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One of the most popular disclosure forms is:
Use -
All Situations
- Consent is sought for use or
disclosure of tax return information, Such as, for example,
use for tax planning as future events
change your situation, or disclosing or
providing a copy of the tax return and discussing same with
your mortgage lender or your lawyer.
Federal
law requires this consent form be provided to you. Unless
authorized by law, we cannot use or disclose, without your
consent, your tax return information 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. 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 four years. |
|
Duration of Consent if other than four years (optional - state
so in "special instructions"
section
of
the
Electronic "Signature" Submission Form): |
I,
[INSERT NAME OF TAXPAYER - in the
Electronic "Signature" Submission
Form]
authorize Colin M. Cody, CPA, CMA to disclose to my banker, lawyer
etc. or use for updating me as applicable [SPECIFY RESTRICTIONS
OR ADDITIONAL TAX RETURN
INFORMATION TO BE DISCLOSED / USED - in "special instructions"
section
of the Electronic "Signature" Submission
Form]
for any purpose [DESCRIBE RESTRICTIONS OR ADDITIONAL AUTHORIZED USE
AND DISCLOSURES in "special instructions"
section
of the
Electronic "Signature" Submission Form].
Note: If there are multiple reasons for requesting consent to use
tax return information they may all be listed in one consent
form. See Revenue Procedure 2008-35, section 6 for examples. |
| 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. |
| Taxpayer
Signature: |
Date: |
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