Impact Complex, LLC,
[insert address]
Client Name:
Client Address:
Conflict of Interest Waiver
Please read the following carefully. This Company, Impact Complex, LLC in accordance with Department of
the Treasury Circular 230, has determined that its acceptance of your United States Federal and State Tax
Preparation, including but not limited to 1040, 1065, 1120, and 1120s may constitute a conflict of interest
under Sec. 10.29. A conflict of interest arises when the representation of one client will be directly adverse to
another client. A conflict of interest also arises if there is a significant risk that the representation of a client will
be materially limited by the practitioner’s responsibilities to another client.
We believe we can both perform the above-described engagement and fulfill the duties owed to you in an
objective, impartial and intellectually honest manner.
However, before we can continue the engagement, Circular 230 requires that we obtain your informed written
consent. By giving your consent, you are agreeing to waive any objection to any potential or actual conflict of
interest arising from our acceptance or performance of the above-described engagement.
With this waiver, you agree to the following:
1. Any and all information obtained from one spouse or ex-spouse regarding this tax return will be shared
with the other spouse. We will routinely cc email to the other spouse. Or in the case of a business,
other business partners.
2. All eligible filing statuses will be considered and outcomes discussed with both parties.
3. If one spouse or business partner later decides to withdraw from this engagement, any conflict arising
from continuing to represent the other spouse or business partner will continue to be waived, and
information obtained from the withdrawing spouse or business partner may still be considered in the
other spouse’s or business partner’s engagement.
4. If you file a joint return (MFJ): Both spouses must sign a joint return and independently deliver e-file
authorizations to our firm. You understand that the IRS can hold each spouse independently liable for
the full amount of a balance due. You further acknowledge and accept that filing a joint return precludes
later amendments to married-filing-separate status and likely precludes innocent spouse relief.
5. If you file separate returns (MFS): The results/outcome of MFS returns will be shared with both
spouses, and information obtained from one spouse or business partner will be considered when
preparing either MFS return. However, a copy of the filed MFS return will not be provided to the other
spouse or business partner without further written consent.
6. We will not file a return that is inaccurate or untrue, even if both spouses or business partners are
willing. If one spouse or business partner does not agree with our preparation of the return, that spouse
or business partner may withdraw from this engagement.
If you consent, please sign below. If you have any questions, feel free to contact us or to consult with legal
counsel.
Thank you.
I hereby consent to the performance by Impact Complex, LLC and its members of the above-
described engagement and waive any conflict of interest that may arise out of that engagement.
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