KEEPS ACCOUNTING SOLUTIONS - Tax Preparation Questionnaire

KEEPS ACCOUNTING SOLUTIONS - Tax Preparation Questionnaire

Tax Preparation Questionnaire

Keeps Accounting Solutions
Please read carefully and complete the tax questionnaire below. This form should take between 10-30 minutes to complete. Please don't hesitate to contact us with any questions or concerns. Thank you for choosing Keeps Accounting Solutions!
Filing Status

Name

First NameLast Name
Age
Years
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone numberFormat: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState

Zip Code
Occupation
SSN
Are you a full-time student?
Are you totally and permanently disabled?
Are you legally blind?
Can you be claimed as a dependent on a separate tax return?

Name

First NameLast Name
Age
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address (if different from Taxpayer)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
SSN
Are you a full-time student?
Are you totally and permanently disabled?
Are you legally blind?
Can you be claimed as a dependent on a separate tax return?

Enter your dependents here.

Rows	Name	SSN	Date of Birth	Relationship	Months Lived in Home	Income over $2,600? (Y/N)
1
2
3
4
5
6

Do you, your spouse, and your dependent(s) have health insurance within 12 months during the tax year? If yes, complete below as applicable.

Rows	Yes/No	Employer	Spouse Ins	Exchange/ Marketplace	Direct with Insurer	Medicare	Medicaid
Taxpayer
Spouse
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5