Virtual Tax Client Information
Please fill out this form to the best of your knowledge and honesty. This information will be electronically transferred to the IRS and State Treasuries.
Personal Info
Name
*
First Name
Middle Initial
Last Name
SSN or ITIN
*
SSN
Date of Birth
*
/
Month
/
Day
Year
DOB
Occupation
*
Job Title
Identity Protection Pin (IPPIN)
Note:If you received an IPPIN from the IRS, enter it in the space above. If you did not receive an IPPIN, leave this box blank. The IPPIN is 6 digits long, and is not the same as a self-select pin.This pin is primarily for individuals who have been victims of identity theft or those who have specifically requested one.
Select all that apply
Disabled
Blind
Deceased
Student
Was your main home in the United States for more than half of the year?
*
Yes
No
Affordable Care Act (ACA) - Question
Did you receive a Form 1095-A Health Insurance Marketplace Statement?
*
Yes
No
Filing Status
Please Select
Single
Married Filing Jointly
Married Filing Separately
Head of Household
Qualifying Widow(er) with Dependent Child
Are you married filing jointly?
*
Yes
No
What's your status?
*
Single
Head of Household (care for children/dependents)
Spouse's Name
*
First Name
Middle Initial
Last Name
Spouse's SSN or ITIN
*
SSN
Spouse's Date of Birth
*
/
Month
/
Day
Year
DOB
Spouse's Occupation
*
Job Title
Spouse's Identity Protection Pin (IPPIN)
Note:If you received an IPPIN from the IRS, enter it in the space above. If you did not receive an IPPIN, leave this box blank. The IPPIN is 6 digits long, and is not the same as a self-select pin.This pin is primarily for individuals who have been victims of identity theft or those who have specifically requested one.
Select all that apply to spouse
Disabled
Blind
Deceased
Student
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Personal Questions
Can someone else claim you as a dependent on their tax return?
*
Yes
No
List Each Dependent
Name
Date of Birth
Social Security #
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Did any of the above dependents attend college?
*
Yes
No
Did you receive monthly Child Tax Credit payments?
*
Yes
No
Do you have letter 6419 from the IRS showing your Child Tax Payment Balance?
*
Yes
No
Advance Child Tax Credit Payments Received
Amount
Date Received
CTC Payment 1
CTC Payment 2
CTC Payment
3
CTC Payment
4
CTC Payment 5
CTC Payment 6
Did you receive stimulus payments?
*
Yes
No
Did you receive unemployment?
*
Yes
No
Are you behind in any government debt? (Student loans, Child Support, IRS, etc.)
*
Yes
No
List Business Information
Input Needed
Business Name or Sole Proprietor Name
EIN or SSN
Business Address
Type of Business
Do you own or operate a business?
*
Yes
No
Social Security Card(s)
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Driver's License(s) or State ID(s)
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Upload W2(s)
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Prior Year's Tax Return(s)
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1099-G(s) (Unemployment)
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6419 (Advance Child Tax Credit Form)
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6475 (Economic Impact (stimulus) Payment)
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1099-NEC(s) (MISC) (Independent Contractor)
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1098-T (Student Credit)
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Upload Additional Tax Forms
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To receive your refund please list your bank information
Bank Information
Bank Name
Routing Number
Account Number
Sign and Submit
I, hereby, state that all the information above is true to the best of my knowledge and that I am allowing First Class Financial Associates LLC to file my taxes based on the information provided. I understand that I am financially responsible for any outstanding balances due to any false information given. If there is a balance due, I the tax payer is responsible to pay for the tax preparation service. First Class Financial Associates LLC is not liable for any negligence on the tax payer. Please provide all information as accurate as possible. The signature below confirms that you grant First Class Financial Associates LLC permission to submit your taxes to the IRS and State Treasuries with the above information.
Submit
Upload Supporting Business Docs (Income Statement, Excel Docs, etc.)
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