"We Won't Stop Until

 The Job Is Done!"

RELEASE FORM RE: PRIVACY ACT

This is to confirm that I__________________________(Taxpayer Print Name)

give permission to Premier Accounting & Tax Inc. to release information from

my tax return(s) for all years ☐ or specify year(s)______________________.

Authorized person______________________________(Name of Third Party).

Signed:________________________________________________________

Dated:______________________________________