2024 Individual Consent Form

1
Consent to Disclosure of Tax Return Information* This field is required.Please read the statement below. You will be able to consent to or decline authorization for this service on the next screen.
2
Do you authorize Drazan, Henke & Associates PLLC to disclose to its offshore staff member(s), your tax return information, including your SSN, to allow DHA staff to assist in the preparation of your individual tax return and tax planning services?* This field is required.
Yes, I/We authorize this service
No, I/We DO NOT authorize this service
3
The duration of this consent will continue as indicated below, unless DHA CPAs is notified in writing to no longer disclose your tax return information to this recipient:* This field is required.
Remain effective to the extent DHA CPAs is engaged
One year
4
Do you file Married or Single?* This field is required.
Married
Single
5
Taxpayer Full Name (Electronic Signature)* This field is required.By typing your full name in this box, it will serve as your electronic signature and acknowledgment of the terms and conditions listed above.
Taxpayer Full Name
6
Taxpayer and Spouse Full Names (Electronic Signature)* This field is required.By typing your full name in this box, it will serve as your electronic signature and acknowledgment of the terms and conditions listed above.
Taxpayer Full Name
Spouse Full Name
Should be Empty: