CONSENT TO USE OF TAX RETURN INFORMATION

For the purposes of this consent form, "we," "us," and "our" mean
MODERN TAX ATL, LLC a subsidiary of SEAMLESS, LLC.

Federal law requires this consent form to be provided to you ("you" refers to each taxpayer, if more than one). Unless authorized by law, we (we," "us," and "our" refers to the tax return preparer and the tax return preparation firm) cannot use your tax return information to third parties for purposes other than the preparation and filing of your tax return without your consent. 

You are not required to complete this form to engage in our tax preparation services. 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 one year from the date of signature.

If you do not consent, then you may still have your tax return prepared and electronically filed by us for a fee.

For your convenience, we have entered into arrangements with a third party to provide qualifying taxpayers with the opportunity to apply for financial products (Loan, Electronic Refund Check, or electronic Refund Deposit). To determine whether these products may be available to you, we will need to use your tax return information by analyzing it and calculating the amount of your anticipated refund. 

If you would like us to use your tax return information to determine whether these products may be available to you while we are preparing your return, please sign and date this consent to the use of your tax return information.

By 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 year 2024 tax return to determine whether to present you with the opportunity. 

CONSENT TO DISCLOSURE OF TAX RETURN INFORMATION

For the purposes of this consent form, "we," "us," and "our" mean
MODERN TAX ATL, LLC a subsidiary of SEAMLESS, LLC.

Federal law requires this consent form to be provided to you. ("you" refers to each taxpayer, if more than one). Unless authorized by law, we (we," "us," and "our" refers to the tax return preparer and the tax return preparation firm) cannot disclose your tax return information to third parties for purposes other than the preparation and filing of your tax return without your 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 to engage in our tax preparation services. 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 from the date of signature.

You have indicated that you are interested in applying for financial products (an Advance, Electronic Refund Check, or an Electronic Refund Deposit) from Republic Bank & Trust Company ("RBT") (herein referred to as "Third Party or "Third Parties").
In order to have your application processed by the "Third Party(ies") we must disclose all of your tax year 2024 return information. If you request a more limited disclosure of tax return information, you will not be eligible to submit an application request for these Products or Services.

If you would like us to disclose your tax year 2024 return information for this purpose, please sign and date your consent to the disclosure of your tax return information.

By signing below, you (including each of you if there is more than one taxpayer) authorize us to disclose to Third Party(ies) all of your tax year 2024 return information so that the Third Party(ies) can evaluate and process your application for a financial product. You understand that if you are not willing to authorize the disclosure of your tax return information with the Third Party, you will not be able to obtain a financial product from the third party but you can still choose to pay us directly to have your tax return prepared and filed. This consent is valid for the duration indicated above.

CERTIFICATIONS:

You understand that the Refund Disbursement Service is (i) an optional product offered in exchange for or receive a tax refund.

1. The information I have provided is true and accurate.

2. You are at least eighteen (18) years old (or older as required by applicable state law), and have presented to Tax Preparer one of the following valid forms of Picture ID: Driver's License, BMV/DMV State ID, Military ID, Passport, Resident Alien ID, or other Government-Issued Picture ID.

3.payment of a fee, (ii) n o t a loan or an extension of credit, and (iii) n o t required in order to file your taxes

4. You received a completed copy of this Application and Agreement, and you have carefully read and considered all of the provisions of this Application and Agreement.

5. You agree that the "Expected Refund Amount," "Authorized Fees and Payments Disbursed from Refund,"Estimated Total Deductions," and "Estimate Refund Amount Paid to You" are good faith estimates based upon the amount of your tax return filings.

6. You authorize that we make each disbursement specified on the "Authorized Fees and Payments Disbursed from Refund" prior to disbursing the remaining proceeds to you.

 7. You have selected the disbursement option above to receive the remaining proceeds from your tax return(s), if any.

8. You have authorized your tax preparer to submit this Application on your behalf.

9. You have read, understand, and agree to all of the terms of this Application and Agreement, including the

WAIVER OF RIGHT TO TRIAL BY JURY AND ARBITRATION PROVISION

10. You understand and agree to be bound by the terms of the Refund Disbursement Service Agreement.

USA PATRIOT ACT DISCLOSURE: IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT: In an effort to protect you and our country, the USA PATRIOT Act was signed into law. To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens a new account. As such, we ask for your name, address, date of birth, and other information that will allow us to identify you. We may ask for a driver's license or other identifying documents. We will share certain of this information with third parties as necessary to fulfill our obligations and as disclosed in this Application and Agreement.

I, acknowledge that I have receipts regarding my personal business in my possession. I have provided the above summary to Modern Tax ATLANTA Tax Service for the preparation of my 2024 tax return but did/did not provide them with all of the receipts and records.