Name (First and Last)
*
Email
*
example@example.com
Date of Birth (DOB)
*
-
Month
-
Day
Year
Date Picker Icon
Preferred Contact Phone
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Marital Status
*
Single
Married
Divorced
Separated
Widowed
Spouse Name
Spouse DOB
-
Month
-
Day
Year
Date
Spouse email
Major Life Changes during Prior Year
*
Got Married
Got Divorced
Birth of a Child
Adoption of a Child
Lost Job
Retired
Sold Primary Residence
Received Inheritance
Death of Spouse
Nothing Changed
Children (Name and DOB)
Sources of Income
*
Employee Wages (W-2)
Self-Employed
Retirement Funds
Social Security Benefits
Investment Income
Real Estate/Rental Income
No Income
Other
If you are self-employed, do you have accurate books and records to support all income and deductions?
*
Yes
No
Maybe
N/A
Do you have an interest in foreign bank accounts or foreign trusts?
*
Yes
No
Maybe
Have all prior year tax returns been filed?
*
Yes
No
Maybe
Please include any other important information that you would like for us to be aware of.
How did you hear about Jimerson Tax and Accounting, LLC?
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