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The form explains that consent is voluntary, outlines consequences if consent is not provided, and specifies that consent lasts for the duration selected or one year if no duration is provided. It authorizes disclosure to a partnered financial institution to offer Refund Transfer and/or loan products, with refund timing options and upfront payment requirements. 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Unless authorized by law, we cannot use or disclose your tax return information for purposes other than the preparation and filing of your tax return.  \nYou are not required to complete this form. Because our ability to disclose your tax return information to another institution affects the service(s) that we provide to you and its (their) cost, we may decline to provide you with the tax return preparation services or change the terms (including the cost) of the tax return preparation services that we provide to you. 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.  \nFor your convenience, we have entered into agreements with a bank to provide qualifying taxpayers with the opportunity to apply for a (bank product) Refund Transfer (RT) and/or Loan via Electronic Refund Check or Electronic Refund Deposit. In order to provide you with the opportunity to apply for one of these Products or Services, we must disclose all of your tax return information to our partnered financial institution.  \nBy signing below, you (including each of you if there is more than one taxpayer) authorize us to disclose to financial institution we partnered with all your tax return information.  \nBy signing below, you (including each of you if there is more than one taxpayer) authorize us to use the information you provided to us during the preparation of your tax return to determine whether to present you with the opportunity to apply for a bank product (described above) and services.  \nName of Taxpayer    \nTaxpayer Signature   Date    \nName of joint Taxpayer    \nJoint Taxpayer Signature   Date    \nTax Intake Form  \nPage-2  \nTAXPAYER  \nSocial Security Number:   -   -    \nFirst Name:   MI:   Last Name:   Date of Birth:   Date of Death:   Work Phone:   Cell/Other Phone:   Occupation:   Email:    \nLegally Blind? Yes   NO  Dependent of Other? Yes   NO   \nSPOUSE  \nSocial Security Number:   -   -    \nFirst Name:   MI:   Last Name:   Date of Birth:   Date of Death:   Work Phone:   Cell/Other Phone:   Occupation:   Email:    \nLegally Blind? Yes   NO  Dependent of Other? Yes   NO   \n\n| FILING STATUS\u003Cbr>Single:  \u003Cbr>Married Filing Joint:  \u003Cbr>Married Filing Separately:  \u003Cbr>Head of Household:  \u003Cbr>Qualifying Widower:   | ADDRESS\u003Cbr>Street & Apt. No.   City:   State:   Zip:   County:   |\n| --- | --- |\n|  |  |\n| HOW DO YOU WANT YOUR REFUND? (Check one of the following)\u003Cbr>o 7-14 days (RT Refund Transfer: Check)\u003Cbr>􀂅 In about 7-14 days from the date your return is accepted electronically by the IRS, you receive a check for the amount your refund less filing fees. (Check will be available in our office)\u003Cbr>o 7-14 days (RT Refund Transfer: Debit Card)\u003Cbr>􀂅 In about 7-14 days from the date your refund is accepted electronically by the IRS, for the amount your refund less filing fees will be deposited onto the debit card we issue you.\u003Cbr>o 7-14 days (RT Refund Transfer: Direct Deposit)\u003Cbr>􀂅 In about 7-14 days from the date your refund is accepted electronically by the IRS, for the amount your refund less filing fees will be deposited into your bank account.\u003Cbr>CASH ADVANCE OPTION (Check one of the following)\u003Cbr>*The loan offered based on your expected tax refund. Some loans are interest bearing loan, and will have an annual APR. Please confirm the interest rates with your preparer.\u003Cbr>o Apply for Cash Advance (RT Refund Transfer)\u003Cbr>􀂅 YES\u003Cbr>􀂅 NO\u003Cbr>THE FOLLOWING REQUIRES UPFRONT PAYMENT\u003Cbr>o E-file: Direct Deposit\u003Cbr>▪ Your refund will be deposited into your savings or checking account directly from IRS approximately 10-14 days after your return is accepted by IRS.\u003Cbr>o 3-4 Weeks (E-file: Check)\u003Cbr>▪ Your refund will be mailed to you directly from IRS in approximately 3-4-we","cbCaieKrCxt66wqB","https://ap.wps.com/l/cbCaieKrCxt66wqB","pdf",617815,8,"English","# Consent and Authorization\n## Taxpayer and Signature Details\n## Filing Status and Refund Options\n## Cash Advance and Upfront Payment\n## Dependents Details\n## Daycare Information\n## Single Parent With Dependents\n## Non-Standard and Adult Dependents\n## Additional Notes","[{\"question\":\"Is the consent form required, and what happens if it is not completed?\",\"answer\":\"You are not required to complete the form. The preparer may decline tax return preparation services or change the terms, including cost, because providing disclosure affects service and fees.\"},{\"question\":\"How long is my consent valid if I do not specify a duration?\",\"answer\":\"If you do not specify the duration, your consent is valid for one year.\"},{\"question\":\"What do I authorize when I sign regarding Refund Transfer or loan products?\",\"answer\":\"By signing, you authorize disclosure of your tax return information to the partnered financial institution to determine eligibility and to provide the opportunity to apply for the listed bank products and services.\"}]","Consent to Use and Disclose of the Tax Return - Tax Intake Form | PDF",1789821945]