power of attorney.
- 4. Address: The address of the permittee, including street, city, state, and ZIP code.
- 5. Telephone Number: The permittee's contact number.
- 6. Individual Representative/Firm Corporation Name: The name of the appointed individual or firm.
- 7. Address: The address of the appointed representative, including street, city, state, and ZIP code.
- 8. Representative(s) Name: The names of individual representatives if a firm or corporation is appointed.
- 9. Signature: The signature of the permittee or authorized corporate officer.
- 10. Printed Name: The printed name of the signee.
- 11. Date: The date of the signing.
- 12. Title: The title of the signee if applicable.
- 13. Notary Public: The section to be filled out by the notary public, including name and commission details.
What happens if I fail to submit this form?
Failing to submit this form may result in the inability to delegate authority or manage permit matters effectively.
- Loss of Representation: Without submission, you cannot delegate authority to the appointed representative.
- Permit Management Issues: Failure to submit may impede proper handling of permit-related tasks.
- Legal Non-Compliance: Non-submission could result in non-compliance with legal requirements.
How do I know when to use this form?

- 1. Delegating Authority: When you need someone to act on your behalf for permit-related actions.
- 2. Confidential Information Handling: To authorize a representative to manage sensitive information.
- 3. Document Execution: When documents need to be executed by a designated individual.
- 4. Permit Management: For effective delegation of permit-related responsibilities.
- 5. Legal Requirements: To ensure compliance with Indiana Alcohol and Tobacco Commission regulations.
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