ELITE TAX GROUP

What year(s) are you filing
2018 
2019
2020   

First Economic Stimulus Payment $   Amount    
Second Economic Stimulus Payment $   Amount   

SPOUSE
SSN#   Number   
DOB   Date   
DL#   Number   State    Please Select AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY  ISS Date   Date   
 EXP Date   Date   
Occupation       
Phone   Area Code   Phone Number   

First Name   Last Name   
SSN#   Number   
DOB   Date   
Relationship    Please Select Daughter Son Niece Nephew      
Tuition/dependent care  $ Number   
Disabled   Yes   No      

First Name   Last Name   
SSN#   Number   
DOB   Date   
Relationship    Please Select Daughter Son Niece Nephew
Tuition/dependent care  $ Number   
Disabled   Yes   No      

First Name   Last Name   
SSN#   Number   
DOB   Date   
Relationship    Please Select Daughter Son Niece Nephew      
Tuition/dependent care  $ Number   
Disabled   Yes   No   

First Name   Last Name   
SSN#   Number   
DOB   Date   
Relationship    Please Select Daughter Son Niece Nephew      
Tuition/dependent care  $    
Disabled   Yes   No   

Medical Insurance $   Number   
Dental $   Number  
Vision $   Number       

Taxpayer   Signature   Date Spouse   Signature   Date