MTP Taxpayer Questionnaire

The information provided in the questionnaire is true and correct, and I/we understand that the information given will be used to complete my/our tax return(s). I/We agree to hold this company harmless for any errors that they may make on my/our tax return. I/We also understand that error on my/our return will cause a delay in processing of the return and the receipt of the refund, if any.
Taxpayer Signature
Date

MonthDayYear
Date
Spouse Signature
Date

MonthDayYear
Date

INFORMATION FOR YOUR TAX PREPARER
Answer each question that applies to YOU. Additional Space provided if needed

SCHOOL INFORMATION (IF APPLICABLE)

Rows	1	2	3	4	5
Taxpayer Name
Name of School/Institution
Year in School
Amount Paid (if applicable)

INCOME INFO

Rows	Please answer Yes or No
Did you receive unemployment
DID you receive any bank interest?
Did you receive any Misc. 1099 income?
Do you have rental property?
Do you have social security?
Did you take money from your 401K?
Did you have self employment income?
Did you have any foreign income, account which had an aggregate value over $10,000?

How many W2's do you have?

DEDUCTIONS

Rows	Please answer Yes or No
Do you have Mortgage interest?
Did you pay vehicle tax?
Did you pay tithes?
Did you pay Real Estate tax?

How many properties do you have?

YES, state how many

STOCK/CRYPTO CURRENCY

Rows	Please answer Yes or No
Did you sell any stock?
Did you buy, sell, or invest in any Crypto Currency?

PAY OUT OF POCKET

Rows	Please answer Yes or No
Did you owe the state last year?
Did you pay the State?
Did you pay Alimony?
Did you receive a Federal refund last year?
Have your received any IRS letters from the IRS?
DId you pay or borrow funds for college tuition?
Do you owe the IRS?

How much do you owe?
(Estimates Allowed! Only answer this question if you owe the IRS)
Are you a victim of Identity Theft?

MISC INFO

Rows	Please answer Yes or No
Are you a Armed Forces Reservist?
Are you part of a business Partnership or Corporation?

UPLOAD ID ONLY HERE!
DRAG ID IMAGE HERE ONLY!

Cancelof
EMAIL ALL TAX DOCUMENTS TO DOCS.MTPCHI@GMAIL.COM
Taxpayer Signature

Were any of your dependents legally adopted within the past year?
What is your relationship to the child?

DEPENDENT(S) INFORMATION

Rows	Name	Birthdate	SSN#	Relationship to Taxpayer	# of Mo nths lived with you	Daycare enrolled? Y or N	Grade
1
2
3
4
5

Dependents who live with you but are being claimed on another return

Rows	Name	Birthdate	SSN#	Relationship to Taxpayer	# of Months
1
2
3
4
5

Has Form 8332 (Release/Revocation of Release of Claim for Exemption for Child by Custodial Parent) been completed?

CHILD CARE EXPENSES (For children under the age of 13 or disabled adults)

Rows	1	2	3	4	5
Dependent Name
Name of Child Care Provider
Federal ID Number
Amount

EARNED INCOME CREDIT

Part 1: Qualifications - To be complete by Taxpayers WITH and WITHOUT a Qualifying Child(ren)
Could you or your spouse if filing jointly, be considered "Qualifying Child" on another person's income tax return during the current tax year?

Part II: Qualifying Children - To be completed by Taxpayers WITH dependents ONLY

Rows	Child 1	Child 2	Child 3	Child 4	Child 5	Child 6
Is the Child: The taxpayer's son, daughter or adopted child OR A child of the taxpayer's stepchild OR the taxpayer's eligible foster child?
If the child is married, are you claiming this child as a dependent? If the child is not married, then choose yes.
Did the child live with you in the United States for over half the year OR the full year if the child is an eligible foster child?
Was the child, at the end of the year: Under the age of 19 OR Under the age of 24 and a full time student OR Any age and permanently and totally disabled?

If you checked "NO" on any of the first four questions, then:

The child is not the taxpayer's qualifying child. If the taxpayer does not have a qualifying child, go to Part III to see if the taxpayer can claim the EIC for people who do not have qualifying children.

