Walt Tax
We understand tax preparation and assist with planning, to help you save money and pay less.
Name
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First Name
Last Name
Email
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example@example.com
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Job Title
example@example.com
Are you inquiring about business tax services?
Yes
No
Unsure
If so, what type of business do you have?
Ex: S-Corp, C-Corp, LLC
Did you file a 2020 tax return?
Yes
No
Unsure
What is your marital status as of December
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Single (Not Married)
Married living with Spouse
Married not living with spouse
Spouse Name (if applicable/filing jointly)
First Name
Last Name
Spouse's Phone Number
Example: xxx-xxx-xxxx
Spouse's Email Address
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Spouse's Job Title
Home Address
Street Address
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Are you self employed?
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Yes
No
Did you and your spouse live apart during the year?
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Yes
No
Not Applicable
Did you support a child or family member for more than 6 months out of the year?
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Yes
No
Are you on any Government Assistance
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Yes
No
Not Applicable
How many dependents are you claiming?
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Please Select
0
1
2
3
4
5
How many months did your Dependent(s) live with you in 2021? (If all year, enter 12)
Are there any dependents in daycare?
Yes
No
How would you like to receive your tax refund?
Check (Only available for in office visits)
Direct Deposit
Which type of account would you like your refund deposited into?
Checking Account
Savings Account
Other
Can someone else claim you as a dependent?
Yes
No
Did you have health insurance in 2021?
Yes
No
Did you have health insurance for the entire year?
Yes
No
Was your insurance through your employer?
Yes
No
Did your dependents have health insurance for the entire year?
Yes
No
Not Appliable
Did you receive the first round of stimulus check?
*
Yes
No
Did you receive the second round of stimulus check?
Yes
No
Were you or any of your dependents in college in 2021?
Yes
No
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