Tax Return Release Form

Taxpayer Consent to Use Tax Return Information Pursuant to Treasury Regulation §301.7216-3(a)

Internal Revenue Code §7216 generally prohibits any person who is engaged in the business of preparing U.S. income tax returns from using information furnished to that individual for the preparation of any such return. Treasury Reg. §301.7216- 3(a)(1) provides that such tax return information can be used if written consent of the taxpayer is obtained. This document is intended to provide written consent to use your tax return information for purposes other than the preparation and filing of your return

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Client Information

Name

First

Last

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Phone

Release Information

Release:

Individual Tax Return (Form 1040 & accompanying state forms)
Corporate Tax Return (Form 1120 or 1120S & accompanying state forms)
Partnership Tax Return (Form 1065 & accompanying state forms)
Other

For the tax year(s):

Recipient Information

Company Name

Contact Name

First

Last

Delivery Method:

Email
Fax
Mail

This consent is valid through

Release Terms & Conditions

I/We hereby authorize MJO Bookkeeping Services, LLC to disclose the specified information to the designated recipients mentioned above.

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 the preparation and filing of your tax return, without your written 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. 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 and financial statements, 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.

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Taxpayer Signature

Date

Spouse Signature

Date

MJO Bookkeeping Services LLC

Tax Return Release Form

Taxpayer Consent to Use Tax Return Information Pursuant to Treasury Regulation §301.7216-3(a)

Client Information

Release Information

Recipient Information

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