Diamond's Tax Return Questionnaire

Marital Status

Taxpayer Name

First NameLast Name

Social Security Number

Spouse Social Security Number

Taxpayer Date of Birth

Date

Taxpayer Occupation

Check all that apply:

Spouse Name

First NameLast Name

Spouse Date of Birth

Date

Spouse Occupation

Check all that apply:

Taxpayer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Taxpayer Phone Number

Format: (000) 000-0000.

Spouse Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Spouse Phone Number

Format: (000) 000-0000.

Taxpayer Email Address

example@example.com

Spouse Email Address

example@example.com

DEPENDENTS INFORMATION

Rows	FULL DEPENDENT NAME	DATE OF BIRTH	# OF MONTHS DEPENDENT RESIDE WITH TAXPAYER	Social Security Number
DEPENDENT 1
DEPENDENT 2
DEPENDENT 3
DEPENDENT 4
DEPENDENT 5

Do you have a "Special Needs" child?

DID YOU RECEIVED HEALTH COVERAGE (INSURANCE) THROUGH YOUR STATE MARKETPLACE OR HEALTHCARE.GOV? IF SO, PLEASE UPLOAD YOUR FORM 1095A

Please upload 1095A

Wages and Salaries (Attach W-2's)

Interest Income (Attach 1099's) (List and identify as non-taxable Interest Income)

Unemployment Compensation Received (FORM 1099G) PLEASE UPLOAD FORM BELOW:

Id or license

File Upload

Were you, your spouse, or any dependent registered in college? Do you have a form 1098T?

File Upload

If you would like your tax refund (if any) deposited directly into your bank

Bank Name

Your Account Number

Bank Routing Number

Business Income & Expenses (Sole Proprietorship, LLC)

Owner Name

First NameLast Name

Business name

Employer ID number

Business Type

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Employer ID number (EIN)

Do you use any part of your home regularly and exclusively for business?

Estimated percentage of time spent in home office compared to total time spent in this business

Estimated of time in home office compared to total time in this business

Description of work done in home office

Description of work done outside of work office

Total area of home

Total area of home used regularly for business

Please upload any additional tax documents below:

Does anyone listed on the Tax Return have an Identity Pin? If so, please list the name and Identity Pin below:

Please provide times and dates you are available for an appointment, After submission please allow 24 hours to receive a response .

HEAD OF HOUSEHOLD FILERS MUST PRESENT ONE OF THE FOLLOWING TO FILE THIS STATUS. PLEASE SUBMIT A LEASE, MORTGAGE STATEMENT OR UTILTY BILL.THIS WILL BE SUBMIT TO BE APPROVED TO FILE HEAD OF HOUSEHOLD.ONLY. FOR NEW FILERS AND IF YOU MOVED SINCE LAST FILING YEAR.

Did you pay someone to watch your child/children?

Were you ever disallowed the E.I.T.C prior to this year?

Do you owe any delinquent:*

Other

Signature

please download and email back

I, hereby, state that all the information above is true to the best of my knowledge and that I am allowing Diamond Tax Service to prepare my taxes based on that fact. I understand that I am financially responsible for any outstanding balance due to any false information given.

If there is a balance due, you must pay the tax preparation fee upfront. If for any reason you owe an entity and they take the entire refund, you are STILL responsible to pay the tax preparation fee for services rendered.

*For any reason an amendment has to be filed with no fault of the tax preparer, an upfront fee of $150.00 is required! Please view your tax return, which is emailed to you (it is sent prior to submission). Any copy after the first copy is a fee of $10.00.

ALL FEES (bank and service fees) are found in the return and are non-refundable nor negotiable! NO EXCEPTIONS TO THIS!!

Please utilize www.irs.gov for all federal refund tracking. Please utilze your state Department of Revenue site for any State Refund tracking. Do NOT add the amounts together. Federal taxes are federal, and state taxes are state when tracking your status. Please allow 8 weeks to surpass from the date of submission before calling the IRS, if you have any tracking questions.

For any direct assistance please email BLACKDIAMONDFAMILY2021@GMAIL.COM

IRS Contact 800-829-1040

Please click this link to check your federal refund status. You will need your filing status, social security number, and the total amount of the refund before fees

https://sa.www4.irs.gov/irfof/lang/en/irfofgetstatus.jsp

Diamond's Tax Return Questionnaire

Taxpayer Information

HEALTH INSURANCE COVERAGE: