CHICAGO TAX PREPARATION DISCLOSURE Tax Preparation Fees: (Taxpayer Initial) Tax preparation fees are determined and charged based upon the complexity of the tax return. You will have the opportunity to review all fees associated with your tax return. MINIMUM INCOME TAX PREPARATION FEES: FEDERAL FORMS 1040EZ* 1040A 1040 FEDERAL $99.00 $189.00 $189.00 STATE $29.00 $29.00 $29.00 Miscellaneous fees that may apply: (Taxpayer Initial) Data and Document Storage Fee $20.00 Gold Guarantee – Not Available Assisted Refund - Federal Assisted Refund Fee $32.95 Assisted Refund - State Assisted Refund Fee $12.95 Assisted Refund - Office Disbursement Fee $20.00 Written Estimate: (Taxpayer Initial) Based upon a review of the documentation and information provided in our introductory conversation, we estimate the total charge for tax preparation service to be: 1040EZ, fees start at $99, if 1040A or 1040, fees start at $189.00. Your actual charge will be determined during our full tax preparation interview. Refund Timing Estimate: (Taxpayer Initial) According to the IRS, 9 out of 10 refunds will be issued in less than 21 days. Our experience over the last three years shows many Jackson Hewitt customers received their refunds in 10 days or less. My tax preparer has verbally reviewed the above disclosures with me. Taxpayer Signature Date I have verbally reviewed the above disclosures with the taxpayer. Tax Preparer Signature This information is being provided to you as required by SECTION 4-44-030 of the CHICAGO MUNICIPAL CODE Date