Tax E-signatures Needed

Tax E-signatures Needed

This form documents the taxpayer's authorization to execute tax returns and related documents electronically and to permit electronic filing for the tax periods and return types indicated below. Provide a Social Security Number or Employer Identification Number and complete all applicable sections.

Taxpayer Information

Taxpayer Name:

Taxpayer Identification Number (TIN)

Provide either a Social Security Number OR an Employer Identification Number. Do not enter both unless required for multiple tax entities.

Entity Type (check applicable boxes)

Individual / Sole Proprietor C Corporation S Corporation Partnership Trust / Estate LLC Other:

Tax Periods and Return Types

Return types to be electronically signed and filed (check all that apply):

Federal income tax return State income tax return(s) — State(s): Extension request Amended return Estimated tax payment authorization

Authorization for Electronic Signature and Filing

By signing this form, the taxpayer grants the following authorizations and makes the certifications set forth below. The taxpayer understands that an electronic signature on a tax return has the same legal force and effect as a handwritten signature.

1. I certify, under penalties of perjury, that I have examined the tax return(s) to be filed electronically and to the best of my knowledge and belief they are true, correct and complete.
2. I authorize the preparer or authorized representative identified on this form to transmit the return(s) and to use my electronic signature or Personal Identification Number (PIN) on my behalf solely for the purpose of electronically filing the return(s) listed above.
3. I consent to receive electronically delivered copies of the filed return(s), acknowledgements, and any communications required in connection with electronic filing unless otherwise agreed in writing.
4. I understand that I remain legally responsible for the accuracy of the information reported on the return(s) and that signing does not relieve me of any tax liability or penalties that may result from incorrect or incomplete information.
5. I authorize the disclosure of tax return information necessary for electronic filing and acknowledgment of filing between tax authorities and the preparer for the limited purpose of filing and verification.
6. I will notify the preparer promptly if any information provided to the preparer changes before the return(s) are filed or if I revoke this authorization in writing.

I expressly consent to the use of electronic signatures and authorize electronic filing as described above. I authorize the preparer to apply my electronic signature or PIN on my behalf when submitting the return(s).

Preparer / Representative (if applicable)

Important: Signing below constitutes a legal signature for the return(s) and authorizations contained in this form. False statements made knowingly may be subject to penalties under applicable law.

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