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Adele’s Tax Service (“we,” “us,” and “our”)

Federal law requires this consent form to be provided to you (“you” refers to each taxpayer, if more than one). Unless authorized by law, we cannot use, without your consent, your tax return information for purposes other than the preparation and filing of your tax return.

You are not required to complete this form. If we obtain your signature on this form by conditioning our 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.

If you do not consent, then you may still have your tax return prepared and electronically filed by us for a fee.

Examples of ways we may use your information include the mailing of birthday cards or other special occasion cards, the notification of a tax law change that may directly affect you, notification of upcoming seminars of special interest, and other such items. Your name and information will NEVER be shared with any other business or organization.

By signing below, you (including each of you, if there is more than one taxpayer) authorize us to use the information you provide to us during the preparation of your 2011 tax return. If you wish to authorize us to use information in future years until you specifically revoke your permission, please check the appropriate box.

Printed name of Taxpayer:_________________________________________________

Taxpayer signature:_____________________________________ Date:___________

This permission valid:_______ for 20_____ return only _________ until revoked in writing

Printed name of Taxpayer:_________________________________________________

Taxpayer Signature:______________________________________ Date:___________

This permission valid:_______ for 20___ return only _________ until revoked in writing

If you believe your tax information has been used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) at 1-800-366-4484 or complaints@tigta.treas.gov.