Client Tax Data Sheet

Client Tax Data Sheet
Fill out the form below to submit your tax information to me. If you have any questions prior to completing this form, do not hesitate to contact me at 866-936-6618. Thank you and have a great day!
How did you hear about us or who referred you?
First Name

First NameLast Name
Middle Name

First NameLast Name
Last Name

First NameLast Name
Suffix
Jr, Sr, II, III
Social Security Number
Date of Birth

MonthDayYear
Identity Protection Pin IPPIN
The IRS assigns a 6-digit pin for identity theft. If you don't have one put N/A
Occupation
Address

Street Address
Street Address Line 2
City
State
Phone Number *

Area CodePhone Number
Zip Code
Email *
example@example.com
Driver's License # *
State Driver's License Was Issued *
Date Driver's License Was Issued *

MonthDayYear
Date
Driver's License Expiration Date *

MonthDayYear
Date
What is your filing status?
Single is only if you have NO dependents. If you have dependents you are Head of Household
Are you filing an eligible spouse on your tax return? *

Did you attend a College or university last year?
Do you currently have any owed tax obligations with the IRS (delinquent student loans, delinquent child support, tax liens etc)? *If you suspect that you have an offset call (800)304-3107 to confirm *
Do you have any children or dependents to file? *
Dependents
Should only be listed if you take care of the dependent over half of the year
1. Dependent Information
Dependent Name

First NameMiddle InitialLast NameSuffix
Date Of Birth

MonthDayYear
Social Security Number
Do you want to enter another dependent?
2. Dependent Information
Dependent Name

First NameMiddle InitialLast NameSuffix

Area Code
Provider Address
Provider Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Upload photos of your W-2,1099, and ALL documents
Attach an image of all documents that can be used to assist your tax preparer with the preparation of your tax
return.
Enter any additional information or comments that you would like the include for your tax preparer
Do you owe from previous years?
Do you have a business that you would like to be included on your return? *
Business Owners Data Sheet
Schedule C
Name of Business