Release of Information Template

CUSTOMIZED TAX REFUND FORM

PERSONAL TAX REFUND INFORMATION
CONFIDENTIAL AND ENCRYPTED FORM

Please Be Advised, That In Accordance To Federal And State Laws, This Particular Form Is Engineered And Sustained To Transmit Any And All Data, Submitted Via Clients, Confidentially, Successfully, And Securely. With That Said, We Encourage, Recommend, And Suggest That You Submit Any And All Information, Documents, And Or Data Via A Private Device; And, Not That Of A Shared Nor Public Platform. Given Our Instructions, Be Assured That All Transmittals, Are Received Via Our Firm Via No Interruption, Manipulation, Nor Interference; With, The Most Sophisticated, Secure, And Innovative Technology.

- Traci Thomas, CEO Fin-Tech Bank And Designer, NTT Management Group, Inc
Upload A Clear Color Copy Of Your Driver's License ( ALL 4 CORNERS MUST SHOW )

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Upload A Clear Color Copy Of Your Social Security Card ( ALL 4 CORNERS MUST SHOW )

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HOMEOWNER'S ONLY : Upload A Copy Of Your Mortgage 1098 Form From Your Lender

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CALIFORNIA RESIDENTS ONLY : 1095-A Form Healthcare Insurance Form ( If You Do Not Have This Specific Form; Then, Obtain One Immediately Via Website: www.HealthCare.gov

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Upload A Clear And Color Copy Of Voided Check For Deposit Of Funds ( ALL 4 CORNERS MUST SHOW )

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PLEASE BE ACCURATE WITH YOUR INFORMATION

CUSTOMIZED REFUND IS THE SUM OF : $30,000 USD (2021) / $35,000 USD (2022)
CLIENT NAME WHOM IS REQUESTING BUSINESS CUSTOMIZED REFUND

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth

MonthDayYear
Date
WHAT TAX YEAR ARE YOU REQUESTING CUSTOMIZED PERSONAL REFUND

202120222021 AND 2022
Social Security Number
PLEASE READ CAREFULLY : If You Do Not Have Your Personal Income Tax, Identity Protection Pin ( IP PIN ) ; Then, You May Obtain It By Visiting The Following Website : www.irs.gov ( Retrieve Your Identity Protection PIN ) Tab. Please Note, If You DO NOT Have Your Personal Identity Protection PIN ( IP PIN ) Now To Complete This Form; Then, You Must Have One Re-Issued Via The Internal Revenue Service ( IRS ) ; Which, Will Take An Additional 21( TWENTY-ONE ) Days To Receive, By " Mail " Via The United States Postal Service ( USPS ) . However, You May Move Forward With Us, To Request Your Customized Personal Refund Upon This Specific Form; However, It Will Be " Mailed " By Our Firm; Then Forwarded By Us, Directly To The Internal Revenue Service ( IRS ) , Via The United States Postal Service ( USPS ) ; And, Not E-Filed ( Electronically Filed ); Which, Will Delay The Receipt Of Your Refund. Lastly, Should You Owe Any Personal Taxes Via Previous Tax Years; Then, That Specific Owed Amount Will Be Deducted From Your Customized Personal Refund; And, You Will Receive The Net Sum, Of The Difference, As Your Customized Personal Refund. And, E-Filed Submissions Produce A Customized Personal Refund Directly To Your Designated Bank Account, Or Cash App, Within 14 ( FOURTEEN ) - 21 ( TWENTY-ONE ) Business Days; As, Mail Submissions Via The United States Postal Service, Are Indeed Delayed.
Please Read The Above Disclosure And Type " YES " Via The Above Field To Agree To Our Terms And Conditions
If You Are Requesting 2022 Personal Refund, Please Provide Tax PIN From 2021 ( Line 11 )
What Tax Year Did You Last File Your Personal Tax Via The Internal Revenue Service ( IRS )

MonthDayYear
Date
Email
example@example.com
Phone Number

Area CodePhone Number
******* FOR EXPEDITED RECEIPT OF YOUR CUSTOMIZED TAX CREDIT*********
AN INTERNAL REVENUE SERVICE ( IRS ) IDENTITY PROTECTION PIN IS REQUIRED: PLEASE PROVIDE PIN : blanks To Obtain AN IRS PIN, Please Visit Encrypted Website, To Obtain One Immediately, By Applying Directly Upon The Following IRS Website : www.irs.gov
Marital Status
Please Be Accurate With Your Submission Of Data
Number Of Dependents
Name Of Dependent #1 Dependent #1 DOB / SS#
Name Of Dependent #2 Dependent #2 DOB / SS#
Name Of Dependent #3 Dependent #3 DOB / SS#
Name Of Dependent #4 Dependent #4 DOB / SS#
What Is The Best Time To Reach You To Verify Your Personal Income, Which Will Be Requested Verbally Via Our Firm, To Verify Amount, With This Form Submission?

MorningAfternoonEveningWeekend
Signature

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Date of Signing

MonthDayYear
Date
On Behalf Of MAX 4 TAX, Founder And Originator, L. Montgomery CPA, We Are Honored To Assist You Via This Legal, Lawful, Logical; Yet, Innovative Process. And, We Are Determined To Move Forward With Greater Capabilities; Such That, Communities Nationwide Are Serviced With Immaculate Expertise. Therefore, We Greatly Appreciate Your Sincere Feedback Regarding Our Techniques.

Please Rate Our Digital Interface Platform Experience ( 1 STAR - POOR / 5 STARS - EXCELLENT )
VERIFY CASH APP OR BANK ROUTING NUMBER ACCOUNT NUMBER
VERIFY CASH APP OR BANK ROUTING NUMBER ACCOUNT NUMBER blank
Should be Empty:

CUSTOMIZED TAX REFUND FORM

PLEASE BE ACCURATE WITH YOUR INFORMATION