Information about you giving the power of attorney

Name	Norwegian ID number
Address
Email	Telephone number

Who can act on your behalf? (attorney / representative)

Name	Norwegian ID number
Address
Email	Telephone number

Power of attorney regarding	Valid from date	to date
What kind of information do you want your representative to have? (for example tax assessment or refund)
Do you want refund paid to a bank account that does not belong to you, give us information about the bank account here. We can only register a power of attorney bank account for up to 3 years at the time.
Power of attorney – bank account number / IBAN	Power of attorney - BIC / SWIFT

You must enclose a copy of a valid ID.

Place and date	Signature (you giving the power of attorney)