• TAXPAYER QUESTIONNAIRE

    TAXPAYER QUESTIONNAIRE

    Identity Verification, Due Diligence & Direct Deposit Form
    • 1. Getting to know you - Client(s) 

    • Identity Verification

      Taxpayer name(s) as appeared on previous year tax return or W2 or 1099*. If you are a first time client, please provide a copy of your previous year tax return.  Upload to portal or email to info@affluenttax.com.*

    • NEW*** - Third Party Designee
      Do you want to allow the Tax Professional or another person to discuss this return with the IRS? Make selection below, if Another Person is selected, please provide his/her contact information in the spaces provided.
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    • 2. Additional Information about you - Client(s) 

    • Please complete

      Select "Yes" only if questions are applicable to you. "No is the default response"

    • * Gifts to Charitable organizations of all types in excess of $250 must be accompanied by a statement from the organization that needs to be kept by the taxpayer in case the IRS requests it. This must contain the amount of money contributed or a description of the property donated, and indicate what, if any, benefit was received in connection with the donation.

      ** Gifts not of cash or its equivalent in excess of $500 must have a completed Form 8283 for each donation attached to the return.

      This will be completed by the tax preparer and will need information on the organization (address, name), dates (of donation and purchase), the costs (value of donation, method to determine, category of gains treatment, etc.)

    • Did you know

      *Doctor includes Acupuncturists, chiropractors, dentists, eye doctors, medical doctors, occupational therapists, osteopathic doctors, physical therapists, podiatrists, psychiatrists, psychoanalysts (medical care only) and psychologists
    • 3. No Dependents, Skip to Direct Deposit/Debit Information 

    • Due Diligence

      ***Complete the following questions only if dependents are being filed on Return*** Otherwise, scroll down to Direct Deposit section.

    • EIC Tie-breaker Rule:

      The parent with whom the child/children lived the longest during the tax year or the parent with the highest AGI or if the child/children lived with both parents for the same amount of time during the tax year is allowed to claim the child/children.

    • Please Note:

      If you are claiming the CTC/ACTC/ODC for a child of divorced or separated parents (or parents who live apart), a Form 8332 or similar statement must be completed
    • 4. Getting Started with Direct Deposit/Debt Information  

    • Direct Deposit/Debit or Paper Check

      Add bank account information below for Refunds/Withdrawals. Want the state Refund deposited into a different account; enter your account information under "State". If you owe and want a direct debit complete the Direct Debit Date also.
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    • Please Note:

      By signing I/spouse agree the contents of the above pages are accurate to the best of my/our knowledge and will not hold the preparer/business liable for any inaccurate or omitted information contained herein:
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    • 5. The Client(s) almost Done: Save, Submit & Print 
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