General Power of Attorney

BY INDIVIDUAL FOR THE COLLECTION OF CERTAIN

CHECKS DRAWN ON THE UNITED STATES TREASURY
Know all by these Presents:
That the undersigned, ____________________________ , of ___________________________________
(address)
does hereby appoint _____________________________ , of ___________________________________
(address)
as his/her attorney to receive, endorse, and collect checks payable to the order of the undersigned, drawn on the
United States Treasury, and to execute in the name and on behalf of the undersigned, all bonds, indemnities,
applications, or other documents, which may be required by law or regulation to secure the issuance of substitutes
for such checks, and to give full discharge for same, granting to said attorney full power of substitution and
revocation, hereby ratifying and confirming all that said attorney, or his substitute, shall lawfully do or cause to be
done by virtue hereof.
WITNESS the signature of the undersigned, this _________day of __________________ , 20 ____
________________________________
(Signature of grantor)
* Personally appeared before me the above-named ________________________________________________
known or proved to me to be the same person who executed the foregoing instrument, and acknowledged to me
that he executed the same as his free act and deed.
WITNESS my signature, official designation, and seal.
________________________________
[IMPRESS SEAL HERE] (Signature of attesting officer)
________________________________
(Official designation)
Dated at ____________________ , this ______ day of ____________________ , 20 _____
My commission expires ______________________, 20 _____
IMPORTANT Do not execute this instrument without first reading the instructions on the next
page. Exact compliance with these instructions will avoid complications.
* See Instructions on next page Paragraphs 2(a) and 2(b)
DEPARTMENT OF THE TREASURY
FINANCIAL MANAGEMENT SERVICE FMS 231 (SUPERSEDES SF 231 (DECEMBER 1974)
FORM
1-04
The Chief Financial Officer
IIE, 809 United Nations Plaza, NY, NY 10017
Reset
INSTRUCTIONS FMS FORM 231



Complete the following items on the General Power of Attorney (FMS form 231)



1) Type or print your name (you are the undersigned)


2) Type or print your address (the form needs your current address as of the date that you are
signing this Form 231.


3) You are the Grantor and so you have to sign and date Form 231 in front of a Notary Public.
Please ask a Notary Public to notarize your signature on the Form 231. (Your International
Student Office may have a person who is a Notary Public or may be able to tell you where to
find a Notary Public).
If possible please ask the notary to use a stamp instead of a seal since it is easier when
Grantax is making copies of your form 231.






Please submit your completed & notarized form 231 with your tax documents to Grantax
by fax (212-984-5553), email (grantax3@iie.org) or regular mail to Grantax/IIE, 809
United Nations Plaza, 6
th
Floor, NY, NY 10017-3580.
Please note that IIEs email system only accepts email attachments that are 5 MB or less.