Form
PERSONAL INFORMATION
FILING STATUS
*
SINGLE
HEAD OF HOUSEHOLD
MARRIED FILING JOINT
MARRIED FILING SEPERATE
Other
DRIVERS LICENSE OR ID FOR YOURSELF AND SPOUSE IF FILING JOINTLY
*
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SOCIALS FOR TAX PAYER AND SPOUSE IF FILING JOINT
*
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ADDRESS:
*
PHONE NUMBER:
*
Email
*
example@example.com
ARE YOU OR YOUR SPOUSE DISABLED?
*
YES
NO
IF SO, WHO
DEPENDENT INFO
DEPENDENTS FULL NAME & DATE OF BIRTH
DEPENDENTS SOCIALS
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INCOME
ARE YOU SELF EMPLOYED?
*
YES
NO
INCOME FORMS (EX: W2S, 1099S, SELF EMPLOYED INCOME AND EXPENSES, UNEMPLOYMENT)
*
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CREDITS AND DEDUCTIONS
IS ANYONE A FULL-TIME COLLEGE STUDENT? IF SO, UPLOAD 1098T
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DID YOU PAY CHILD CARE? IF SO, UPLOAD CHILD CARE FORM
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DID YOU PAY PROPERTY TAX? IF SO, UPLOAD DOCUMENTS
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DO YOU OWN A HOME? IF SO, UPLOAD 1098 MORTGAGE INTEREST STATEMENT/
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DID YOU CONTRIBUTE TO CHARITY? IF SO, PLEASE UPLOAD DOCUMENTS.
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HAVE YOU MADE ANY ENERGY EFFICIENT UPGRADES TO YOUR HOME?
WINDOWS
DOORS
FURNACE
OTHER
IF ANY OF THESE APPLY TO YOU, FILL IN THE AMOUNTS
Rows
AMOUNT
MEDICAL EXPENSES
DENTAL EXPENSES
INSURANCE PREMIUMS PAID
PRESCRIPTION DRUGS & MEDICATIONS
How did you hear about us? If you were referred, please add persons name.
ACKNOWLEDGMENT & SIGNATURE
I CONFIRMED THAT ALL INFORMATION I ENTERED HERE IS ALL ACCURATE AND TRUE.
I ALLOW TRUE NORTH TAX & CREDIT TO CAPTURE MY SENSITIVE DATA LIKE PERSONAL ID, SOCIALS, & OTHER INFORMATION.
BY SIGNING BELOW, YOU ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD YOUR RESPONSIBILITIES AND OUR RESPONSIBILITIES IN DOING THIS RETURN
Date Signed
-
Month
-
Day
Year
Date
Taxpayer Signature
Date Signed
-
Month
-
Day
Year
Date
Spouse Signature
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