Consent To Disclosure Of Tax Return Information printable pdf download

Consent To Disclosure Of Tax Return Information

Consent to Disclosure Of Tax Return Information

("we," "us" and "our")

Printed name of tax preparer

Federal law requires this consent form be provided to you. Unless authorized by law, we

cannot disclose your tax return information to third parties for purposes other than those

related to the preparation and filing of your tax return without your consent. If you

consent to the disclosure of your tax return information, Federal law may not protect

your tax return information from further use or distribution.

You are not required to complete this form. Because our ability to disclose your tax

return information to another tax return preparer affects the tax return preparation

service(s) that we provide to you and its (their) cost, we may decline to provide you with

tax return preparation services or change the terms (including the cost) of the tax return

preparation services that we provide to you if you do not sign this form. If you agree to

the disclosure of your tax return information, your consent is valid for the amount of time

that you specify. If you do not specify the duration of your consent, your consent is valid

for one year from the date of signature.

In order to process your return we must disclose all of your 2015 tax return information

that we partner with in order to

provide certain services.

If you will allow us to disclose your 2015 tax return information to

for this purpose, sign and date your consent to the disclosure of your tax return information.

By signing below, you (including each of you if there is more than one taxpayer)

authorize us to disclose to

all of your

2015 tax return information. If you are not willing to authorize us to share your tax

information with the other firms, you can still choose to have your tax return prepared

and filed by us for a fee.

Printed Name of Taxpayer:

Taxpayer Signature:

Date:

Printed Name of Joint Taxpayer:

Joint Taxpayer Signature:

Date:

If you believe your tax return information has been disclosed or used improperly in a

manner unauthorized by law or without your permission, you may contact the Treasury

Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or

by e-mail at complaints@tigta.treas.gov.

Consent To Disclosure Of Tax Return Information