EFS Finance Client Profile 2021

Client Profile
Filing Status *
Prior Year Customer *

Taxpayer *


First and Last name
Date of Birth
Social/ ITIN
Phone Number
Email Address

Spouse, If any *

	If none, type N/A
First and Last name
Date of Birth
Social/ ITIN
Phone Number
Email Address

Address *

Street Address

Street Address Line 2

City State

Zip Code
Do you have any of the following:

Daycare Expenses Education Expenses
Economic Stimulus Payment 3 Amount Received *
If not received, enter 0
Amount of Advance Child Tax Credit Received *
If not received, enter 0

Dependents Information Page
Do you have Dependents? *
If no, Skip to next page

All Tax Returns w/ dependents and/or qualifying children :

	Yes	No	Does not apply
Did you provide over 50% of total support for each dependent?

Dependent 1


First and Last name
Date of Birth
Social/ ITIN
Relationship
Months in home in 2021

Dependent 2

	Type N/A if none
First and Last name
Date of Birth
Social/ ITIN
Relationship
Months in home in 2021

Dependent 3

	Type N/A if none
First and Last name
Date of Birth
Social/ ITIN
Relationship
Months in home in 2021

Dependent 4

	Type N/A if none
First and Last name
Date of Birth
Social/ ITIN
Relationship
Months in home in 2021

Dependent 5

	Type N/A if none
First and Last name
Date of Birth
Social/ ITIN
Relationship
Months in home in 2021

Dependent 6

	Type N/A if none
First and Last name
Date of Birth
Social/ ITIN
Relationship
Months in home in 2021

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EFS Finance will prepare your tax return from the information you have provided. You, the taxpayer, are ultimately responsible for the preparation and filing of your tax return.
Taxpayer's Signature *

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Spouse's Signature

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