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To better serve you and meet your tax preparation expectations, we ask that you take a few minutes to fill out the information below.
Are you a returning Client?
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No
Do you have a security PIN:
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No
#(Security Pin)
INFORMATION:
Marital Status:
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Single
Married Filing Jointly
Married filing separately
Widowed
Head of household
Preferred Contact Method:
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English
Spanish
Spouse Preferred Contact Method (IF Married):
English
Spanish
Primary Taxpayer Name:
*
Spouse Name:
Date of Birth:
*
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Month
-
Day
Year
Spouse Date of Birth:
SSN or ITIN:
*
Spouse SSN or ITIN :
Occupation:
*
Spouse Occupation:
Home Address:
*
Spouse Address (If different):
City,State,Zip:
*
City,State,Zip:
Phone Number:
*
Spouse Phone Number:
Email
*
Spouse Email:
Can you be claimed as a dependent by someone else?
*
Yes
No
DEPENDENTS* (or person living in your household)
Name
Relationship
Date of Birth
SSN or ITIN
Full Time Student
Disabled?
CHILDCARE INFORMATION
Provider Name
Provider Address
Provider SSN /EIN
Amount Paid
*If any dependents listed did not live at the primary taxpayers address the entire year, please discuss this with your tax professional. This is critical to help us help you accurately report your residency and dependency to the tax authorities.
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INCOME: (Check all that Apply & Include Documents.)
*
Employee (W-2)
1099-Misc
Self-Employment*
Interest (1099-Int)
Social Security/Retirement
Dividends (1099-Div)
Rental Property*
Stock or Mutual Fund Sale (1099-B)
Unemployment
N/A
EXPENSES: (Check all that apply. )
*
Self-Employment (Profit & Loss)
Not Reimbursed by your
Employer
Education (Supplies &
Rental Property(Upgrades/
Energy)
Medical/Dental Care
Union Dues
Moving Cost
N/A
CREDIT & DEDUCTIONS: (Check all that apply)
*
Charitable Donations?
Pay Student Loan Interest?
Pay Child/Dependent Care Expense?
Mortgage Payment? (1098)
IRA Contribution?
Make a Major Taxable Purchase?
Property Taxes?
N/A
MISCELLANEOUS: (Check all that apply and include all Documents) Did you or your spouse:
*
Sell or Buy a Home?
Take an IRA or 401(k)Distribution?
Pay/Receive Alimony?
Suffer Catastrophic Loss?
Have Gambling Winnings/Losses?
N/A
HEALTH INSURANCE (Check all that apply & include documents.) Were you or any members of your household Enrolled in:
*
Obamacare (Marketplace): 1095-A
Employer Insurance: 1095-C
Medicare or Medicaid: 1095-B
N/A
Other
Employee (W-2)
1099-Misc
Self-Employment*
Interest (1099-Int)
Social Security/Retirement
Dividends (1099-Div)
Rental Property*
Stock or Mutual Fund Sale (1099-B)
Unemployment
N/A
Other Income Not Listed Explain:
EXPENSES: (Check all that apply. )
Self-Employment (Profit & Loss)
Not Reimbursed by your
Employer
Education (Supplies &
Rental Property(Upgrades/
Energy)
Medical/Dental Care
Union Dues
Moving Cost
N/A
CREDIT & DEDUCTIONS: (Check all that apply)
Charitable Donations?
Pay Student Loan Interest?
Pay Child/Dependent Care Expense?
Mortgage Payment? (1098)
IRA Contribution?
Make a Major Taxable Purchase?
Property Taxes?
N/A
MISCELLANEOUS: (Check all that apply and include all Documents) Did you or your spouse:
Sell or Buy a Home?
Take an IRA or 401(k)Distribution?
Pay/Receive Alimony?
Suffer Catastrophic Loss?
Have Gambling Winnings/Losses?
N/A
Government Payment Amount:
*
ADDITIONAL INFORMATION
Are you or your Spouse in Debt with the IRS or any other Government Agencies?
*
Yes
No
Are you purchasing a Home within the next two years?
Yes
No
Did you receive self-employment income or 1099 income?
*
Yes
No
PREFERRED FORM OF CONTACT
*
Email
SMS
Phone
FORM OF PAYMENT (THIS CAN NOT BE CHANGED ONCE PROCESSED)
*
Credit Card
Bank Product
Zelle (docs@swiftbooks.co)
Where would you like your federal or state income tax refund direct deposited?
*
Routing Number
Account Number
DIRECT DEPOSIT ACCOUNT INFORMATION:
Routing Number:
Account Number
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Social Security cards, W-2 forms...etc
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Taxpayer Signature
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Date
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-
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Year
Date
Spouse Signature:
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Date
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