The document provides instructions for filing a US individual income tax return through Taxback.com. It outlines the following steps:
1. Print and complete required forms using the provided checklist to ensure all necessary documentation and information is included.
2. Scan/copy forms and supporting documents like W-2s and 1099s. Save files in PDF, JPG, or JPEG format under 2MB and email to the provided address.
3. Include identification documents like a US visa page or passport ID page along with a social security card copy.
The checklist details the forms, signatures, and documentation needed like employer information, program expenses, residency details, and payment documents to fully complete the tax
This document provides instructions for completing IRS Form 4506-T to request tax transcripts. It emphasizes that the form must be filled out completely and correctly or it will be rejected, delaying mortgage assistance reviews. Specifically, it highlights that lines 1b, 2b, 6, 6a, 9, and the signature section need attention to ensure the name, SSN/ITIN, tax year, form number, and signature are provided. It also notes that copies of signed federal tax returns from the past two years must be included.
This document provides instructions for Carter L April regarding their 2009 federal tax return. It shows that April is due a $437 refund, which was reduced to $379.10 after TurboTax fees were deducted. It provides information on when the refund should be deposited, how to check the status of the refund, and a summary of April's tax filing information. No signature is needed as the return was filed electronically. It includes consent forms for TurboTax to use and disclose certain tax return information in order to process the refund and pay for tax preparation services.
This document summarizes Steffanie M Popejoy's 2013 federal tax return. It shows that she is due a $200 refund, which will be direct deposited into her bank account. It provides her address, income of $3,289, and tax details showing $0 tax owed and a $200 refund. The document includes instructions to keep it along with her printed tax return and other tax documents.
This document provides instructions for completing Form SS-4, which is used to apply for an Employer Identification Number (EIN) from the IRS. It explains that an EIN is a nine-digit number assigned for tax filing and reporting purposes. The form is used to establish a business tax account. It provides details on how to apply for an EIN online, by phone, fax or mail. It also lists related forms and publications for additional information.
The document provides filing instructions for Fran Swaine's 2013 federal tax return. It shows that she owes $2,941, which she will pay by check by the April 15, 2014 deadline. It includes her signed Form 1040 to mail with her payment, as well as estimated tax payment vouchers for 2014 that she should not send with her 2013 return. Finally, it notes that she can still choose to e-file her 2013 return instead of mailing it.
Norma J. Buchanon electronically filed her 2011 federal tax return showing a refund of $8,234. Some fees were deducted, lowering the refund to $8,176.10. The IRS estimates the refund will be direct deposited by February 1, 2012. Norma provided her bank account information for the deposit. She is not required to sign any documents since she filed electronically. Norma needs to keep her electronic filing instructions and a printed copy of her return.
This document is an IRS Form 1040A for an individual income tax return. It includes information such as the filer's name, address, social security number, filing status, exemptions, income sources, adjustments, tax, credits and payments. The summary is:
1. John and Jane Doe filed a married filing jointly Form 1040A for tax year 2014 reporting $10,779 in total income and $3,975 in adjusted gross income.
2. They claimed one dependent, Elizabeth M Law, and received a standard deduction of $9,100, resulting in $3,305 in taxable income.
3. After credits and withholdings, the Does owed $670 in taxes
This document provides instructions for completing IRS Form 4506-T to request tax transcripts. It emphasizes that the form must be filled out completely and correctly or it will be rejected, delaying mortgage assistance reviews. Specifically, it highlights that lines 1b, 2b, 6, 6a, 9, and the signature section need attention to ensure the name, SSN/ITIN, tax year, form number, and signature are provided. It also notes that copies of signed federal tax returns from the past two years must be included.
This document provides instructions for Carter L April regarding their 2009 federal tax return. It shows that April is due a $437 refund, which was reduced to $379.10 after TurboTax fees were deducted. It provides information on when the refund should be deposited, how to check the status of the refund, and a summary of April's tax filing information. No signature is needed as the return was filed electronically. It includes consent forms for TurboTax to use and disclose certain tax return information in order to process the refund and pay for tax preparation services.
This document summarizes Steffanie M Popejoy's 2013 federal tax return. It shows that she is due a $200 refund, which will be direct deposited into her bank account. It provides her address, income of $3,289, and tax details showing $0 tax owed and a $200 refund. The document includes instructions to keep it along with her printed tax return and other tax documents.
This document provides instructions for completing Form SS-4, which is used to apply for an Employer Identification Number (EIN) from the IRS. It explains that an EIN is a nine-digit number assigned for tax filing and reporting purposes. The form is used to establish a business tax account. It provides details on how to apply for an EIN online, by phone, fax or mail. It also lists related forms and publications for additional information.
The document provides filing instructions for Fran Swaine's 2013 federal tax return. It shows that she owes $2,941, which she will pay by check by the April 15, 2014 deadline. It includes her signed Form 1040 to mail with her payment, as well as estimated tax payment vouchers for 2014 that she should not send with her 2013 return. Finally, it notes that she can still choose to e-file her 2013 return instead of mailing it.
Norma J. Buchanon electronically filed her 2011 federal tax return showing a refund of $8,234. Some fees were deducted, lowering the refund to $8,176.10. The IRS estimates the refund will be direct deposited by February 1, 2012. Norma provided her bank account information for the deposit. She is not required to sign any documents since she filed electronically. Norma needs to keep her electronic filing instructions and a printed copy of her return.
This document is an IRS Form 1040A for an individual income tax return. It includes information such as the filer's name, address, social security number, filing status, exemptions, income sources, adjustments, tax, credits and payments. The summary is:
1. John and Jane Doe filed a married filing jointly Form 1040A for tax year 2014 reporting $10,779 in total income and $3,975 in adjusted gross income.
2. They claimed one dependent, Elizabeth M Law, and received a standard deduction of $9,100, resulting in $3,305 in taxable income.
3. After credits and withholdings, the Does owed $670 in taxes
1. The document is an IRS form used to register and pay occupational tax for businesses accepting wagers. It requires information about the business such as names, addresses, and employer identification numbers.
2. It specifies that a principal who operates their own wagering business must complete different sections than an agent who accepts wagers on behalf of others. Principals must provide additional details about locations, agents, and tax payments.
3. The form instructions provide guidance on who must file, when to file, how to calculate taxes, and requirements for supplemental registrations for changes in business information or agents. Failure to comply with the filing requirements can result in penalties.
The document is a letter from Mark B. Lackie, PC summarizing tax filings for NOWCASTSA for the 2016 tax year. It states that NOWCASTSA's Form 990 shows no balance due to the IRS. It provides filing instructions and reminds NOWCASTSA to retain records for 7 years in case of an audit. It is signed by Mark B. Lackie, PC and encourages NOWCASTSA to contact them if any questions arise.
