New Client Information Sheet 2023
Please Fill Out Completely: Due To IRS Ruling, We Need Proper Names
YOUR NAME
S.S. #
D.O.B.
-
Month
-
Day
Year
Date
Cell #
Occupation
SPOUSE Name
SPOUSE S.S. #
SPOUSE D.O.B.
-
Month
-
Day
Year
Date
Cell #
Occupation
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
EMAIL ADDRESS
example@example.com
Spouse Email
example@example.com
Marital Status in 2021
Single
Widower
Date of Spouse's Death
/
Month
/
Day
Year
Date
File Jointly
Yes
No
If Filing separately Spouses Adjusted Gross Income is required
**IOWA RESIDENTS ONLY: School District you Live In?
**ILLINOIS RESIDENTS ONLY: Parcel ID #
DEPENDENTS (CHILDREN & OTHER)
**COPY OF BIRTH CERTIFICATE AND SOCIAL SECURITY CARD REQUIRED FOR ALL DEPENDENTS**
Name (First, Last)
Relationship
Date of Birth
/
Month
/
Day
Year
Date
SS
Months Lived with you
Disabled?
Yes
No
Full Time Student?
Yes
No
Dependent's Gross Income
Dependent # 2
Name (First, Last)
Relationship
Date of Birth
/
Month
/
Day
Year
Date
SS #
Months Lived with you
Disabled?
Yes
No
Full Time Student?
Yes
No
Dependent's Gross Income
Dependent # 3
Name (First, Last)
Relationship
Date of Birth
/
Month
/
Day
Year
Date
SS #
Months Lived with you
Disabled?
Yes
No
Full Time Student?
Yes
No
Dependent's Gross Income
Did you claim the First Time Homebuyer Credit on your 2008 tax return? (for payback on credit) Were you referred by someone?
Yes
No
Were you referred by someone?
Yes
No
(If Yes)Name
Please include documents needed for filing:
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*ALL NEW CLIENTS NEED COPY OF 2021 TAX RETURN FOR FEDERAL & STATE
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