Dynasty Tax Solutions is not responsible if the taxpayer provides us with incorrect information (i.e. social security numbers for self, spouse, or dependents, last names, birth dates). This may delay your refund. Dynasty Solutions is not responsible for any IRS audits. All information obtained from the taxpayer and/or spouse must be presentable if the IRS audits your tax return. Dynasty Solutions is not responsible for any incorrect tax figures provided by the taxpayer and/or spouse. If your tax figures change you will need to do an Amendment. Prices Vary. If you have any federal or government debts (i.e. school loans, child support, DFCS, etc….) there is a chance that your refund will be applied towards your debt. You can call the offset department at 1-800-304-3107 or 1-800-829-7650 to see if your refund will be partially or fully taken. If your refund is fully taken you are responsible for paying the preparation fees. Dynasty Solutions provides the taxpayer with ONE complimentary copy of their tax return. Should you need any additional copies, there is a $30 fee per copy (federal and state included). Dynasty Tax Solutions is not responsible for any discussions or changes the IRS or bank may make on disbursement dates, filing status or any other required information from the IRS. Dynasty Tax Solutions is not responsible for any IRS glitches or problems that may cause a delay in your tax refund. We DO NOT reimburse any bank fees in the event of this occurrence.

Consent to Use Taxpayer Information

This form is provided to you by Dynasty Tax Solutions. 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 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 our tax return preparation services. If we obtain your signature on this form by conditioning our tax preparation 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. 

Consent to Disclosure of Tax Return Information for Financial Products

This form is provided to you by Dynasty Tax Solutions. Federal law requires this consent form be provided to you. Unless authorized by law, we, as your Tax Preparer, cannot use your tax return information 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 our tax return preparation services. If we obtain your signature on this form by conditioning our tax return preparation 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. 

Taxpayer Declaration and Signature Authorization

Under penalties of perjury, I declare that I have examined a copy of the income tax return (original or amended) I am now authorizing, and to the best of my knowledge and belief, it is true, correct, and complete. I further declare that the amounts in Part I above are the amounts from the income tax return (original or amended) I am now authorizing. I consent to allow my intermediate service provider, transmitter, or electronic return originator (ERO) to send my return to the IRS and to receive from the IRS an acknowledgement of receipt or reason for rejection of the transmission, the reason for any delay in processing the return or refund, and the date of any refund. If applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicated in the tax preparation software for payment of my federal taxes owed on this return and/or a payment of estimated tax, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke (cancel) a payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537. Payment cancellation requests must be received no later than 2 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. I further acknowledge that the personal identification number (PIN) below is my signature for the income tax return (original or amended) I am now authorizing and, if applicable, my Electronic Funds Withdrawal Consent. 

DISCLOSURE AND CONSENT TO RECEIVE DOCUMENTS ELECTRONICALLY
With your consent, Republic Bank & Trust Company (“Republic”) will deliver the Refund Transfer Application and Agreement (the “Agreement”) and all related disclosures and notices (collectively referred to as “Bank Documents”) to you by displaying or delivering them electronically, and requesting that you print or download and retain the Bank Documents for your records. If you are filing a joint tax return, the pronouns “you” and “your” used in this shall be understood to include both you and your spouse, where applicable.

DISCLOSURE AND CONSENT TO RECEIVE DOCUMENTS ELECTRONICALLY
This Disclosure contains important information that you are entitled to receive before you consent to electronic delivery of the Bank Documents. Your consent also permits the use of electronic signatures and electronic records in connection with the Agreement. Please print or download a copy this Disclosure for your files.

After you have read this Disclosure, if you agree to receive the Bank Documents from Republic electronically, and if you agree to the general use of electronic records and electronic signatures with Republic, please sign below.

Computer Hardware/Software Requirements
In order to access your Bank Documents electronically, you must: 1. Be able to view the Bank Documents on your monitor. 2. Have access to an internet service provider and use Internet Explorer 11.0 and higher, Firefox 51.0 and higher, Google Chrome 56 and higher, Safari 7 and higher, or Edge 20 and higher to receive required information. 3. Be able to print (recommended) or download the Bank Documents. 

Your Consent is Required
Please be advised that if you do not consent to electronic delivery of the Bank Documents, Republic cannot proceed with the acceptance and processing of your Agreement. Your consent does not require Republic to provide the Bank Documents electronically. Republic, at its discretion, may deliver the Bank Documents or otherwise communicate with you through other means. Furthermore, Republic may require certain communications from you to be delivered to Republic, on paper, at a specified address.

Withdrawal of Consent
If you consent to electronic delivery of the Bank Documents, you may withdraw that consent at any time. To withdraw consent after clicking below, please contact Republic’s Tax Refund Solutions’ Taxpayer Support at 1-866-581-1040.

Paper Copies Available
At any time, you may request to receive paper copies of the Bank Documents by mailing Republic’s Tax Refund Solutions ATTN: Exception Processing, PO Box 2348, Louisville, KY 40201. Postage fees may apply.

Consent
Please read the below paragraph and if you consent to the terms, sign below.

I confirm that the Internet access device I will use to receive the Bank Documents meets the requirements described above and that I have been able to view this Disclosure using that Internet access device. I have read the Disclosure and consent to receiving the Bank Documents electronically and also consent to the use of electronic signatures in place of handwritten signatures and the use of electronic records in connection with the Bank Documents *