SIGN - UNITED WAY OF PINAL COUNTY

Instructions. This form is only for VITA clients who cannot scan or take a picture of their signature pages. Please enter your name(s), amounts from FORM 8879 boxes 1 through 5 (if a box is blank enter 0 in the form), and check the boxes certifying that you have signed all forms and given authorization to e-file. (check all the boxes)
Call or text 520-333-5152 for assistance.

signature AUTHORIZATION CERTIFICATION

* Indicates required field

Taxpayer Name *

First

Last

Spouse Name (if none enter NA) *

First

Last

BOX 1. ADJUSTED GROSS INCOME *

BOX 2. TOTAL TAX *

BOX 3. FEDERAL INCOME TAX WITHHELD FROM FORMS W2 AND 1099 *

BOX 4. REFUND *

BOX 5. AMOUNT YOU OWE *

I have received and examined a copy of my tax return with accompanying schedules and forms in electronic format, and to the best of my knowledge and belief, they are true, correct, and complete. I confirm that I have: *

signed the three consent forms signed the IRS e-file signature authorization form signed the state e-file signature authorization forms (if filing state) granted United Way of Pinal County authorization to electronically file my tax return granted United Way of Pinal County said consents as stated on the forms

Submit