This document provides information about tax forms and filing requirements for the 2016 tax year. It discusses changes to various tax forms including the 1042S, 1096, 1098, 1098T, 1099B, 1099OID, 1099R, and W-2G forms. It specifies that W-2 forms must be filed electronically if an employer has 250 or more forms to file. It also lists other forms, such as the 1098, 1099A, 1099G, 1099MISC, 1099R, 1099S, 5498, and W-2G, that must be filed electronically if an employer has 250 or more of those forms to file. The document provides details
This document provides information about the annual convention of the American Association of Physicians of Indian Origin (AAPI) to be held on November 23, 2019. It includes the schedule of events such as the CME lectures on November 3rd and the annual gala on November 23rd. The location of the gala is provided. Sponsorship opportunities and costs are listed for various levels of sponsorship. A registration form is included for attendees to provide their contact information and select payment options. The form also includes the organization's tax ID number and address.
This document is Form 4868, which allows taxpayers to request an automatic extension of time to file their U.S. individual income tax return. There are three ways to request the extension: 1) filing the form electronically and paying all or part of the estimated tax due, 2) filing the form electronically using IRS e-file software or a tax professional, or 3) filing a paper copy of the form. The form provides an extension of 6 months to file individual income tax returns, with exceptions for taxpayers living outside the country.
The document provides electronic filing instructions for Antoine Robinson's 2011 federal tax return. It shows that his refund is $1,447.20 after fees were deducted from the original $1,607 refund amount. It provides details on where the refund will be deposited and when it should arrive. It also gives contact information if he has questions about the status of his refund.
2013 north carolina_return sylvia_jarrellnellynell
This document provides instructions for filing an individual income tax payment voucher (Form D-400V) with the North Carolina Department of Revenue. It explains that the voucher should be used to pay any balance due on the 2013 Form D-400 tax return. It provides directions on how to prepare and send the payment, including making the check payable to the NC Department of Revenue, writing the taxpayer's name and address on the check, and entering identifying information like the tax year and social security number. It also lists alternative payment methods like paying online or by credit/debit card and reminds filers of important details like not stapling checks to the voucher or using photocopies of the form.
This document provides instructions for requesting a reduction in Medicare premiums due to a life-changing event that has reduced income. It allows reporting of reduced income from either the current or previous tax year. Key details include choosing a qualifying life event, entering adjusted gross income and tax filing status for the selected year, and providing documentation of income and the event. Estimates for an even lower income in the following year can also be provided.
This document is an application for enrollment to practice before the Internal Revenue Service. It requests information such as the applicant's name, address, date of birth, social security number, tax filing history, and questions regarding any past misconduct or legal issues. If approved, it will allow the applicant to represent taxpayers before the IRS. The application must be completed in full and signed, with the $80 fee, to be considered for enrollment status.
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The document provides financial information for NOWCASTSA for the year ending December 31, 2017. It includes details on net assets, revenues, expenses, and beginning and ending balances. Total revenue was $95,848, including $87,482 in contributions. Total expenses were $90,887, resulting in net income of $4,961. Net assets increased from a deficit of $4,557 to a balance of $16,230. The 990 tax return is being filed electronically.
Request for Extension of Time to File South Carolina Tax Return (File on-line...taxman taxman
This document provides instructions for filing a South Carolina Individual Income Tax Return extension (Form SC4868). It explains that the extension allows an additional six months to file the tax return. Taxpayers have until April 15th (or the original due date of a fiscal year return) to file for the extension. While the extension provides more time to file, it does not extend the deadline for paying any taxes owed. The form and instructions provide guidance on calculating balances due and ensuring payment is submitted on time.
gov revenue formsandresources forms NR-1_fill-intaxman taxman
This document is an affidavit form for North Dakota residents to claim exemption from Montana state income tax under the Montana-North Dakota reciprocal tax agreement. It requires the filer to provide identifying information, the tax year, income earned and tax withheld in Montana, employer information, and an attestation that the filer was a North Dakota resident. Instructions indicate that to claim the exemption, the filer must submit this affidavit form, Montana W-2s, and a copy of their North Dakota tax return with their Montana return.
The document is a grant agreement from the U.S. Department of Labor to the Community College of Denver awarding them $17,256,881 through the Trade Adjustment Assistance Community College and Career Training Grants program. It provides instructions on accessing awarded funds through the Payment Management System and the Grantee Reporting System. It also outlines administrative cost limitations and incorporates the solicitation for grant applications into the agreement.
The document is an application form for individuals seeking enrollment to practice before the Internal Revenue Service (IRS). It requests information such as the applicant's name, address, date of birth, social security number, and tax filing history. The form also asks if the applicant has ever been sanctioned or investigated by a professional or government body. Applicants must sign to confirm the accuracy of the information provided and authorize an investigation into their application.
Presentasi PowerPoint mempromosikan situs web Tommy's Window dan menawarkan presentasi PowerPoint tambahan yang dapat diunduh dari situs web tersebut. Presentasi ini dilindungi hak cipta.
The weather describes the current conditions of the atmosphere like temperature, wind, and precipitation. There are several common weather types including rainy days with water falling from clouds, windy days with gusts forming from differences in air pressures, cloudy days where the sun is blocked by clouds which can feel cold or trap warmth, and sunny days when clouds are absent and the sun can provide warmth despite possible cold or wind.
This document is a resume for Joshua Emmanuel R. Dee. It summarizes his objective, education history including a barista certificate from 2015 and a Bachelor's degree in Business Management from 2014. It lists work experience as a sales executive from 2012-present and assisting in operations of a bakery from 2014-present. It also provides details on co-curricular activities such as kids ministry and being an information executive. Personal details are given such as date of birth, location, languages spoken, interests and availability of references.
Dokumen tersebut membahas definisi, struktur, klasifikasi, dan patogenesis virus. Secara ringkas:
1) Virus adalah agen infeksi berukuran mikro yang hanya bereplikasi di dalam sel hidup.
2) Virus terdiri atas materi genetik yang dikelilingi kapsid protein. Ada berbagai bentuk virus.
3) Virus diklasifikasi berdasarkan kandungan asam nukleat, keberadaan selubung, jumlah kapsomer, dan tropisme
Dr. Shivram Krishnan presents ways for individuals to discover their innate potential and create a vision for themselves. He suggests answering questions about one's background, interests, strengths, and weaknesses to gain self-knowledge. Outlining career and life dreams as well as methods to achieve them can provide direction. Developing disciplines like timeliness, persistence, and investing in self-improvement through reading, skills training and education are important. Making small changes like keeping organized files and reading reports can help cultivate discipline over time.
1. The document is an IRS form used to register and pay occupational tax for businesses accepting wagers. It requires information about the business such as names, addresses, and employer identification numbers.
2. It specifies that a principal who operates their own wagering business must complete different sections than an agent who accepts wagers on behalf of others. Principals must provide additional details about locations, agents, and tax payments.
3. The form instructions provide guidance on who must file, when to file, how to calculate taxes, and requirements for supplemental registrations for changes in business information or agents. Failure to comply with the filing requirements can result in penalties.
The document is a letter from Mark B. Lackie, PC summarizing tax filings for NOWCASTSA for the 2016 tax year. It states that NOWCASTSA's Form 990 shows no balance due to the IRS. It provides filing instructions and reminds NOWCASTSA to retain records for 7 years in case of an audit. It is signed by Mark B. Lackie, PC and encourages NOWCASTSA to contact them if any questions arise.
This document provides information about tax forms and filing requirements for the 2016 tax year. It discusses changes to various tax forms including the 1042S, 1096, 1098, 1098T, 1099B, 1099OID, 1099R, and W-2G forms. It specifies that W-2 forms must be filed electronically if an employer has 250 or more forms to file. It also lists other forms, such as the 1098, 1099A, 1099G, 1099MISC, 1099R, 1099S, 5498, and W-2G, that must be filed electronically if an employer has 250 or more of those forms to file. The document provides details
This document provides information about the annual convention of the American Association of Physicians of Indian Origin (AAPI) to be held on November 23, 2019. It includes the schedule of events such as the CME lectures on November 3rd and the annual gala on November 23rd. The location of the gala is provided. Sponsorship opportunities and costs are listed for various levels of sponsorship. A registration form is included for attendees to provide their contact information and select payment options. The form also includes the organization's tax ID number and address.
This document is Form 4868, which allows taxpayers to request an automatic extension of time to file their U.S. individual income tax return. There are three ways to request the extension: 1) filing the form electronically and paying all or part of the estimated tax due, 2) filing the form electronically using IRS e-file software or a tax professional, or 3) filing a paper copy of the form. The form provides an extension of 6 months to file individual income tax returns, with exceptions for taxpayers living outside the country.
The document provides electronic filing instructions for Antoine Robinson's 2011 federal tax return. It shows that his refund is $1,447.20 after fees were deducted from the original $1,607 refund amount. It provides details on where the refund will be deposited and when it should arrive. It also gives contact information if he has questions about the status of his refund.
2013 north carolina_return sylvia_jarrellnellynell
This document provides instructions for filing an individual income tax payment voucher (Form D-400V) with the North Carolina Department of Revenue. It explains that the voucher should be used to pay any balance due on the 2013 Form D-400 tax return. It provides directions on how to prepare and send the payment, including making the check payable to the NC Department of Revenue, writing the taxpayer's name and address on the check, and entering identifying information like the tax year and social security number. It also lists alternative payment methods like paying online or by credit/debit card and reminds filers of important details like not stapling checks to the voucher or using photocopies of the form.
This document provides instructions for requesting a reduction in Medicare premiums due to a life-changing event that has reduced income. It allows reporting of reduced income from either the current or previous tax year. Key details include choosing a qualifying life event, entering adjusted gross income and tax filing status for the selected year, and providing documentation of income and the event. Estimates for an even lower income in the following year can also be provided.
This document is an application for enrollment to practice before the Internal Revenue Service. It requests information such as the applicant's name, address, date of birth, social security number, tax filing history, and questions regarding any past misconduct or legal issues. If approved, it will allow the applicant to represent taxpayers before the IRS. The application must be completed in full and signed, with the $80 fee, to be considered for enrollment status.
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The document provides financial information for NOWCASTSA for the year ending December 31, 2017. It includes details on net assets, revenues, expenses, and beginning and ending balances. Total revenue was $95,848, including $87,482 in contributions. Total expenses were $90,887, resulting in net income of $4,961. Net assets increased from a deficit of $4,557 to a balance of $16,230. The 990 tax return is being filed electronically.
Request for Extension of Time to File South Carolina Tax Return (File on-line...taxman taxman
This document provides instructions for filing a South Carolina Individual Income Tax Return extension (Form SC4868). It explains that the extension allows an additional six months to file the tax return. Taxpayers have until April 15th (or the original due date of a fiscal year return) to file for the extension. While the extension provides more time to file, it does not extend the deadline for paying any taxes owed. The form and instructions provide guidance on calculating balances due and ensuring payment is submitted on time.
gov revenue formsandresources forms NR-1_fill-intaxman taxman
This document is an affidavit form for North Dakota residents to claim exemption from Montana state income tax under the Montana-North Dakota reciprocal tax agreement. It requires the filer to provide identifying information, the tax year, income earned and tax withheld in Montana, employer information, and an attestation that the filer was a North Dakota resident. Instructions indicate that to claim the exemption, the filer must submit this affidavit form, Montana W-2s, and a copy of their North Dakota tax return with their Montana return.
The document is a grant agreement from the U.S. Department of Labor to the Community College of Denver awarding them $17,256,881 through the Trade Adjustment Assistance Community College and Career Training Grants program. It provides instructions on accessing awarded funds through the Payment Management System and the Grantee Reporting System. It also outlines administrative cost limitations and incorporates the solicitation for grant applications into the agreement.
The document is an application form for individuals seeking enrollment to practice before the Internal Revenue Service (IRS). It requests information such as the applicant's name, address, date of birth, social security number, and tax filing history. The form also asks if the applicant has ever been sanctioned or investigated by a professional or government body. Applicants must sign to confirm the accuracy of the information provided and authorize an investigation into their application.
Presentasi PowerPoint mempromosikan situs web Tommy's Window dan menawarkan presentasi PowerPoint tambahan yang dapat diunduh dari situs web tersebut. Presentasi ini dilindungi hak cipta.
The weather describes the current conditions of the atmosphere like temperature, wind, and precipitation. There are several common weather types including rainy days with water falling from clouds, windy days with gusts forming from differences in air pressures, cloudy days where the sun is blocked by clouds which can feel cold or trap warmth, and sunny days when clouds are absent and the sun can provide warmth despite possible cold or wind.
This document is a resume for Joshua Emmanuel R. Dee. It summarizes his objective, education history including a barista certificate from 2015 and a Bachelor's degree in Business Management from 2014. It lists work experience as a sales executive from 2012-present and assisting in operations of a bakery from 2014-present. It also provides details on co-curricular activities such as kids ministry and being an information executive. Personal details are given such as date of birth, location, languages spoken, interests and availability of references.
Dokumen tersebut membahas definisi, struktur, klasifikasi, dan patogenesis virus. Secara ringkas:
1) Virus adalah agen infeksi berukuran mikro yang hanya bereplikasi di dalam sel hidup.
2) Virus terdiri atas materi genetik yang dikelilingi kapsid protein. Ada berbagai bentuk virus.
3) Virus diklasifikasi berdasarkan kandungan asam nukleat, keberadaan selubung, jumlah kapsomer, dan tropisme
Dr. Shivram Krishnan presents ways for individuals to discover their innate potential and create a vision for themselves. He suggests answering questions about one's background, interests, strengths, and weaknesses to gain self-knowledge. Outlining career and life dreams as well as methods to achieve them can provide direction. Developing disciplines like timeliness, persistence, and investing in self-improvement through reading, skills training and education are important. Making small changes like keeping organized files and reading reports can help cultivate discipline over time.
This document is a project report submitted by Smritti Shaji Mathew to their professor on the topic of presumption as to proof of dowry death under Indian law. The report includes an introduction outlining the problem of dowry demands in India, relevant sections of law regarding dowry death, and the objectives and methodology of the project. It examines key aspects of proving dowry death such as the proximity test, definition of dowry, cruelty by family for dowry demands, and evidentiary standards and presumptions regarding dowry death. The report relies on legal sources and references to analyze the presumption of guilt in cases of dowry death.
This document is an application for enrollment to practice before the Internal Revenue Service. It provides instructions for completing the application, including providing contact information, eligibility details, and tax return filing history. Applicants must pay a $80 non-refundable fee and read and be familiar with Treasury Department Circular No. 230. An incomplete or intentionally false application may be denied or result in later penalties.
This document is an application for enrollment to practice before the Internal Revenue Service. It requests information such as the applicant's name, address, date of birth, social security number, tax filing history, and questions regarding any past misconduct or legal issues. If approved, it will allow the applicant to represent taxpayers before the IRS. The application must be completed in full and signed, with the $80 fee, to be considered for enrollment status.
This document is an application for enrollment to practice before the Internal Revenue Service. It requests information such as the applicant's name, address, date of birth, tax filing history, and questions regarding past conduct and eligibility. The instructions provide details on completing and submitting the application, as well as information about the enrollment process and requirements. Applicants may be limited in scope of practice depending on the basis for their eligibility such as former IRS employment. A former IRS employee applicant must demonstrate 5 years of qualifying experience interpreting tax code.
The document is an application form for individuals seeking enrollment to practice before the Internal Revenue Service (IRS). It requests information such as the applicant's name, address, date of birth, tax filing history, and questions regarding past legal or professional issues. If approved, enrollment allows one to represent taxpayers before the IRS. The form instructs applicants to complete all items, submit payment of $80, and mail the application to the IRS for review and determination of eligibility for enrollment.
The document is an application form for individuals seeking enrollment to practice before the Internal Revenue Service (IRS). It requests information such as the applicant's name, address, date of birth, tax filing history, and questions regarding past legal or professional issues. If approved, enrollment allows one to represent taxpayers before the IRS. The form instructs applicants to complete all items, submit payment of $80, and mail the application to the IRS for review and determination of eligibility.
This document summarizes an application for employment. It contains sections for general information about the applicant, the position being applied for, education and training history, work experience, and a signature agreeing to the information provided. The applicant is providing all necessary details for a potential employer to evaluate their application.
The IRS issued an Employer Identification Number (EIN) of 81-6503186 to Syntax Security Systems Trust with trustee Thomas G. Ash. The trust must file Form 1041 by April 15, 2017 and use the EIN to identify the trust on all tax forms, payments, and correspondence. The IRS also provided reminders to keep the notice and use the EIN and name exactly as shown.
This document is a request form for a monthly payment plan to pay back taxes owed to the Utah State Tax Commission. It provides instructions for taxpayers to request spreading payments of their tax debt over multiple months instead of paying the full amount at once. Key details include entering contact and account information, the tax period and amount owed, proposed monthly payment amounts, and requirements to have filed all prior tax returns to qualify for the payment plan. It explains the payment plan approval process and consequences for missing payments or future tax filing obligations.
The IRS assigned POP Protocol an Employer Identification Number (EIN) of 81-2402073. POP Protocol must use this EIN and its complete name and address exactly as shown when filing taxes, payments, and correspondence. While POP Protocol indicated it is non-profit, being assigned an EIN does not grant tax-exempt status - it must apply using Form 1023 or 1024. POP Protocol also likely needs to file a Form 990 to maintain tax-exempt status if it qualifies.
This document is an application form for individuals seeking enrollment to practice before the Internal Revenue Service (IRS). It requests information such as the applicant's name, contact details, eligibility details including examination results and tax filing history. It also includes instructions on how to complete and submit the application along with the required fee. If approved, enrollment allows practitioners to represent taxpayers before the IRS.
This document is an application for enrollment to practice before the Internal Revenue Service. It requests information such as the applicant's name, address, tax filing history, and eligibility details. If applying based on former IRS employment, the applicant must provide job history, dates of employment, and explanations for any issues. The applicant must sign to confirm the accuracy of the information and authorize an investigation.
The IRS has assigned an Employer Identification Number of 27-3958675 to BenePractice c/o Julianne Tondre. They must use this EIN and their exact legal name and address on all tax forms and correspondence. BenePractice must file Form 1120 corporate tax returns by March 15, 2011 and may need to make estimated tax deposits. The notice also provides information on S corporation elections and where to find tax forms and assistance.
The IRS assigned an employer identification number (EIN) of 47-4031466 to Singer Sensation. They must use this EIN and the name and address shown exactly when filing tax documents. Singer Sensation must file Form 1120 by May 18, 2015 for tax periods back to 2008, or risk penalties for late filing if balances are due. The IRS also provided information on S corporation elections and electronic payment options.
The IRS assigned ABC Finest Concepts EIN 47-4798029 and informed them to use this number on all tax forms and filings. ABC Finest Concepts must file Forms 940, 944, and 1120 by the dates shown in the notice. The IRS also provided information on available filing assistance and reminded ABC Finest Concepts to keep the notice for their records and use the EIN exactly as displayed.
The IRS assigned David Michael Tweedie an Employer Identification Number (EIN) of 27-4074069. Tweedie must file Form 941 by April 30, 2011 and Form 940 by January 31, 2012. The IRS also provided information on electronic filing requirements and tax deposit procedures.
This document is a payment agreement request form for the Utah State Tax Commission. It allows taxpayers to request a monthly payment plan if they cannot pay the full amount owed on their individual income tax return. Taxpayers provide personal information and details of the requested payment plan such as the monthly payment amount and due date. The form instructions explain how to complete the form and the requirements of the payment agreement if approved.
This document provides filing instructions for mailing in a 2006 federal tax return. It includes:
- What to include with the return - the signed Form 1040 and copies of Forms W-2.
- Where to mail the return - the Internal Revenue Service Center in Austin, TX by April 17, 2007.
- What to keep for records - a copy of the return and these filing instructions.
This new representative form from MyVideoTalk USA requires the representative to provide contact information and acknowledge company policies. The representative must sign and date the form, and attach a completed W-9 tax form, in order for commissions to be paid.