Part III: Earned Income Credit - To be completed by Taxpayers WITHOUT a Qualifying Child

Rows	Select answer Yes or No
Was your main home and your spouse, if filing jointly, in the United States for more than half the year? Military personnel on extended active duty outside of the U.S. are considered to be living in the U.S. during that period. NOTE: IF you answered "NO", you are not able to qualify for the earned income credit.

The above information is true and correct, and I/We understand that the information given will be used to complete my/our current year income tax return. I/We agree to hold this company harmless for any errors that they may make on my/our return. I/We also understand that error on my/our return will cause a delay in processing the return and the receipt of the refund, if any.
Taxpayer Signature
Spouse Signature
Date

MonthDayYear
Date

ATTESTATION AND DISCLAIMER
Tax Year
Taxpayer Name: First Name* Last Name*SSN: *
Spouse Name: First Name Last NameSSN:
MPOWER Tax Pros, LLC is not responsible if taxpayer provides us with incorrect information (i.e. social security numbers for self, spouse, or dependents, last names, birth dates.) This may delay your refund. MPOWER Tax Pro's, LLC is not responsible for any discussions or changes the IRS or bank may make on disbursement dates, filing status or any other required information from the IRS.
Taxpayer Initial Initial*
Spouse Initial Initial
MPOWER Tax Pros, LLC is not responsible for any IRS audits. All information obtained from the taxpayer and/or spouse must be presentable if the IRS audits your tax return.
Taxpayer Initial Initial*
Spouse Initial Initial
MPOWER Tax Pros, LLC is not responsible for any incorrect tax figures provided by the taxpayer and/or spouse. If your tax figures change you will need to do an Amendment. Amendments are an additional fee and Prices vary.
Taxpayer Initial Initial*
Spouse Initial Initial
If you have any federal or government debts (i.e. school loans, child support, DPP, DFCS, etc...) there is a chance that your refund will be applied towards your debt. You can call the offset department at 1-800-304-3107 or 1-800-829-7650 to see if your refund will be partially or fully taken. If your refund is fully taken you are responsible for paying the preparation fees.
Taxpayer Initial Initial*
Spouse Initial Initial
MPOWER Tax Pros, LLC is not responsible for any IRS glitch problems or IRS problems that may cause a delay in your tax refund. We DO NOT reimburse any bank fees in the event of this occurrence.
Taxpayer Initial Initial*
Spouse Initial Initial
There will be a Fifty Dollar ($50.00) charge if a representative of MPOWER Tax Pros, LLC completes Twenty-Five Percent (25%) of the taxpayer's return before it has been filed. Additionally, there will be a Seventy-Five (75%) charge of preparation fees required if a representative of MPOWER Tax Pros, LLC has completed Fifty Percent (50%) or more of the taxpayer's return and then decide that to no file utilizing our firm.
Taxpayer InitialSignature*
Signature
Spouse Initial Initial
MPOWER Tax Pros, LLC provides the taxpayer with ONE complimentary copy of their tax return. Should you need any additional copies, there is a $25 fee per copy (federal and state included)
Taxpayer Initial Initial*
Spouse Initial Initial
The information contained in this office or on this website is of a general nature. It should not be construed as legal advice nor should it be acted upon in your specific situation without further details and/or professional assistance. Any use of information contained in this office or on our web site is done so at the risk of the user, and MPOWER Tax Pros, LLC is not responsible for the result or outcome of
its use.

MPOWER Tax Pros, LLC does not guarantee, and is not liable for the truthfulness, accuracy, effectiveness, or any resulting effects of the use of any information contained in this office or on the web site. It is advised and it is the responsibility of the visitor of this office or web site to seek proper instruction and/or seek professional assistance in all matters regarding taxes and the IRS.

MPOWER Tax Pros, LLC is thus held harmless, released of, and users of information contained in this office or on this web site assume full responsibility for, any violation of Tax laws and/or IRS procedure, and any other legal liability resulting from use of any information contained in this office or on this web site.

I attest that all information contained in this income tax return was obtained from the taxpayer or spouse and is true and correct to the best of his/her knowledge.
Taxpayer's Signature Signature* Date Date*
Spouse Signature Signature Date Date
Should be Empty:

TAX CLIENT QUESTIONNAIRE

*Married Filing Jointly/Separately

INFORMATION FOR YOUR TAX PREPARER

ATTESTATION AND DISCLAIMER