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IMPORTANT: Please scroll through and read the ENTIRE agreement in order to Authorize your E-Signature.
Electronic Communication and Digital Signature Consent
Please read this Federal ESIGN Disclosure and Consent carefully and keep a copy for your records. This disclosure is required by the federal Electronic Signatures in Global and National Commerce Act ("ESIGN").
Thank you for considering {{hostInfo.CompanyName}} for your lending needs. To serve you better we have provided you with a secure platform through which you can electronically authorize the release of your tax records from the IRS. This information is used for the purpose of verifying certain information on your loan application.
This disclosure document is your consent to electronically authorize the IRS to release your tax records to {{hostInfo.CompanyName}} and to receive copies of your digitally signed IRS Form 8821 electronically. Your consent also confirms that you meet the following software and hardware requirements:
- A personal computer or other device which is capable of accessing the Internet. Your access to this page verifies that your system/device meets these requirements.
- An Internet web browser which is capable of supporting 128-bit SSL encrypted communications. Your access to this page verifies that your browser and encryption software/device meet these requirements.
- You must have software which permits you to receive and access Portable Document Format or "PDF" files, such as Adobe® Acrobat Reader® version 8.0 and above (available for downloading at https://get.adobe.com/reader/).
You may opt out of this consent by clicking the "Cancel" button. Even after your consent, you may still request paper copies of the IRS forms to be delivered to you in paper or non-electronic form by calling the number below, or by writing to us at the address listed below.
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HALCYON CONSENT & DISCLOSURE FORM
Purposes for using and disclosing information:For use by {{hostInfo.CompanyName}} and tax transcript service provider, Halcyon Still Water LLC, to retrieve and analyze information as requested by the sponsoring financial institution(s) named below to facilitate loan processing, including, but not limited to, transmitting the information to Freddie Mac, Fannie Mae, as well as any approved use related to this loan as outlined in the Gramm-Leach-Bliley Act. This includes determining relevant financial offers and opportunities, and approvals. In no case shall this data be used and disclosed in anyway inconsistent with this agreement.
Halcyon Still Water, LLC is required by the IRS to provide the individual names of authorized tax professionals working for the company. On the 8821 form you will see
James McGowan and
Elizabeth Boonin identified; these are officers of Halcyon Still Water, LLC individually authorized by, and registered with, the IRS for the purpose outlined above.
Federal law requires this consent form be provided to you. Unless authorized by law, we cannot use or disclose your personal financial information, including tax transcript data, to third parties for purposes other than those directly related to the services provided without your consent. If you consent to the use and disclosure of your personal financial information, federal law may not protect your information from further use or distribution.
Information used and disclosed:"Personal financial information" includes any data element obtained throughout the tax data retrieval process or other financial services, including but not limited to, IRS tax transcript data and source documents, information derived from tax transcript elements, or other information provided related to your financial situation.
Name, and address of recipient:
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The duration of this consent will remain in effect in perpetuity. If you approve the use and disclosure of your IRS tax data and tax transcript information to {{hostInfo.CompanyName}}, please sign below.