1. The document is an IRS form for occupational tax and registration for wagering activities. It is used to register wagering businesses and pay the associated occupational tax.
2. The form must be filed by principal operators, who accept wagers for their own account, and employee-agents, who accept wagers on behalf of others. It collects information about the business such as addresses, ownership, and agents.
3. Supplemental registration returns must be filed when changes occur, such as hiring a new agent, to update the IRS on the current business registration information.
1. This document is an Occupational Tax and Registration Return form for wagering activities. It is used to register wagering businesses and pay the required occupational tax.
2. The form must be filed by principal operators, who accept wagers for their own account, and employee-agents, who accept wagers on behalf of others. It requires information about the business owners, locations, employees, and any changes that require supplemental registration.
3. Failure to accurately and timely file this form can result in penalties. All businesses accepting wagers must register, pay the occupational tax, and keep accurate records according to the instructions in order to comply with Internal Revenue Service regulations.
1. USA TAX REGISTRATION
www.taxback.comtaxback.com, 333 N. Michigan Avenue, Suite 2415, Chicago, IL, 60601
1
IT’S QUICK AND EASY TO ORGANIZE YOUR US INDIVIDUAL INCOME
TAX RETURN WITH TAXBACK.COM. JUST FOLLOW THE STEPS BELOW:
Print and complete the forms using
the checklist below to help you
Email these scanned copies to
usdocuments@taxback.com
Scan / copy all forms*
CHECKLIST
Please note that we will need a fully completed pack before we can confirm your US tax position. We’ve prepared this checklist
below so you can ensure you’ve completed all sections and included any required documentation.
1. Application Form
Please complete both pages in full.
The more details you provide, the
faster we can process your claim.
2. 2848 Form
Please sign and date the form on the second
page where indicated by the .
Note: If you are married, each spouse must sign
and date a separate copy of the 2848 form.
3. 8821 and 8822 Forms
Please sign and date the forms
where indicated by the .
5. 7216 Form
Please write your name, sign and date
the form where indicated by the .
4. Customer Agreement and Power of Attorney
Forms
Please sign and date where indicated by the .
6. ID
Send us a photocopy of your US visa
(or the ID page of your passport) and
a copy of your social security card.
7. Your payment documents
Send us your final payment documents from
each employer - W2 forms, final pay slips or
any other cumulative statements of earnings
supporting US source income and taxes paid in
USA (such as 1099 forms, 1042S, etc).
Thank you for choosing to use taxback.com. We look forward to working with you to file your US tax return. In this pack, you will
find everything you need to authorise taxback.com to file this return on your behalf. At Taxback.com, we know that not everyone’s
tax affairs are the same. That’s why there is quite a lot of information in this pack. However, you only need to complete the sections that are
relevant to you. If you’d like help with the form, let us know and we’ll arrange for someone to talk you through filling it out.
*Make sure you set the paper size to A4 and the resolution to at least 300dpi. Save the file in PDF, JPG or JPEG format before you email them to us. Each file should not exceed 2MB. If you are
having any difficulties with scanning your documents, please talk to us at www.taxback.com/chat or ring your local office at www.taxback.com/contactus.asp
1
2. USA TAX REGISTRATION
www.taxback.comtaxback.com, 333 N. Michigan Avenue, Suite 2415, Chicago, IL, 60601
APPLICATION FORM
CONTACT INFORMATION PLEASE PRINT IN BLOCK CAPITALS
Title: Mr Mrs Miss First Name
Middle
Initial
Surname
Date of Birth dd / mm / yy Mobile Telephone
Email
Postal Address
Nationality How did you hear about our services?
VISA INFORMATION
Visa Type: J1 F1 H1B H2B Q L E P O
Tourist Other (please specify) ___________________________________
Program Type: Work & Travel Intern
Other (please specify) ____________________________________
Date of arrival in the USA dd / mm / yy Date of departure from the USA dd / mm / yy
Have you ever filed a US tax return with the IRS before? Yes No If yes, please state for which year: __________________________________
Which tax year are you applying for now? _________________ Have you applied for this tax year before? Yes No
If you were in the US before the tax year you are applying for, it is important to provide information about those visits including visa type and days of
presence in the US - please complete the information in the grid below:
2013 2012 2011 2010 2009
Visa Type
(see list above for options)
Number of days spent in
the US
RESIDENCY INFORMATION
Before you were in the US
Did you have a job in your home country? Yes No
Which country did you spend most of your time in? ____________________________________
While you were in the US
Did your mail go to your home address? Yes No
Did you intend to return to your home country? Yes No
Did you have a bank account in your home country? Yes No
After you were in the US Did you return to University? Yes No
2
Brian Henry
3. USA TAX REGISTRATION
www.taxback.comtaxback.com, 333 N. Michigan Avenue, Suite 2415, Chicago, IL, 60601 3
EMPLOYER 1
Company name
Address
Telephone State you worked in
Start work date dd / mm / yy Final work date dd / mm / yy
Did your employer cover the cost of your: Food Yes No Accommodation Yes No
Do you have your W2 Form? Yes No If no, would you like us to get a replacement for you?* Yes No
YOUR US PROGRAM EXPENSES
Costs Currency Amount Year Paid Receipt Yes/No* If No can you obtain proof
Program
(Work & Travel, Internship, etc)
Yes No Yes No
Flights (to and from the US) Yes No Yes No
Rent (total rent paid in the US) Yes No Yes No
*If you have receipts please include a copy of the receipts when you return this pack to us.
If you do not have receipts, please note receipts are required if the above expenses can be used in your calculation – your account manager will advise you if we need you
to obtain copies at that time.
*Document retrieval fee applies
EMPLOYMENT INFORMATION
EMPLOYER 2
Company name
Address
Telephone State you worked in
Start work date dd / mm / yy Final work date dd / mm / yy
Did your employer cover the cost of your: Food Yes No Accommodation Yes No
Do you have your W2 Form? Yes No If no, would you like us to get a replacement for you?* Yes No
If you had more than 2 employers or any additional income from the US please include information on a separate page.
Please tick which living expenses you paid for in your home country, while you were on your US program:
Insurance (Medical / Home / Health etc) Club Membership (Gym / Sports / Social etc)
Mobile Phone Costs Insurance/Registration fees for transportation vehicles (Car / Motorbike / Bicycle)
Housing Costs (Rent / Mortgage) Other (please specify) __________________________________________________
4. USA TAX REGISTRATION
Form 2848(Rev. July 2014)
Department of the Treasury
Internal Revenue Service
Information about Form 2848 and its instructions is at www.irs.gov/form2848.
OMB No. 1545-0150
For IRS Use Only
Received by:
Name
Telephone
Function
Date / /
Part I Power of Attorney
Caution: A separate Form 2848 must be completed for each taxpayer. Form 2848 will not be honored
for any purpose other than representation before the IRS.
1 Taxpayer information. Taxpayer must sign and date this form on page 2, line 7.
Taxpayer name and address Taxpayer identification number(s)
Daytime telephone number Plan number (if applicable)
hereby appoints the following representative(s) as attorney(s)-in-fact:
2 Representative(s) must sign and date this form on page 2, Part II.
Name and address
Check if to be sent copies of notices and communications
CAF No.
PTIN
Telephone No.
Fax No.
Check if new: Address Telephone No. Fax No.
Name and address
Check if to be sent copies of notices and communications
CAF No.
PTIN
Telephone No.
Fax No.
Check if new: Address Telephone No. Fax No.
Name and address
(Note. IRS sends notices and communications to only two representatives.)
CAF No.
PTIN
Telephone No.
Fax No.
Check if new: Address Telephone No. Fax No.
Name and address
(Note. IRS sends notices and communications to only two representatives.)
CAF No.
PTIN
Telephone No.
Fax No.
Check if new: Address Telephone No. Fax No.
to represent the taxpayer before the Internal Revenue Service and perform the following acts:
3 Acts authorized (you are required to complete this line 3). With the exception of the acts described in line 5b, I authorize my representative(s) to receive and
inspect my confidential tax information and to perform acts that I can perform with respect to the tax matters described below. For example, my representative(s)
shall have the authority to sign any agreements, consents, or similar documents (see instructions for line 5a for authorizing a representative to sign a return).
Description of Matter (Income, Employment, Payroll, Excise, Estate, Gift, Whistleblower,
Practitioner Discipline, PLR, FOIA, Civil Penalty, Sec. 5000A Shared Responsibility
Payment, Sec. 4980H Shared Responsibility Payment, etc.) (see instructions)
Tax Form Number
(1040, 941, 720, etc.) (if applicable)
Year(s) or Period(s) (if applicable)
(see instructions)
4 Specific use not recorded on Centralized Authorization File (CAF). If the power of attorney is for a specific use not recorded on CAF,
check this box. See the instructions for Line 4. Specific Use Not Recorded on CAF . . . . . . . . . . . . . . .
5a Additional acts authorized. In addition to the acts listed on line 3 above, I authorize my representative(s) to perform the following acts (see
instructions for line 5a for more information):
Authorize disclosure to third parties; Substitute or add representative(s); Sign a return;
Other acts authorized:
For Privacy Act and Paperwork Reduction Act Notice, see the instructions. Cat. No. 11980J Form 2848 (Rev. 7-2014)
✔
✔ ✔ ✔ THIS POWER OF ATTORNEY IS
✔
ILIYAN TZAKOV
TAXBACK
14 ST STEPHEN'S GREEN, DUBLIN 2, IRELAND
0304-87184R
P00745795
+353 1 635 3740
+353 1 670 6963
INDIVIDUAL INCOME TAX 1040, 1040NR 2014, 2013, 2012, 2011
FICA TAX 843, 8316 2014, 2013, 2012, 2011
ITIN W-7
BEING FILED PURSUANT TO REGULATIONS SECTION 1.6012-1(a)(5) BY REASON OF CONTINUOUS ABSENCE FROM THE USA AS
APPLICABLE TO US RESIDENTS AND SECTION 1.6012-1(b)(3) AS APPLICABLE TO NON-RESIDENTS
RECEIPT OF REFUND CHECKS AS AGENT FOR TAXPAYER
Brian Henry
5. USA TAX REGISTRATIONForm 2848 (Rev. 7-2014) Page 2
b Specific acts not authorized. My representative(s) is (are) not authorized to endorse or otherwise negotiate any check (including directing or
accepting payment by any means, electronic or otherwise, into an account owned or controlled by the representative(s) or any firm or other
entity with whom the representative(s) is (are) associated) issued by the government in respect of a federal tax liability.
List any specific deletions to the acts otherwise authorized in this power of attorney (see instructions for line 5b):
6 Retention/revocation of prior power(s) of attorney. The filing of this power of attorney automatically revokes all earlier power(s) of
attorney on file with the Internal Revenue Service for the same matters and years or periods covered by this document. If you do not want
to revoke a prior power of attorney, check here . . . . . . . . . . . . . . . . . . . . . . . . . .
YOU MUST ATTACH A COPY OF ANY POWER OF ATTORNEY YOU WANT TO REMAIN IN EFFECT.
7 Signature of taxpayer. If a tax matter concerns a year in which a joint return was filed, each spouse must file a separate power of attorney
even if they are appointing the same representative(s). If signed by a corporate officer, partner, guardian, tax matters partner, executor,
receiver, administrator, or trustee on behalf of the taxpayer, I certify that I have the authority to execute this form on behalf of the taxpayer.
IF NOT COMPLETED, SIGNED, AND DATED, THE IRS WILL RETURN THIS POWER OF ATTORNEY TO THE TAXPAYER.
Signature
Print Name
Date Title (if applicable)
Print name of taxpayer from line 1 if other than individual
Part II Declaration of Representative
Under penalties of perjury, by my signature below I declare that:
• I am not currently suspended or disbarred from practice before the Internal Revenue Service;
• I am subject to regulations contained in Circular 230 (31 CFR, Subtitle A, Part 10), as amended, governing practice before the Internal Revenue Service;
• I am authorized to represent the taxpayer identified in Part I for the matter(s) specified there; and
• I am one of the following:
a Attorney—a member in good standing of the bar of the highest court of the jurisdiction shown below.
b Certified Public Accountant—duly qualified to practice as a certified public accountant in the jurisdiction shown below.
c Enrolled Agent—enrolled as an agent by the Internal Revenue Service per the requirements of Circular 230.
d Officer—a bona fide officer of the taxpayer organization.
e Full-Time Employee—a full-time employee of the taxpayer.
f Family Member—a member of the taxpayer’s immediate family (for example, spouse, parent, child, grandparent, grandchild, step-parent, step-
child, brother, or sister).
g Enrolled Actuary—enrolled as an actuary by the Joint Board for the Enrollment of Actuaries under 29 U.S.C. 1242 (the authority to practice before
the Internal Revenue Service is limited by section 10.3(d) of Circular 230).
h Unenrolled Return Preparer—Your authority to practice before the Internal Revenue Service is limited. You must have been eligible to sign the
return under examination and have prepared and signed the return. See Notice 2011-6 and Special rules for registered tax return preparers
and unenrolled return preparers in the instructions (PTIN required for designation h).
i Registered Tax Return Preparer—registered as a tax return preparer under the requirements of section 10.4 of Circular 230. Your authority to
practice before the Internal Revenue Service is limited. You must have been eligible to sign the return under examination and have prepared and
signed the return. See Notice 2011-6 and Special rules for registered tax return preparers and unenrolled return preparers in the
instructions (PTIN required for designation i).
k Student Attorney or CPA—receives permission to represent taxpayers before the IRS by virtue of his/her status as a law, business, or accounting
student working in an LITC or STCP. See instructions for Part II for additional information and requirements.
r Enrolled Retirement Plan Agent—enrolled as a retirement plan agent under the requirements of Circular 230 (the authority to practice before the
Internal Revenue Service is limited by section 10.3(e)).
