7216 - Standard - Consent for Disclosure of Tax Information

Please note, if you are married, we will need a disclosure from BOTH spouses to provide joint information to an outside vendor. You will need to use the same link again (go back to the original link) to fill out a second copy of the form. Thanks!

Call us if you have questions, 602-357-3275, or for faster response text us at 602-362-7939.
Consent for Disclosure of Tax Information

Pursuant to IRC Section 7216
Federal law requires this consent form be given to you. Unless authorized by law, we cannot disclose, without your consent, your tax return information to third parties for purposes other than the preparation and filing of your tax return. 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. If we obtain your signature on this form by conditioning our services on your consent, your consent will not be valid. 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.
Your Name (This is you, the Tax Goddess client)*

First NameLast Name
Your E-mail*
example@example.com
Company Name(s) if applicable:
I authorize the following disclosure of my tax/other information:
Information to be disclosed:*

All Information: Any information, related to any service or data we maintain, or other knowledge we have on you/your personal/business records including but not limited to WOI (Waiting on information) Sheets.Only Tax Returns: Any & All (Past & Future)Share 1099, W2, etc copies with Staff / ContractorsOther: Describe in the box below
If you checked the other box, explain here
Any other information pertaining to the approved person(s) or business entity/entities for all/specific years.This could include things such as: ALL/EVERYTHING; IRS matters, Payment arrangements, Mortgage Balances, Financial Accounts, etc, etc. This can be ANYTHING you want it to be. Please be as specific or as broad as you want. Example: If you wrote (EVERYTHING) that means that our firm would release to this person anything they ask us for / about that we know regarding you.
Person(s) to whom disclosure is authorized: (This is the person you want us to speak to on your behalf)

Examples: Financial Planner, Attorney, Banker, Insurance Rep, Real Estate Agent, Mortgage Broker, Etc.
Full Name*

First NameLast Name
Company or Affiliation
E-mail*
Telephone Number*

Area CodePhone Number
Any additional authorized person(s):, (Put their contact details in the box below)
The manner in which information is to be disclosed: (select all applicable)*

In any way (inclusive, but not limited to, text, call, email, "all of the ways")via telephone conversationvia emailvia faxvia U.S. mailvia in-person meetingSlack
Duration of consent*

perpetualone weekone monthone year
Authorization to provide additional information or respond to inquiries:
Should the parties identified above request additional information,*

Authorization is given to provide additional information related to the initial inquiry without an additional or amended authorization. Authorization is given to respond to inquiries in any manner.Authorization is withheld.
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 email at complaints@tigta.treas.gov.

Do not sign this form is you have not read it and understood what it asks for, and the permissions you are giving us.
Signature (Taxpayer)*
Date*

MonthDayYear
Should be Empty:

Consent for Disclosure of Tax Information

I authorize the following disclosure of my tax/other information:

Person(s) to whom disclosure is authorized: (This is the person you want us to speak to on your behalf)

Authorization to provide additional information or respond to inquiries: