Client Verification for Tax Return Request

Client Verification for Tax Return Request

Section 1: Notice and Consent
To protect your personal information, we must verify your identity before releasing any tax documents. Please complete the following verification form. All responses are required for compliance with our data security policies. We are no longer able to distribute to a third party.
I understand that providing false information may delay or prevent the fulfillment of my request.*

Yes
I consent to digital identity verification in place of phone verification.*

Yes
Enter email to receive submission confirmation
example@example.com

Client Verification for Tax Return Request

Section 2: Identity Verification Questions (At least 4 of 5 required)
Full Name (as listed on your most recent tax return)*

First NameLast Name
Business Name (if requesting business returns)
Last 4 Digits of SSN or EIN SSN or EIN*
Mailing Address from Most Recent Tax Return *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Tax Year(s) Being Requested *
If requesting a specific document (not tax return), please list below
Name of Spouse or Dependent on Return (if applicable)

First NameLast Name

Client Verification for Tax Return Request

Section 3: Delivery Preference
How would you like to receive your documents?*

Encrypted Email (only if approved)Priority Mail (client will be responsible for postage costs)
If encrypted email is chosen, what email would you like it sent to?
example@example.com
If priority mail is chosen, what address would you like it mailed to?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Client Verification for Tax Return Request

Section 4: Signature & Attestation
I certify that the above information is accurate and complete. I understand that Adams Samartino & Co PC reserves the right to deny this request if verification fails or if required documentation is not provided.*

Yes
Date*

MonthDayYear
Date
Signature*

Clear
Should be Empty: