Client List

Full Name*

First NameLast Name

Full Address *

Contact Number*

Please enter a valid phone number.

Email Address (you will be automatically added to our email list) *

example@example.com

Date Of Birth*

Date

Are you a returning client?*

YesNo

Filing Status*

SingleMarried Filing JointHead of Household

If filing a joint return please list your spouses name as it appears on their Social Security Card

Dependents (Please list yourself as a dependent) *

	Dependent Name	SSN	DOB	Relationship
Self
Dependent 1
Dependent 2
Dependent 3
Dependent 4

Do you have Child Care expenses*

YesNo

If you had Child Care Expenses please list (Name of Child Care Provider, Address, Federal ID Number, and Amount Paid):

Income (Please answer Y or N) *

	Income Info
How many W2's do you have
Did you receive unemployment
Did you receive bank interest
Did you receive any Misc 1099 income
Do you have rental property
Do you receive social security
Did you take money from your 401
Do you have self employment income
Did you sale any stock

Deduction (Please answer Y or N) *

	Income Info
Do you have mortgage interest
Do you pay Real Estate taxes
Do you pay vehicle tax
Do you pay tithes

If You Received Self Employment Income Please Provide An Amount For Each Expense Type That Pertains To Your Business. (If not please enter "0" in at least one box)*

	Income Info
Advertising & Marketing
Company Vehicle Expenses
Insurance
Maintenance & Repairs
Contract Labor
Payroll Expenses
Rent
Travel
Utilities ( cell phone, light bill etc)
Meals and Entertainment
Office Supplies
Parking Fees & Tolls
Equipment & Software

Pay Out Of Pocket (Please answer Y or N) *

	Income Info
Did you owe the state last year
Did you pay the state
Did you pay Alimony
Did you file taxes last year
Did you receive a Federal refund last year
Did you owe the IRS? If so, how much did you owe?
Did you pay or borrow, fund college tuition
How much paid for self
How much paid for child

Have you received all your tax documents and ready to file your return? (If you are ready to begin the filing process please click the blue hyper link on the Thank You page)*

YesNo

Appointment type?*

Virtual (recommended for faster processing time)In Office (by appointment only)

Appointment

Are you a Armed Forces Reservist?*

YesNo

Are you part of a business Partnership or Corporation*

YesNo

Do you owe $7,000 or more in back taxes?

YesNo

If you owe back taxes, would you like to receive more information about Tax Debt Resolution?

YesNo

Do you have questions regarding your return and would like a call back?*

YesNo

PLEASE READ!!!!!!!!!!!!

Once you complete and submit the contact form you will be redirected to the Taxs To Go website. If you have not done so already you will need to download the app to upload your tax documents securely. If you have used the Taxs To Go app before, you may need to create a new account.

ONCE THE DOCUMENTS HAVE BEEN UPLOADED SUCCESSFULLY PLEASE TEXT YOUR 6-DIGIT TAX CODE TO 463-400-7416.

THANK YOU

Signature (I confirm that the information provided is true to the best best of my knowledge)

New Day Solution Services Client Contact Form