<p> MELLOYS BIG AUTOPLEX MR REFUND INFO SHEET NAME FIRST MI LAST SOCIAL BIRTHDAY Taxpayer Spouse Dependent Dependent Dependent ADDRESS PHONES City State Zip Day Evening Filing Status: Single Joint Separated Head Household Widow Bank Routing # Account # Cell Credit Card: MC VISA Account Exp Fax Sales fax Salesperson Phone / extension (505) 246-8800 (505) 764-8892 </p><p>Fax W-2s, 1099-Rs, Mortgage Interest Statements, Donations, Real Estate tax Bills, Private School and or College Attendance records. MR REFUND will fax back Form 8879 and Form 8453 IL for your signature authorizing us to e-file your returns. Sales please put name phone line and fax numbers for fastest service.</p><p>All information I have given is true and correct to the best of my knowledge. If I choose not to sign the completed return there will be a minimum $50 consulting fee.</p><p>Customer Signature: ______DATE ______</p><p>Fax back with W-2s to 847-675-3027 MR REFUND’s direct line 847-675-0030 National Office: 3458 W Devon, Lincolnwood, IL 60712 Chicago, Las Vegas MrRefund.com New York, Orlando</p>