VITA QUALIFICATION FORM

1

Name* This field is required.

Prefix

First Name

Last Name

Suffix

2

Email* This field is required.

example@example.com

Confirm Email

3

Phone Number* This field is required.

Please enter a valid phone number.

4

Are you a U.S. citizen or a resident alien?* This field is required.

YESNO

5

Did your annual income exceed $67,000?* This field is required.

YESNO

6

Did you receive income from rental properties?* This field is required.

YESNO

7

Did you have foreign financial accounts or income?* This field is required.

YESNO

8

Are you a military service member or a qualifying veteran?* This field is required.

YESNO

9

Do you receive a Form K-1 (income from partnerships, royalties)?* This field is required.

YESNO

10

Are you self-employed (own your own small business or paid as a contractor?)* This field is required.

YESNO

11

Did you:Have more than $10,000 in expenses?Have a net loss from the business?Depreciate any items?Have more than one business?Have any employees?* This field is required.

YESNO

12

Do you have dependents that you can claim on your tax return?* This field is required.

YESNO

13

Are you able to provide all necessary documentation, such as W-2s, 1099s, and receipts for deductions?* This field is required.

YESNO

14

You Do not Qualify for the VITA programHowever, you may be able to file your own tax return at MyFreeTaxes.com

15

Appointment* This field is required.Pick your appointment time