Customer Details:
Full Name
*
First Name
Last Name
Date of Birth
*
Social Security#
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
E-mail
*
example@example.com
Occupation
What Tax year are you filing?
2022
2021
2020
Multiple
Spouse Full Name(If aplicable)
*
First Name
Last Name
Spouse Date of Birth
*
Spouse Social Security#
*
Spouse Number#
*
Spouse E-mail
*
example@example.com
Spouse Occupation
Did your spouse receive W2's?
*
Yes
No
Did you or your spouse own/rent a home?
*
Own
Rent
How much do you pay monthly for rent?
Answer only if filing 2021 Did you receive any of the Advance Child Tax Credit monthly payments in 2021? if none insert 0. If yes insert the number of amounts received .
How many months. Ex. 4 months
Did you receive a first time home buyer credit in 2008, 2009, 2010? If so are you required to pay this credit back ?
*
Yes
No
Required to pay back
Did you sell or buy any stock in the tax year you are filing?
*
Yes
No
Check if Documentation is Available
Filing Status?
*
Head of Household
Single
Married Filing Seperated
Married Filing Jointly
Did you pay more than half of the expense at your residence for the entire year?
*
Yes
No
Will you claim any dependents who lived with you & who you supported for more than 6 months, for filing year?
*
Yes
No
Dependent 1
Full Name
Date of Birth
Social Security Number
Postal / Zip Code
Dependent 2
Full Name
Date of Birth
Social Security Number
Postal / Zip Code
Dependent 3
Full Name
Date of Birth
Social Security Number
Postal / Zip Code
Can you or any dependents be claimed by anyone else?
Yes
No
If yes, which dependent can be claimed by someone else?
Name
Which dependent did you pay daycare for?
Name
Please check all Forms you have/will receive
*
W2
1099G-Unemployment Compensation
Schedule C-Self Employed *verifiable information
401K/403B
Investments/Coins
Mortgage Interest
Daycare expenses/Total Amount for the year $_____________
Social Security/Retirement Income
1099R-Early Withdrawal from retirement account
Student
*
Yes
1098T
Ever received American Opportunity Credit
No to all above
1095A Health Insurance Form? Market Place/ObamaCare
*
Yes
No
Did you receive any Child Tax Credit payments?
*
$_______________
No
Signature
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