I hereby certify that all information disclosed here is complete and accurate to the best of my knowledge. 

*must pay tax prep fees upfront; must attach bank document for any direct deposit.

I do solemnly swear, affirm and promise under criminal penalty for fraudulent use of a false or fictitious name or address or for making a false material statement punishable by law that the statements contained herein are true and accurate.

I here absolve, defend, indemnify and hold harmless: the owners, management, employees, independent contractors, sub-contractors, and affiliates of YTL Financial Enterprises Inc and all dba’s from any and all claims arising from the authorized or unauthorized use of the requested, specified, and acknowledged services described herein.

I do promise to cease all communication by mail, phone calls, and visits to the business establishment if contract is revoked or future service of products or services are cancelled with verbal or written notice.

Federal law requires this consent form be provided to you (“you” refers to each taxpayer, if more than one). Unless authorized by law, we (“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 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 the signature.

You have indicated that you are interested in receiving an Electronic Disbursement Service and/or Loan (or collectively, “Products or Service”) from a financial institution, a division of Pathward Bank, First Century Bank N.A., or Green Dot Bank. In order to provide you with the opportunity to apply for one of these Products or Services, we must disclose all of your tax return information necessary for evaluating the request to a financial institution. 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 return information for this purpose, please sign and date your consent to the disclosure of your tax return information.

By signing below, you authorize us to disclose to the financial institution all of your tax return information necessary for the evaluation and processing of your request for a Product or Service. You understand that if you are unwilling to authorize the disclosure and sharing of your tax return information with the financial institution, you will not be able to obtain a Product or Service, but you may still choose to have your tax return prepared and filed by us for a fee.

 

Federal law requires this consent form to be provided to you (“you” refers to each tax payer, if more than one). Unless authorized by law, we cannot use your return information for purposes other than the preparation and filling 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. 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 tax payer) authorize us to use the information you provide to us during the preparation of your tax return to determine whether to present you with the opportunity to apply for these products and services.

 

Click on the 'Browse Files' button below to upload all unexpired identification cards, social secuirty cards, and ALL income and expense documents and all documents you would like considered in the preparation of your taxes. If applicable, attach an Income and Expense statement and/or a Profit and Loss statement.