New Individual Client - General Information Form
Please fill out truthfully and to best of your ability so we can internally onboard you (and your family) in the relevant applications.
Taxpayer First Name
*
Taxpayer Last Name
*
Taxpayer Occupation
*
Taxpayer Date of Birth
*
-
Month
-
Day
Year
Date
Taxpayer Social Security Number (SSN)
*
Taxpayer Email Address
*
Taxpayer Mobile Phone Number
*
Home/Mailing Address
*
Home/Mailing Unit/Apt.
Home/Mailing Town/City
*
Home/Mailing State
*
Home/Mailing Zip Code
*
Bank or Financial Institution Name
*
Account Number
*
Routing Number
*
Account Type
*
Checking
Savings
How did you hear about us?
*
Our website
Google
Yelp
Referral
Other
If you checked Referral in the previous question, please tell us who referred you:
*
Are you married?
*
Yes
No
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Spouse Information
Please enter your spouse's legal information/details
Spouse First Name
*
Spouse Last Name
*
Spouse Occupation
*
Spouse Date of Birth
*
-
Month
-
Day
Year
Date
Spouse Social Security Number
*
Spouse Email Address
*
Spouse Mobile Number
*
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Do you have any kids or other dependents?
*
Yes
No
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Child/Other Dependent #1 Information
Please enter your (first) dependent's legal information/details
Child/Other Dependent #1: First name
*
Child/Other Dependent #1: Last name
*
Child/Other Dependent #1: Date of birth
*
-
Month
-
Day
Year
Date
Child/Other Dependent #1: Social security number
*
Child/Other Dependent #1: What is the relationship to the Taxpayer?
*
Daughter
Son
Father
Mother
Brother
Foster child
Grandchild
Grandparent
Half brother
Half sister
Nephew
Niece
Other
Sister
Stepbrother
Stepchild
Stepsister
Other
Any kids or other dependents?
*
Yes
No
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Child/Other Dependent #2 Information
Please enter your (first) dependent's legal information/details
Child/Other Dependent #2: First name
*
Child/Other Dependent #2: Last name
*
Child/Other Dependent #2: Date of birth
*
-
Month
-
Day
Year
Date
Child/Other Dependent #2: Social security number
*
Child/Other Dependent #2: What is the relationship to the Taxpayer?
*
Daughter
Son
Father
Mother
Brother
Foster child
Grandchild
Grandparent
Half brother
Half sister
Nephew
Niece
Other
Sister
Stepbrother
Stepchild
Stepsister
Other
Any kids or other dependents?
*
Yes
No
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Next
Child/Other Dependent #3 Information
Please enter your (first) dependent's legal information/details
Child/Other Dependent #3: First name
*
Child/Other Dependent #3: Last name
*
Child/Other Dependent #3: Date of birth
*
-
Month
-
Day
Year
Date
Child/Other Dependent #3: Social security number
*
Child/Other Dependent #3: What is the relationship to the Taxpayer?
*
Daughter
Son
Father
Mother
Brother
Foster child
Grandchild
Grandparent
Half brother
Half sister
Nephew
Niece
Other
Sister
Stepbrother
Stepchild
Stepsister
Other
Any kids or other dependents?
*
Yes
No
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Next
Child/Other Dependent #4 Information
Please enter your (first) dependent's legal information/details
Child/Other Dependent #4: First name
*
Child/Other Dependent #4: Last name
*
Child/Other Dependent #4: Date of birth
*
-
Month
-
Day
Year
Date
Child/Other Dependent #4: Social security number
*
Child/Other Dependent #4: What is the relationship to the Taxpayer?
*
Daughter
Son
Father
Mother
Brother
Foster child
Grandchild
Grandparent
Half brother
Half sister
Nephew
Niece
Other
Sister
Stepbrother
Stepchild
Stepsister
Other
Any kids or other dependents?
*
Yes
No
Back
Next
Child/Other Dependent #5 Information
Please enter your (first) dependent's legal information/details
Child/Other Dependent #5: First name
*
Child/Other Dependent #5: Last name
*
Child/Other Dependent #5: Date of birth
*
-
Month
-
Day
Year
Date
Child/Other Dependent #5: Social security number
*
Child/Other Dependent #5: What is the relationship to the Taxpayer?
*
Daughter
Son
Father
Mother
Brother
Foster child
Grandchild
Grandparent
Half brother
Half sister
Nephew
Niece
Other
Sister
Stepbrother
Stepchild
Stepsister
Other
Back
Next
Review your entered information
Please review your entered information by using the Back button below. Once you submit this form, you will not be able to make any changes. If you feel that anything was incorrectly entered, please email us at ukpshared@ukpcpa.com for a copy of the submission. We will upload it to your client portal account, where you can register and view all documents related to your taxes.
By electronically signing this form, I certify that I have answered all questions herein accurately and completely. I certify that I am one of the individuals listed on this submission and take full responsibility for the data submitted.
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