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Taxpayer Information

Social Security Number
Date of Birth
Telephone
Email Address
Country
Occupation

If no, please complete the next question

Street Address
Government Issued Photo ID, Social Security Card

Returning clients, please note: Your ID will not roll over from last year. The IRS requires that your government-issued ID is submitted annually.

Spouse Information

Social Security Number
Telephone Number
Street Address
Occupation
Government Issued Photo ID, Social Security Card

Dependent Information

if none, put "0"
Social Security Card(s), Birth Certificate(s)
Documents from daycare provider

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Amendment Information

COVID RELIEF

Only answer if you are filing for years 2020-2022

Please indicate whether or not your received any of the following COVID- relief options for yourself, your business, or both.

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Income

for taxpayer
for taxpayer
if applicable
if applicable
Wage Statements; W2, 1099, etc.

Profit or Loss From Business

Self-Employment/1099 Income/LLC (Schedule C)

Street Address
Profit & Loss Statement (P&L)

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Itemized Deductions

Please indicate if any of the following items apply to you, your spouse or your dependents during the filing year

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Debts

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Refund Options

Returning clients, please note: Your banking details will not roll over from the previous filing year. The IRS requires that these details are submitted annually.

Example: Wells Fargo
What is the answer to the security question you selected?

*PLEASE NOTE: YOU MUST SCROLL THROUGH ALL TERMS BEFORE YOU ARE ABLE TO AGREE AND SUBMIT FORM.

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Consents Page

TERMS AND CONDITIONS OF USE

1. Introduction

For the purposes of this consent form, “we,” “us,” and “our” mean ARC Tax.

2. Terms

By accessing this form, you are agreeing to be bound by these Terms and Conditions of Use, all applicable laws and regulations, and agree that you are responsible for compliance with any applicable local laws. If you do not agree with any of these terms, you are prohibited from using or accessing this site. The materials contained in this from are protected by applicable copyright and trademark law.

3. Use License

Permission is granted to temporarily download one copy of the materials (information or software) on our form for personal, non-commercial transitory viewing only. This is the grant of a license, not a transfer of title, and under this license you may not:

modify or copy the materials;

use the materials for any commercial purpose, or for any public display (commercial or non-commercial);

attempt to decompile or reverse engineer any software contained on our form;

remove any copyright or other proprietary notations from the materials; or

transfer the materials to another person or "mirror" the materials on any other server.

This license shall automatically terminate if you violate any of these restrictions and may be terminated by we at any time. Upon terminating your viewing of these materials or upon the termination of this license, you must destroy any downloaded materials in your possession whether in electronic or printed format.

4. Disclaimer

The materials on our form are provided "as is". We make no warranties, expressed or implied, and hereby disclaim and negate all other warranties, including without limitation, implied warranties or conditions of merchantability, fitness for a particular purpose, or non-infringement of intellectual property or other violation of rights. Further, we do not warrant or make any representations concerning the accuracy, likely results, or reliability of the use of the materials on its internet form or otherwise relating to such materials or on any sites linked to this site.

5. Limitations

In no event shall we or our suppliers be liable for any damages (including, without limitation, damages for loss of data or profit, or due to business interruption,) arising out of the use or inability to use the materials on our Internet site, even if we or an authorized representative has been notified orally or in writing of the possibility of such damage. Because some jurisdictions do not allow limitations on implied warranties, or limitations of liability for consequential or incidental damages, these limitations may not apply to you.

6. Revisions and Errata

The materials appearing on our form could include technical, typographical, or photographic errors. We do not warrant that any of the materials on this form are accurate, complete, or current. We may make changes to the materials contained on this form at any time without notice. We do not, however, make any commitment to update the materials.

7. Links

We have not reviewed all of the sites linked to this internet form and are not responsible for the contents of any such linked site. The inclusion of any link does not imply endorsement by use of the site. Use of any such linked form is at the user's own risk.

8. Site Terms of Use Modifications

We may revise these terms of use for this form at any time without notice. By using this form, you are agreeing to be bound by the then current version of these Terms and Conditions of Use.

9. Governing Law

Any claim relating to our form shall be governed by the laws of the State of Georgia without regard to its conflict of law provisions.

10. Payment

By signing this agreement, you understand that your tax fees are being deferred until your tax return is received by the IRS. If for any reason your tax return is held up or not received from the IRS you are still responsible for our tax preparation, service and transmitter fees.

In the event that your state or federal refund is reduced or intercepted to pay off delinquent debt, such as past-due child support, outstanding student loans, or unpaid state income tax or your entire refund was applied to your debt, you acknowledge that it is your responsibility to make your payment in full by October 15 of the current filing year by signing this agreement.

If you are unable to make your payment in full, you are to contact our office to set up a payment arrangement. If our fees are not paid by October 15 of the current filing year or a payment arrangement is not in place and we are forced to take legal action in the state in which you reside by way of garnishment, lien and/or credit reporting you will be solely responsible for filing fees, attorney fees or any other fees associated with collecting this debt.

PRIVACY POLICY

Your privacy is very important to us. Accordingly, we have developed this Policy in order for you to understand how we collect, use, communicate and disclose and make use of personal information. The following outlines our privacy policy.

Before or at the time of collecting personal information, we will identify the purposes for which information is being collected.

We will collect and use of personal information solely with the objective of fulfilling those purposes specified by us and for other compatible purposes, unless we obtain the consent of the individual concerned or as required by law.

We will only retain personal information as long as necessary for the fulfillment of those purposes.

We will collect personal information by lawful and fair means and, where appropriate, with the knowledge or consent of the individual concerned.

Personal data should be relevant to the purposes for which it is to be used, and, to the extent necessary for those purposes, should be accurate, complete, and up-to-date.

We will protect personal information by reasonable security safeguards against loss or theft, as well as unauthorized access, disclosure, copying, use or modification.

We will make readily available to customers information about our policies and practices relating to the management of personal information.

We are committed to conducting our business in accordance with these principles in order to ensure that the confidentiality of personal information is protected and maintained.

Submission of this form serves as written consent for this entity to verify any federal non-tax debt & debt owed to state, business, government or other non-consumer activity on my behalf.

CONSENT TO DISCLOSURE OF TAX RETURN INFORMATION

For the purposes of this consent form, “we,” “us,” and “our” mean ARC Tax. Federal law requires this consent form be provided to you. Unless authorized by law, 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 in 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 signature.

You have indicated that you are interested in receiving an Electronic Disbursement Service and/or Loan (or collectively, “Products or Services”) from Refund Advantage, a division of MetaBank, National Association. In order to provide you with the opportunity to apply for one of these Products or Services, we must disclose all of your 2019 tax return information necessary for evaluating the request to Refund Advantage. 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 2019 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 Refund Advantage 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 Refund Advantage, 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.

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 e-mail at [email protected].

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Hours

Mon – Fri 9:00am – 5:00pm

Saturday – Appt only

Sunday – CLOSED

Location

3293 Stone Mountain Hwy

Ste G-116

Snellville, GA 30078

Phone

678-921-5278

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