D&D Business Services - Notary & Taxes 2021 Income Tax Extension: Customer Data Information
470-556-0672 l www.DDNotaryandTax.com
1. Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
example@example.com
2. Your Social Security Number
*
3. Your Spouse Social Security Number
*
4. Estimate of Total Tax Liability for 2020
*
5. Total 2020 Payments
*
6. Balance Due
*
7. Amount you are paying
*
8. Check here if you're out of the country and a U.S. citizen or resident
*
Yes
No
9. Check here if you're file Form 1040-NR and didn't received wages as an employee subject to U.S. income tax withholding
*
Yes
No
How did you hear about us?
*
Please Select
Newspaper
Internet
Magazine
Other (Please specify...)
Will you be willing to recommend us to complete your Income Taxes?
Yes
No
Feedback about us:
Please give reference of any two people whom you feel will benefit from our services:
Rows
Full Name
Address
Contact Number
1
2
Submit
Should be Empty: