EXXACT TAX CLIENT QUESTIONNAIRE

EXXACT TAX CLIENT QUESTIONNAIRE

Name*

First NameMiddle NameLast Name
SUFFIX:
MARITAL STATUS*
SOCIAL SECURITY #*
DATE OF BIRTH:*

MonthDayYear
Date
AGE: *
OCCUPATION:*
PHONE NUMBER*
Please enter a valid phone number.Format: (000) 000-0000.
CELLPHONE CARRIER (ex.T-Mobile, AT&T, Verizon)*
YesNo
EMAIL ADDRESS:*
example@example.com
ADDRESS:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
IS THERE ANYONE ELSE AT THIS ADDRESS WHO CAN FILE HEAD OF HOUSEHOLD?
YesNo
OTHER ADDRESS USED (IF APPLICABLE)
YesNo
YesNo
SPOUSE INFORMATION(IF APPLICABLE):

First NameMiddle NameLast Name
SUFFIX:
SOCIAL SECURITY #
DATE OF BIRTH:

MonthDayYear
Date
AGE:
OCCUPATION:
PHONE NUMBER
Please enter a valid phone number.Format: (000) 000-0000.