[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-301461-105":3,"detail-sidebar-cat-1-en-105":80,"doc-detail-301461-en":126},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","individual-tax-disclosure-fill-in-1040blue","Individual Tax Disclosure - Fill In - 1040Blue","","Individual Tax Disclosure consent form used to authorize release of U.S. tax return information. It collects the individual’s identity details, contact information, and affiliation, then specifies how disclosure may occur (telephone, email, in-person, or U.S. mail). It also defines the authorization period, whether additional information can be provided or inquiries answered, and warns about rights and validity of consent. It includes signatures, dates, and contact address details.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/forms/","Forms",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/individual-tax-disclosure-fill-in-1040blue/301461/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/individual-tax-disclosure-fill-in-1040blue/301461.png","ImageObject",442,249,{"name":42,"@type":43},"eBook King","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-09-23","2026-09-19",true,{"@type":52,"interactionType":53,"userInteractionCount":22},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What information does the form collect from the individual?","Question",{"text":62,"@type":63},"It collects the individual’s name, email address, company or affiliation, and phone number, along with the printed name, signed name, and date.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"How can the tax return information be disclosed according to the form?",{"text":67,"@type":63},"Disclosure can be authorized via telephone conversation, email, person-to-person meeting, or U.S. mail.",{"name":69,"@type":60,"acceptedAnswer":70},"What happens if the consent period is not specified?",{"text":71,"@type":63},"If no duration is specified, the consent is valid for one year.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},301461,1790148105,{"code":4,"msg":81,"data":82},"success",[83,88,93,98,103,108,112,117,122],{"id":84,"doc_module":22,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},11,"Presentations",90,"presentations",{"id":89,"doc_module":22,"doc_module_name":25,"category_name":90,"show_sort_weight":91,"slug":92},12,"Resumes",80,"resumes",{"id":94,"doc_module":22,"doc_module_name":25,"category_name":95,"show_sort_weight":96,"slug":97},14,"Invoices",70,"invoices",{"id":99,"doc_module":22,"doc_module_name":25,"category_name":100,"show_sort_weight":101,"slug":102},15,"Posters",60,"posters",{"id":104,"doc_module":22,"doc_module_name":25,"category_name":105,"show_sort_weight":106,"slug":107},16,"Social Media",50,"social-media",{"id":109,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":110,"slug":111},17,40,"forms",{"id":113,"doc_module":22,"doc_module_name":25,"category_name":114,"show_sort_weight":115,"slug":116},18,"Letters",30,"letters",{"id":118,"doc_module":22,"doc_module_name":25,"category_name":119,"show_sort_weight":120,"slug":121},21,"Paper Templates",5,"papers-templates",{"id":123,"doc_module":22,"doc_module_name":25,"category_name":124,"show_sort_weight":4,"slug":125},158,"General","general-158",{"code":4,"msg":81,"data":127},{"doc_id":78,"user_id":128,"nickname":42,"user_avatar":129,"doc_module":22,"category_id":109,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":22,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":135,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":12,"update_tm":139,"read_time":4},962088006270,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Name  \nEmail Address  \nCompany or affiliation  \n(  )  Phone Number  \nThe manner in which information is to be disclosed:  \n( ) Via telephone conversation  \n( ) Via email  \n( ) Person-to-person meeting  \n( ) Via U.S. mail  \nThe period of time this authorization and consent covers:  \n( ) For a period of ( ) one week ( ) one month ( ) one year ( ) other    \n( ) For the period of time it takes to disclose/communicate information requested  \nAuthorization to provide additional information or respond to inquiries:  \nShould the parties identified above request additional information,  \n( ) authorization is given to provide additional information related to the initial inquiry without an additional or amended authorization.  \n( ) authorization is given to respond to inquiries via telephone or email.  \n( ) authorization is withheld.  \nFederal law requires this consent form to be provided 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.  \nYou 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.  \nIf 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 email at [complaints@tigta.tres.gov](complaints@tigta.tres.gov), or by telephone at 1-800-366-4484.  \nDo not sign this form if you have not read and understood what it asks for, and the permissions you are giving us.  \nPrinted Name Signed Name Date  \nPrinted Name Signed Name Date  \n410 W. Amerige Ave. Fullerton, Ca. 92832  \nTele : (714) 526-1676 Fax : (714) 526-7819 [e-mail :](e-mail : Info@1040Blues.com)[ ](e-mail : Info@1040Blues.com)[Info@1040Blues.com](e-mail : Info@1040Blues.com)  \n[www.](www.1040Blues.com)[1040Blues](www.1040Blues.com)[.com](www.1040Blues.com)","cbCais4DObseiiA7","https://ap.wps.com/l/cbCais4DObseiiA7","pdf",945528,"English","# Individual details and contact information\n## Disclosure methods and authorization period\n## Additional information authorization and consent requirements\n## Signature, date, and sender contact","[{\"question\":\"What information does the form collect from the individual?\",\"answer\":\"It collects the individual’s name, email address, company or affiliation, and phone number, along with the printed name, signed name, and date.\"},{\"question\":\"How can the tax return information be disclosed according to the form?\",\"answer\":\"Disclosure can be authorized via telephone conversation, email, person-to-person meeting, or U.S. mail.\"},{\"question\":\"What happens if the consent period is not specified?\",\"answer\":\"If no duration is specified, the consent is valid for one year.\"}]","Individual Tax Disclosure - Fill In - 1040Blue | PDF",1789782642]