Customer Registration Form
Please take a moment to provide the following details.
Primary Taxpayer
*
First Name
Last Name
DOB
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
SSN
Current Address
*
Street Address
City
State / Province
Postal / Zip Code
Drivers License Number
Drivers License State
Issue Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Expiration Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Phone Number
*
Format: (000) 000-0000.
E-mail
example@example.com
How Did You Hear about Wilder Power Taxes?
Facebook
In person/ Flyer
Email
Referral
If referred , please list the person.
** DO YOU OWE THE IRS ??**
Yes
No
I'm Not Sure
Filing Status
Head of Household
Single
Married Filing Jointly
Married Filing Separately
Widowed
Select Tax Years Needed to be Filed
2023
2024
2025
Other
If filing Jointly, what's the taxpayers name?
First Name
Last Name
SSN
DOB
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Drivers License State
Drivers License Number
Expiration Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Issue Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name the people who has IP Pins along with the CURRENT IP PIN.
Any Dependents?
Please Select
Yes
No
If so, how many dependents are you claiming?
Please Select
1
2
3
4
5
6
7
Dependents
Rows
Name
SSN
DOB
Live with you more than 6 months?
Relation
Dependent
Dependent
Dependent
Dependent
Dependent
Dependent
Dependent
Income
W2
1099-NEC Or 1099- MISC
Unemployment
Tips
Rental Income
Pension / Retirement Income
Self Employment (Schedule C)
Other
Bank Name
Routing
Accounting
Submit
Should be Empty: