CROWNED CONNECTIONS TAX SERVICES
PLEASE READ CAREFULLY
Please have ALL of your documents before submitting. We do not accept paystubs. To help expedite your tax refund, please complete the form below. This information helps process your refund faster and eliminate errors. Once this form is received our agents will contact you directly to get started!
Are you a NEW or EXISTING client?
Please Select
NEW
EXISTING
How did you hear about us?
Are you applying for a FAST CASH ADVANCE? (additional fees apply for advance)
No
Yes
Name
First Name
Last Name
SSN
*
Date of Birth
-
Month
-
Day
Year
Date
UPLOAD YOUR IDENTIFICATION: DRIVERS LICENSE OR STATE ID
Do you have an identity theft pin?
Yes
No
If yes, what is your IP pin number?
Address
Street Address
Street Address Line 2
City
State / Province
Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
What is your filing status?
Single
Head of House
Married Filing Seperately
Married Filing Jointly
Widow
If you are choosing Head of House? Do you have supporting documents that you pay over half of cost maintain your home with dependents that live with you?
Type a question
Did you work 2024?
*
No
Yes
IF YES, PLEASE UPLOAD ALL W2 FORMS (NO PAYSTUBS ACCEPTED)
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Did you receive unemployment?
Yes
No
IF YES TO UNEMPLOYMENT, PLEASE UPLOAD 1099G
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Did you or anyone on your tax return receive health insurance through Market Place in 2024 and receive Form 1095-A?
*
Yes
No
IF YES, PLEASE UPLOAD 1095A FORM
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How many dependents are you claiming?
If you are claiming dependents, they must be related to you! Are these dependents related to you?
Yes
No
PLEASE ENTER ALL DEPENDENTS
Name
Date of Birth
Social Security Number
Relationship
Dependent 1
Son
Daughter
Niece
Nephew
Other Dependent
Dependent 2
Son
Daughter
Niece
Nephew
Other Dependent
Dependent 3
Son
Daughter
Niece
Nephew
Other Dependent
Dependent 4
Son
Daughter
Niece
Nephew
Other Dependent
PLEASE UPLOAD ALL SOCIAL SECURITY CARDS
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PLEASE UPLOAD ALL BIRTH CERTIFICATES
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Did you pay childcare in 2024?
Yes
No
How much child care did you pay?
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SPECIAL DEDUCTIONS
CHECK ALL THAT APPLY
Check all that apply
Payment of qualified post-secondary tuition or expenses for the taxpayer, spouse or dependent children (Education Credits Form 1098T )
I was self-employed (If self-employed, please see below)
Paid sales tax on any large item, such as a car or boat
Paid over $14,000 medical or dental expenses or payments for health insurance
Home Mortgage interest Form 1098
Payment of student loan interest 1098E
Moved in order to be closer to a new job
I adopted a child
Made contributions to charities
Sold stocks, mutual funds, bonds or other non-business securities
Sold rental property
None
Are you self-employed?
Yes
No
What type of business do you have?
What is your EIN? If applicable
What was your gross in 2024? Include all sources of self-employed income
Let's talk about your expenses! Tell us how much you paid, if applicable
Expenses
Advertising
Car and truck expenses
Commissions and fees
Insurance, other than health
Contract labor
Depletion
Depreciation and section 179 expense deduction
Employee benefit programs
Insurance, other than health
Interest Mortgage (paid to banks, etc.) Other
Legal and professional services
Office expense
Pension and profit-sharing plans
Rent or lease a vehicle, machinery, and equipment or other business property
Repairs and maintenance
Supplies not included in Part III
Taxes and licenses :less Form 8846 credits:
Travel and meals
How would you like to receive your refund?
Check
Direct Deposit
Account Number
Routing Number
NOTES FOR TAX PREPARER
Signature - Certify all Information Provided is Correct & Accurate
Submit
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