IF THIS DECLARATION OF REPRESENTATIVE IS NOT COMPLETED, SIGNED, AND DATED, THE IRS WILL RETURN THE
POWER OF ATTORNEY. REPRESENTATIVES MUST SIGN IN THE ORDER LISTED IN PART I, LINE 2. See the instructions for
Part II.
Note. For designations d-f, enter your title, position, or relationship to the taxpayer in the "Licensing jurisdiction" column. See the instructions for Part II
for more information.
Designation—
Insert above
letter (a–r)
Licensing jurisdiction
(state) or other
licensing authority
(if applicable)
Bar, license, certification,
registration, or enrollment
number (if applicable).
See instructions for Part II for
more information.
Signature Date
Form 2848 (Rev. 7-2014)
✔
mm/dd/yy
Your Signature Here
Date Here
Brian Henry
6. USA TAX REGISTRATION
Form 8821
(Rev. October 2012)
Department of the Treasury
Internal Revenue Service
Tax Information Authorization
Information about Form 8821 and its instructions is at www.irs.gov/form8821.
Do not sign this form unless all applicable lines have been completed.
To request a copy or transcript of your tax return, use Form 4506, 4506-T, or 4506T-EZ.
OMB No. 1545-1165
For IRS Use Only
Received by:
Name
Telephone
Function
Date
1 Taxpayer information. Taxpayer must sign and date this form on line 7.
Taxpayer name and address (type or print) Taxpayer identification number(s)
Daytime telephone number Plan number (if applicable)
2 Appointee. If you wish to name more than one appointee, attach a list to this form.
Name and address CAF No.
PTIN
Telephone No.
Fax No.
Check if new: Address Telephone No. Fax No.
3 Tax matters. The appointee is authorized to inspect and/or receive confidential tax information for the tax matters listed on this
line. Do not use Form 8821 to request copies of tax returns.
(a)
Type of Tax
(Income, Employment, Payroll, Excise, Estate,
Gift, Civil Penalty, etc.) (see instructions)
(b)
Tax Form Number
(1040, 941, 720, etc.)
(c)
Year(s) or Period(s)
(see the instructions for line 3)
(d)
Specific Tax Matters (see instr.)
4 Specific use not recorded on Centralized Authorization File (CAF). If the tax information authorization is for a specific
use not recorded on CAF, check this box. See the instructions. If you check this box, skip lines 5 and 6 . . . . . .
5 Disclosure of tax information (you must check a box on line 5a or 5b unless the box on line 4 is checked):
a If you want copies of tax information, notices, and other written communications sent to the appointee on an ongoing
basis, check this box . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note. Appointees will no longer receive forms, publications and other related materials with the notices.
b If you do not want any copies of notices or communications sent to your appointee, check this box . . . . . . .
6 Retention/revocation of tax information authorizations. This tax information authorization automatically revokes all prior
authorizations for the same tax matters you listed on line 3 above unless you checked the box on line 4. If you do not want
to revoke a prior tax information authorization, you must attach a copy of any authorizations you want to remain in effect
and check this box . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
To revoke this tax information authorization, see the instructions.
7 Signature of taxpayer. If signed by a corporate officer, partner, guardian, executor, receiver, administrator, trustee, or
party other than the taxpayer, I certify that I have the authority to execute this form with respect to the tax matters and tax
periods shown on line 3 above.
IF NOT SIGNED AND DATED, THIS TAX INFORMATION AUTHORIZATION WILL BE RETURNED.
DO NOT SIGN THIS FORM IF IT IS BLANK OR INCOMPLETE.
Signature Date
Print Name Title (if applicable)
PIN number for electronic signature
For Privacy Act and Paperwork Reduction Act Notice, see instructions. Cat. No. 11596P Form 8821 (Rev. 10-2012)
INA E DWAR DS or DONIK A VLADIMIR OVA or AS HLE Y B R OWN
C/O TAXBACK INC
333 N MICHIGAN AVE , S TE 2415
CHICAGO, IL 60601-4105
1 888 203 8900
1 312 873 4202
INDIVIDUAL INCOME TAX 1040, 1040NR 2014,2013,2012,2011
FICA TAX 843, 8316 2014,2013,2012,2011
✔
mm/dd/yy
Your Signature Here
Date Here
Brian Henry
7. USA TAX REGISTRATION
Form 8822
(Rev. October 2014)
Department of the Treasury
Internal Revenue Service
Change of Address
(For Individual, Gift, Estate, or Generation-Skipping Transfer Tax Returns)
Please type or print. See instructions on back. Do not attach this form to your return.
Information about Form 8822 is available at www.irs.gov/form8822.
OMB No. 1545-1163
Part I Complete This Part To Change Your Home Mailing Address
Check all boxes this change affects:
1 Individual income tax returns (Forms 1040, 1040A, 1040EZ, 1040NR, etc.)
If your last return was a joint return and you are now establishing a residence separate from the spouse with whom
you filed that return, check here . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Gift, estate, or generation-skipping transfer tax returns (Forms 706, 709, etc.)
For Forms 706 and 706-NA, enter the decedent’s name and social security number below.
Decedent’s name Social security number
3a Your name (first name, initial, and last name) 3b Your social security number
4a Spouse’s name (first name, initial, and last name) 4b Spouse’s social security number
5a Your prior name(s). See instructions.
5b Spouse's prior name(s). See instructions.
6a Your old address (no., street, apt. no., city or town, state, and ZIP code). If a P.O. box, see instructions. If foreign address, also complete spaces below,
see instructions.
Foreign country name Foreign province/county Foreign postal code
6b Spouse’s old address, if different from line 6a (no., street, apt. no., city or town, state, and ZIP code). If a P.O. box, see instructions. If foreign address, also
complete spaces below, see instructions.
Foreign country name Foreign province/county Foreign postal code
7 New address (no., street, apt. no., city or town, state, and ZIP code). If a P.O. box, see instructions. If foreign address, also complete spaces below, see
instructions.
Foreign country name Foreign province/county Foreign postal code
Part II Signature
Daytime telephone number of person to contact (optional)
Sign
Here
Your signature Date Signature of representative, executor, administrator/if applicable Date
If joint return, spouse’s signature Date Title
For Privacy Act and Paperwork Reduction Act Notice, see back of form. Cat. No. 12081V Form 8822 (Rev. 10-2014)
C/O TAXBACK, IDA BUSINESS & TECHNOLOGY PARK, RING ROAD, KILKENNY,
✔
IRELAND
mm/dd/yy
Your Signature Here
Date Here
8. USA TAX REGISTRATION
www.taxback.comtaxback.com, 333 N. Michigan Avenue, Suite 2415, Chicago, IL, 60601 8
CUSTOMER AGREEMENT
Name in print Date dd / mm / yy
Social Security Number Signature
I confirm that:
1. I understand that taxback.com is a trading name for the services of Taxback Inc., Chicago, USA, and hereby contract with Taxback Inc. to
carry out the services described herewith.
2. I understand that Taxback Inc will utilize its parent company Taxback and its subsidiary and affiliate companies to gather information
regarding the services where necessary and that the contract remains with Taxback Inc for the duration of the service.
3. I have signed the necessary power of attorneys to authorise Taxback. Inc, and / or its subsidiary undertakings trading as taxback.com and
referred to hereafter as the Agent, to prepare this tax return and represent me before the US tax authorities (IRS and State tax authorities).
4. I authorise the Agent to receive all correspondence from the US tax authorities on my behalf.
5. I understand that receipts are required to substantiate any claim that I make for expenses.
6. I want to avail of the offer to“pay no fee up-front”when I sign up for the service. In order to avail of this option, I understand that the fee
will need to be paid by me when the refund has been issued by the US tax authorities.
7. I authorise the Agent to receive my refund cheque(s) from the tax authorities.
8. I further agree that once the Agent receives my refund cheque(s), I will promptly endorse the cheque in order to allow the agent to deduct
the necessary fee and to send me the remaining amount.
9. I understand that once my refund is processed, I will be contacted by the Agent with regard to payment options for receiving my refund
and will be able to provide my bank details.
10. Should the Agent choose for any reason not to accept my endorsement on the cheque, I understand and agree that I will pay the fee due
and will cash the tax office refund cheque myself.
11. Should I receive the refund directly from any other source other than the Agent, I understand and agree that I will pay the fee due to the
Agent for the work completed.
12. Should I owe income tax for other tax years, and the US tax authorities deduct this owed money from the refund due for other tax year (s), I
understand and agree that I need to pay the Agent processing fee for each tax year for which a tax return was processed.
13. I understand that the US tax authorities will make the final decision on the value of any refund due. I understand that the Agent will
provide the best estimation possible based on current tax law and information given, however this is estimation only, not a guarantee.
14. I agree to and accept the terms and conditions of service as written online at www.taxback.com and to any changes in the terms and
conditions which Taxback Inc may affect from time to time, and to the fees of the agent which represents the services I have requested and
which are provided by Taxback Inc and/or its affiliate companies.
15. I understand that information collected in writing and/or verbally for US tax return filing services can and may be used for internal auditing
purposes by taxback.com and provided to the US Tax Authorities (IRS and State Tax Authorities) for external auditing purposes, subject to
relevant data protection legislation.
16. I confirm that I have given the Agent all information needed and available to me.
17. I commit to updating the Agent of any change in my contact details.
18. I understand that taxback.com will submit my application to the relevant tax office as soon as I have been informed of the refund amount
and have sent all necessary documentation. Should I wish to cancel my application, I will contact taxback.com immediately.
I understand that while taxback.com will make every effort to recall my application, this may not be possible.
The customer agreement forms the basis of the relationship between Taxback and you. It is an important
document, please read the points in full and ensure you understand them, before signing.
Your Signature HereYour SSN Here
Your Name Here Date Here
Brian Henry
9. USA TAX REGISTRATION
www.taxback.comtaxback.com, 333 N. Michigan Avenue, Suite 2415, Chicago, IL, 60601 9
POWER OF ATTORNEY
Taxpayer Name
Date of birth dd / mm / yy SSN (last 4 digits)
Taxpayer Signature Date dd / mm / yy
A) to review, receive and collect original and copied W-2 forms, tax information statements, earnings
statements and any other payroll, tax and income related forms and information.
B) to deal with my Social Security and MediCare (FICA) tax rebate and to receive tax information and
refund cheques issued in my name at the address stated above.
This Power of Attorney shall become effective immediately on the date signed and shall terminate on
the date these matters are completed.
This Power of Attorney revokes all prior Power of Attorney(s) filed.
I am fully informed as to all the contents of this form and understand the full importance of granting
these powers to my representative.
hereby appoint the following representative as attorney- in fact:
Taxback Inc., 333 N. Michigan Avenue, Suite 2415, Chicago IL 60601
to act as my legal representative before my employer(s), to perform any and all acts I can perform
with regards to the following matters:
Please only fill out the fields where you see the indicated.
Your Name Here
Your Signature Here
Date Here
Your SSN Here
Your Date of Birth Here
Brian Henry
10. USA TAX REGISTRATION
www.taxback.comtaxback.com, 333 N. Michigan Avenue, Suite 2415, Chicago, IL, 60601 10
CONSENT TO DISCLOSURE OF TAX RETURN INFORMATION
under IRC Section 7216
Name in print
Signature
Date dd / mm / yy
To ensure your tax return is prepared in a compliant and correct manner, we draw on the expertise and
experience of our international tax team. In line with Treas. Reg. Section 301.7216-3 and Rev. Proc. 2013-14,
we request that you provide consent to us so that we can share and store your data, including your SSN and
employment and tax data, with our international tax team to ensure your tax return is compliant.
Federal law requires this consent form be provided to you. Unless authorized by law, we cannot disclose,
without your consent, your tax return information to third parties (our international colleagues will qualify
as third parties as they are employed by Taxback international offices, not by Taxback Inc. directly) for
purposes other than the preparation and filing of your tax return and, in certain limited circumstances, for
purposes involving tax return preparation.
This consent to disclose may result in your tax return information being disclosed to a tax return preparer
located outside the United States, including your personally identifiable information such as your Social
Security Number (“SSN”). Both the tax return preparer in the United States that will disclose your SSN and
the tax return preparer located outside the United States which will receive your SSN maintain an adequate
data protection safeguard (as required by the regulations under 26 U.S.C. Section 7216) to protect privacy
and prevent unauthorized access of tax return information.
If you believe your tax return information has been disclosed or used improperly in a manner unauthorized
by law or without your permission, you may contact the Treasury Inspector General for Tax Administration
(TIGTA) by telephone at 1-800-366-4484, or by email at complaints@tigta.treas.gov.
If you agree to allow Taxback to disclose your tax return information, including your SSN, to Taxback staff
and affiliates for the purpose of providing assistance in the preparation of your individual income tax
returns, please sign this form and print your name in capital letters.
Your Name Here
Date Here
Your Signature HereBrian Henry