Laza Solutions Tax Intake Form

TAX ESTIMATOR FORM

PLEASE NOTE: This is just for an estimate. In order to E-File you have to sign your Tax Return Documents
Who is your Tax Preparer?
If someone referred you, please type his or her name here.
Did you file a tax return last year?
Upload last year's tax return

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Last Year Tax Return Cancelof
What was your last year's AGI (Adjusted Gross Income)
Tax Payers Name

First NameLast Name
Taxpayer's Email Address
Taxpayer's Phone Number
Example: xxx-xxx-xxxx
Taxpayer's Job Title
Taxpayer's Date of Birth
Example: 01/01/2001
Taxpayer's SSN
Example: xxx-xx-xxxx
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Can someone else claim you as a dependent?
What is your marital status as of December
Did you and your spouse live apart during the year?
If yes, did you live together at any time after June 30th
Spouse's Full Name
First Name
Spouse's SSN
Example: xxx-xx-xxxx
Spouse's Date of Birth
Example: 01/01/2001
Spouse's Phone Number
Example: xxx-xxx-xxxx
Spouse's Email Address
Example: example@example.com
Spouse's Job Title
Are you trying to buy a new home within the next year?
Did you pay over half the expenses of maintaining your residence for the entire year?
Are you on any Government Assistance
How many dependents are you claiming?
Dependent #1

First NameLast Name
Dependent #1 Date of Birth
01/01/2001
Dependent #1 SSN
What is Dependent #1's Relationship to you (son, daughter, mother, etc.)?
How many months did Dependent #1 live with you last year? (If all year, enter 12)
Dependent #2

First NameLast Name
Dependent #2 Date of Birth
Example: 01/01/2001
Dependent #2s SSN
Example: xxx-xx-xxxx
How many months did Dependent #2 live with you last year? (If all year, enter 12)
What is Dependent #2's Relationship to you (son, daughter, etc.)?
Dependent #3

First NameLast Name
Dependent #3's Date of Birth
01/01/2001
How many months did Dependent #3 live with you last year? (If all year, enter 12)
Dependent #3s SSN
Example: xxx-xx-xxxx
What is Dependent #3's Relationship to you (son, daughter, etc.)?
Dependent #4's First Name
First Name
Dependent #4's Last Name
Last Name
Dependent #4's Date of Birth
01/01/2001
Dependent #4's SSN
Example: xxx-xx-xxxx
What is Dependent #4's Relationship to you (son, daughter, mother, etc.)?
How many months did Dependent #4 live with you last year? (If all year, enter 12)
Are there any dependents in daycare? If yes, please upload the form you received from your daycare provider.
Upload a copy of your daycare form here.

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If you do not have a daycare form, please provide Name, Address, and EIN/ SSN and amount paid for childcare:
If requested by the IRS, do you have documentation (i.e. receipts, records) to substantiate your eligibility for the Child Tax Credit, Earned Income Tax Credit and/or Head of Household Filing Status?
Are you self employed?
What is your business name?
What type of business do you have or what type of services do you provide?
Provide a copy of your Business EIN.

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Upload a copy of your DBA or LLC Certificate.

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Did you own livestock or participate in trail ride groups?

Other
Did you have health insurance last year?
Was your insurance through:

Other
Upload Taxpayer & Dependent(s)Insurance Document- 1095-A (if applicable)

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Have you ever been denied the Earned Tax Credit (EITC)?
Were you or any of your dependents in college last year?
Do you have a 1098-T Form from a college for either you or your dependents?
Did you trade any Virtual Currency
Did you own or rent your home last year?
Anything else we should know to prepare your taxes?
Taxpayer's and Driver's License

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Spouse's Driver's License

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Taxpayer's and Dependent(s ) Social Security Card(s)

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Taxpayer's W-2/ 1099'S/

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If you have a 1098-T form, upload it here.

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Self-Employment Expense Log, Summary of Income, Business License, Bank Statements, receipts, etc

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Dependent(s) Birth Certificate(s)

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Dependent(s) Proof of Residency (Lease/Utility Bill)

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Additional Documents

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How would you like to receive your tax refund?
Name of Bank
Which type of account would you like your refund deposited into?

Other
Routing Number
Bank Account Number
Do you want to request a Refund Advance Loan?
Primary Taxpayer's Signature
Spouse's Signature
Date

MonthDayYear
Date
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TAX ESTIMATOR FORM