Hardie CPA Individual Tax Questionnaire

PERSONAL INFORMATION
Returning clients do not need to provide personal details, other than name(s), unless your information has changed.
Taxpayer Name:*

First NameLast Name
Taxpayer SS Number:
Taxpayer Occupation:
Taxpayer Date of Birth:*
Taxpayer Phone Number:
Taxpayer Email:*
example@example.com
Spouse Name:

First NameLast Name
Spouse SS Number:
Spouse Occupation:
Spouse Date of Birth:
Spouse Phone Number:
Spouse Email:
example@example.com
Home Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Would you like any type of tax refund to be deposited directly into your bank account?

YesNo
If yes, please provide your banking information.
Bank Name Routing Number Account Number
Did you make any payments towards your 2023 tax liability?

YesNo
If yes, please list dates and amounts.
Date & amount Date & amount Date & amount Date & amount
Has your marital status changed from the prior year? If so, please explain:

DEPENDENT INFORMATION
Returning clients do not need to provide dependent info above, other than name(s), unless something has changed.
Dependent Children or Other Dependents who lived with you - Please provide:

First Name  Last Name   SS Number   Relationship   Date of Birth
First Name   Last Name   SS Number   Relationship   Date of Birth
First Name   Last Name   SS Number   Relationship   Date of Birth
First Name   Last Name   SS Number   Relationship   Date of Birth
Were there any changes in dependents from the prior year? If so, please provide details.
Is there anyone else who might claim any of your dependents?

YesNo
Are you certain your dependents have not claimed themselves on a personal return?

YesNo
Did any of your dependents have unearned income of $1,250 or more ($350 if self-employed)? If yes, do you want us to prepare your child’s tax return?
Did you have any children (under age 19 or under 24 if a full-time student) who have investment income (Interest, dividends, stock transactions) over $2,500? If yes, do you want to include their income on your return?
Did you pay for childcare to qualified facilities while you worked, looked for work or while a full-time student?

YesNo
Did you or your dependents attend college during 2023? If so, were scholarships awarded?

Hardie CPA Individual Tax Questionnaire - 2023