Mimms Tax Service
2021 Tax Return Questionnaire
Are you new to Mimms Tax Service?
Please provide information on who referred you. They could get $50
Referrer Name
First Name
Last Name
Referrer Phone Number
-
Area Code
Phone Number
Referrer Email
example@example.com
Please email or upload here the following(if applicable) to mimmstaxservice@gmail.com:
ID
Social Security Card
Personal Taxpayer PIN (if applicable)
Wage forms
Dependent Information (ssn, birth certificate, proof of residency, etc)
Payment Information
Filing Status?
Single
Head of Household (non-married with dependent)
Married Filing Jointly
Married Filing Separate
Widower
Primary Filer's Information
Name
First Name
Last Name
Date of Birth
Address
Street Address
Street Address Line 2
City
State
Zip Code
Taxpayer ID
ex SSn, ITIN
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Can/Will you be claimed as a dependent this year?
Yes
No
Spouse Information
If applicable
Name
First Name
Last Name
Suffix
Date of Birth
Taxpayer ID
ex: SSN, ITIN
Phone Number
-
Area Code
Phone Number
Dependent's Information
Please provide the name, relationship, birth date, and social security number for each dependent in the boxes. Unless previously provided, documentation will need to be uploaded. (Check the bottom of the form.)
Income
Upload all relevant documents or bring them to the office
EIP #3 amount?
Stimulus 3
Check all that apply:
W2
Self-Employment (Sch C)
1099-M
Pension/Retirement Income
Rental Income
Other
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Self-Employment Expenses
If filing Schedule C, total your expenses for the year and how much income you grossed.
Consider these when calculating expenses:
Automobile usage (mileage, gas, etc)
Home use for business
Supplies Bought (Any records or receipts?)
Utilities or Taxes paid
Other related expenses
Expenses
Write your expense and the total amount you paid for the year.
Total Gross Income
Tax Advancement
Are you interested in applying for an advancement loan?
EPS Tax Return Advancement
Mimms Tax Service Advancement
None
Upload any other relevant tax documents
Browse Files
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Type any questions, comments or concerns here.
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*
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