New Client Information Sheet
PLEASE FILL OUT COMPLETELY (DUE TO IRS RULING, WE NEED PROPER NAMES)
ALL NEW CLIENTS NEED COPY OF 2023 TAX RETURN FOR FEDERAL & STATE / BUSINESSES NEED LAST 3 YEARS
DEPENDENTS (CHILDREN & OTHER) COPY OF BIRTH CERTIFICATE AND SOCIAL SECURITY CARD REQUIRED FOR ALL DEPENDENTS
Copy of Driver’s License Required from Tax Payer(s) on this Return
Today's Date
-
Month
-
Day
Year
Date
Your Name
SSN
Date of Birth
-
Month
-
Day
Year
Date
Cell
Occupation
Spouse NAME
Spouse SSN
Spouse Date of Birth
-
Month
-
Day
Year
Date
Cell
Occupation
STREET ADDRESS
CITY
STATE
ZIP CODE
EMAIL ADDRESS
example@example.com
Spouse Email
example@example.com
Marital Status in 2023
Married
Single
Widow(er)
Date of Spouses Death
/
Month
/
Day
Year
Date
Filing Jointly
Yes
No
If Filing separately Spouses Adjusted Gross Income is required
**Iowa Residents Only - School District You Live In:
**Illinois Residents Only - Parcel ID #
Did you claim the First Time Homebuyer Credit on your 2008 tax return? (for payback on credit)
Yes
No
Did you have a Business Return in 2023 (Small Business, Farm, Rental or Other ) - If yes, we will need copy of Depreciation Schedule and last 3 years of Federal & State Tax Returns.
Yes
No
Were you referred by someone?
Yes
No
Name Of Referral
Dependents
Dependent #1 Name - First & Last
Relationship
Date of Birth
/
Month
/
Day
Year
Date
SSN
Months Lived with you
Disabled?
Yes
No
Full time student?
Yes
No
Dependents Gross Income
Dependent #2 Name - First & Last
Relationship
Date of Birth
/
Month
/
Day
Year
Date
SSN
Months Lived with you
Disabled?
Yes
No
Full time student?
Yes
No
Dependents Gross Income
Dependent #3 Name - First & Last
Relationship
Date of Birth
/
Month
/
Day
Year
Date
SSN
Months Lived with you
Disabled?
Yes
No
Full time student?
Yes
No
Dependents Gross Income
Dependent #4 Name - First & Last
Relationship
Date of Birth
/
Month
/
Day
Year
Date
SSN
Months Lived with you
Disabled?
Yes
No
Full time student?
Yes
No
Dependents Gross Income
Dependent #5 Name - First & Last
Relationship
Date of Birth
/
Month
/
Day
Year
Date
SSN
Months Lived with you
Disabled?
Yes
No
Full time student?
Yes
No
Dependents Gross Income
Dependent #6 Name - First & Last
Relationship
Date of Birth
/
Month
/
Day
Year
Date
SSN
Months Lived with you
Disabled?
Yes
No
Full time student?
Yes
No
Dependents Gross Income
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