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2023 Tax Filing Intake Form
Please fill out all the information to apply for personal taxes. Kindly provide a detailed answer to the questions on the next page.
24
Questions
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1
Name
*
This field is required.
First Name
Last Name
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2
Email
*
This field is required.
example@example.com
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3
SSN
*
This field is required.
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4
Phone Number
*
This field is required.
Please enter a valid phone number.
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5
Address
*
This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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6
Date of Birth
*
This field is required.
-
Date
Year
Month
Day
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7
Did you file 2021 individual tax return?
*
This field is required.
YES
NO
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8
Occupation
*
This field is required.
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9
Filing Status
*
This field is required.
Single
Married Filing Jointly
Married Filing Separately
Head of Household
Qualifying Widow(er) with dependent child
Single
Married Filing Jointly
Married Filing Separately
Head of Household
Qualifying Widow(er) with dependent child
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10
Do you have children or support someone else?
*
This field is required.
YES
NO
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11
Relationship
Mother
Father
Son
Daughter
Spouse
Mother
Father
Son
Daughter
Spouse
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12
Name
First Name
Last Name
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13
Dependent's DOB
-
Date
Year
Month
Day
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14
Dependent's SSN
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15
What is the citizenship status of the dependent?
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16
Did dependent live with you in 2021?
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17
Did your dependent pay more than half of their living expenses?
Type YES or NO.
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18
Did your dependent pay more than half of their living expenses?
Type YES or NO.
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19
Do you have more children to add?
*
This field is required.
YES
NO
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20
Input Details Here
Children 1
Children 2
Children 3
Children 4
Children 5
Relationship
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Name
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Row 1, Column 4
Dependent's DOB
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
Row 2, Column 4
Dependent's SSN
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
Row 3, Column 4
What is the citizenship status of the dependent?
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
Row 4, Column 4
Did dependent live with you in 2021?
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Row 5, Column 3
Row 5, Column 4
Did your dependent pay more than half of their living expenses?
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Row 6, Column 3
Row 6, Column 4
Relationship
Name
Dependent's DOB
Dependent's SSN
What is the citizenship status of the dependent?
Did dependent live with you in 2021?
Did your dependent pay more than half of their living expenses?
Children 1
Row 0, Column 0
Children 2
Row 0, Column 1
Children 3
Row 0, Column 2
Children 4
Row 0, Column 3
Children 5
Row 0, Column 4
Children 1
Row 1, Column 0
Children 2
Row 1, Column 1
Children 3
Row 1, Column 2
Children 4
Row 1, Column 3
Children 5
Row 1, Column 4
Children 1
Row 2, Column 0
Children 2
Row 2, Column 1
Children 3
Row 2, Column 2
Children 4
Row 2, Column 3
Children 5
Row 2, Column 4
Children 1
Row 3, Column 0
Children 2
Row 3, Column 1
Children 3
Row 3, Column 2
Children 4
Row 3, Column 3
Children 5
Row 3, Column 4
Children 1
Row 4, Column 0
Children 2
Row 4, Column 1
Children 3
Row 4, Column 2
Children 4
Row 4, Column 3
Children 5
Row 4, Column 4
Children 1
Row 5, Column 0
Children 2
Row 5, Column 1
Children 3
Row 5, Column 2
Children 4
Row 5, Column 3
Children 5
Row 5, Column 4
Children 1
Row 6, Column 0
Children 2
Row 6, Column 1
Children 3
Row 6, Column 2
Children 4
Row 6, Column 3
Children 5
Row 6, Column 4
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21
Input all the details needed
Yes
No
If yes, type the amount:
Do you own a home?
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Real Estate Taxes Paid
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Mortagage Interest Paid
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Points Not Reported On 1098
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Do you have unreimbursed expenses related to your job?
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Occupation in which you incurred expenses:
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Parking fees, tolls and transportation (Amount):
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Travel expenses and lodging (Amount):
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Meals and entertainment Expenses (Amount):
Row 8, Column 0
Row 8, Column 1
Row 8, Column 2
Do you use your vehicle for business?
Row 9, Column 0
Row 9, Column 1
Row 9, Column 2
Was your vehicle available for personal use?
Row 10, Column 0
Row 10, Column 1
Row 10, Column 2
Do you own a home?
Real Estate Taxes Paid
Mortagage Interest Paid
Points Not Reported On 1098
Do you have unreimbursed expenses related to your job?
Occupation in which you incurred expenses:
Parking fees, tolls and transportation (Amount):
Travel expenses and lodging (Amount):
Meals and entertainment Expenses (Amount):
Do you use your vehicle for business?
Was your vehicle available for personal use?
Yes
Row 0, Column 0
No
Row 0, Column 1
If yes, type the amount:
Row 0, Column 2
Yes
Row 1, Column 0
No
Row 1, Column 1
If yes, type the amount:
Row 1, Column 2
Yes
Row 2, Column 0
No
Row 2, Column 1
If yes, type the amount:
Row 2, Column 2
Yes
Row 3, Column 0
No
Row 3, Column 1
If yes, type the amount:
Row 3, Column 2
Yes
Row 4, Column 0
No
Row 4, Column 1
If yes, type the amount:
Row 4, Column 2
Yes
Row 5, Column 0
No
Row 5, Column 1
If yes, type the amount:
Row 5, Column 2
Yes
Row 6, Column 0
No
Row 6, Column 1
If yes, type the amount:
Row 6, Column 2
Yes
Row 7, Column 0
No
Row 7, Column 1
If yes, type the amount:
Row 7, Column 2
Yes
Row 8, Column 0
No
Row 8, Column 1
If yes, type the amount:
Row 8, Column 2
Yes
Row 9, Column 0
No
Row 9, Column 1
If yes, type the amount:
Row 9, Column 2
Yes
Row 10, Column 0
No
Row 10, Column 1
If yes, type the amount:
Row 10, Column 2
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22
Input all the details needed
Input amount or details
Yes
No
Did you donate any money or items to a qualified charity?
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
What did you donate?
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Charity Name
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Charity Address
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Date of Donation:
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Did you pay any car registration fees in 2021?
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Enter the amount of all your vehicle registration fees:
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Was student enrolled for at least half-time for at lest one academic period?
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
School Name
Row 8, Column 0
Row 8, Column 1
Row 8, Column 2
School Address:
Row 9, Column 0
Row 9, Column 1
Row 9, Column 2
Did student complete firs years of post-secondary (bachelor's degree) before 2021?
Row 10, Column 0
Row 10, Column 1
Row 10, Column 2
Was student convicted, before end of 2021, of a felony for possession or distribution of a controlled substance?
Row 11, Column 0
Row 11, Column 1
Row 11, Column 2
Did you receive 1098-T for the year 2021?
Row 12, Column 0
Row 12, Column 1
Row 12, Column 2
What type of health insurance did you have?
Row 13, Column 0
Row 13, Column 1
Row 13, Column 2
If you had no coverage or were covered for part of the year, were you exempt?
Row 14, Column 0
Row 14, Column 1
Row 14, Column 2
Enter total unreimbursed health care expenses
Row 15, Column 0
Row 15, Column 1
Row 15, Column 2
Did you donate any money or items to a qualified charity?
What did you donate?
Charity Name
Charity Address
Date of Donation:
Did you pay any car registration fees in 2021?
Enter the amount of all your vehicle registration fees:
Was student enrolled for at least half-time for at lest one academic period?
School Name
School Address:
Did student complete firs years of post-secondary (bachelor's degree) before 2021?
Was student convicted, before end of 2021, of a felony for possession or distribution of a controlled substance?
Did you receive 1098-T for the year 2021?
What type of health insurance did you have?
If you had no coverage or were covered for part of the year, were you exempt?
Enter total unreimbursed health care expenses
Input amount or details
Row 0, Column 0
Yes
Row 0, Column 1
No
Row 0, Column 2
Input amount or details
Row 1, Column 0
Yes
Row 1, Column 1
No
Row 1, Column 2
Input amount or details
Row 2, Column 0
Yes
Row 2, Column 1
No
Row 2, Column 2
Input amount or details
Row 3, Column 0
Yes
Row 3, Column 1
No
Row 3, Column 2
Input amount or details
Row 4, Column 0
Yes
Row 4, Column 1
No
Row 4, Column 2
Input amount or details
Row 5, Column 0
Yes
Row 5, Column 1
No
Row 5, Column 2
Input amount or details
Row 6, Column 0
Yes
Row 6, Column 1
No
Row 6, Column 2
Input amount or details
Row 7, Column 0
Yes
Row 7, Column 1
No
Row 7, Column 2
Input amount or details
Row 8, Column 0
Yes
Row 8, Column 1
No
Row 8, Column 2
Input amount or details
Row 9, Column 0
Yes
Row 9, Column 1
No
Row 9, Column 2
Input amount or details
Row 10, Column 0
Yes
Row 10, Column 1
No
Row 10, Column 2
Input amount or details
Row 11, Column 0
Yes
Row 11, Column 1
No
Row 11, Column 2
Input amount or details
Row 12, Column 0
Yes
Row 12, Column 1
No
Row 12, Column 2
Input amount or details
Row 13, Column 0
Yes
Row 13, Column 1
No
Row 13, Column 2
Input amount or details
Row 14, Column 0
Yes
Row 14, Column 1
No
Row 14, Column 2
Input amount or details
Row 15, Column 0
Yes
Row 15, Column 1
No
Row 15, Column 2
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23
W2 (If applicable)
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
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24
Schedule C (If Applicable)
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
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25
Side Jobs (1099-MISC)
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
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26
Unemployment (1099-G)
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Select files to upload
Max. file size
: 10.6MB
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27
Other supporting docs
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
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28
Upload Front Picture of Driver's License or State Issued ID
*
This field is required.
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
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29
Upload Back Picture of Driver's License or State Issued ID
*
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Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
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30
Upload a Selfie Holding the Driver's License or State Issued ID beside the face (For Verification Purposes)
*
This field is required.
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
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31
Bank Info
*
This field is required.
Details
Bank Name:
Row 0, Column 0
Routing Number:
Row 1, Column 0
Account Number:
Row 2, Column 0
Type of bank account: (CHECKING & SAVINGS)
Row 3, Column 0
Who referred you?
Row 4, Column 0
Bank Name:
Routing Number:
Account Number:
Type of bank account: (CHECKING & SAVINGS)
Who referred you?
Details
Row 0, Column 0
Details
Row 1, Column 0
Details
Row 2, Column 0
Details
Row 3, Column 0
Details
Row 4, Column 0
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32
Who referred You/Broker?
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33
P
Type option 1
Type option 2
Type option 3
Type option 4
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Should be Empty:
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