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Tax Preparer Name (Optional)
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Anyone
Myosha
Edward
Chris
Jazzie
Jazmin
How Did You Hear About Us? (Referred by Anyone)
How Much Was Your Tax Refund Last Year?
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Do you need a cash advance? (Advances are up to $7,500. Please get more details from your preparer.)
Yes
No
Did You Want An Estimate or To File Your Taxes?
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Just an Estimate
File My Taxes
I would like you to give me an estimate then file my taxes
What is your occupation?
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Did You or Any of Your Dependents Receive an Identity Theft Pin? Yes or No? If yes, please type the PIN number below and who it is assigned to.
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Taxpayer Name
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Birth Date
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Month
-
Day
Year
Date
Social Security Number
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Email
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example@example.com
Home Phone
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Area Code
Phone Number
Filing Status
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Single
Head of Household
Married Filing Separate
Married Filing Jointly
Widowed
Current Address
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Do you need any other services besides tax preparation?
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Life Insurance policy as low $20 a month, which includes products for financial planning, college planning etc.
Dental, Vision or Hearing
Health Insurance
Credit Repair Assistance
I don't need anything else
SPOUSE INFORMATION
Only fill this section out if you are filing with your spouse.
Spouse Name
Spouse Birth Date
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Month
-
Day
Year
Spouse Social Security Number
Email
example@example.com
Phone Number
Spouse Occupation
DEPENDENT INFORMATION
Only fill this section out if you are filing with dependents.
Dependent 1
First Name
Middle Name
Last Name
Dependent 1 Birth Date
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Month
-
Day
Year
Date
Dependent 1 SSN
Relationship
Months in Home
Dependent 2
First Name
Middle Name
Last Name
Dependent 2 Birth Date
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Month
-
Day
Year
Date
Dependent 2 SSN
Relationship
Months in Home
Dependent 3
First Name
Middle Name
Last Name
Dependent 3 Birth Date
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Month
-
Day
Year
Date
Dependent 3 SSN
Relationship
Months in Home
Dependent 4
First Name
Middle Name
Last Name
Dependent 4 Birth Date
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Month
-
Day
Year
Date
Dependent 4 SSN
Relationship
Months in Home
Dependent 5
First Name
Middle Name
Last Name
Dependent 5 Birth Date
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Month
-
Day
Year
Date
Dependent 5 SSN
Relationship
Months in Home
Did you have any childcare expenses? If so, please include the daycare name, amount, and address. If you had a babysitter, we will need the name, social, and address of the person.
IDENTIFICATION AND INCOME
Only fill this section out if you have a qualifying dependent and will be claiming them on your tax return
TAXPAYER: Please attach a photo of ID.
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TAXPAYER: Please attach a photo of your Social Security Card
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Spouse: Please attach a photo of ID.
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Spouse: Please attach a photo of your Social Security Card
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Dependents: Please attach a photo of the dependents social and Birth Certificate(s)
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Did you or your spouse receive a Form 1095-A for Marketplace Insurance? If so, please attach the form below
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Please attach Marketplace Form - 1095-A
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Did anyone on your tax return, including yourself, receive unemployment? If so, please attach your 1099-G. If you have any questions in regards to this email us at myosha@porterietaxsolutions.com
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Unemployment Form - 1099G
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Were you in college? If so, what is the name of the school, the address, and how much was classes, books and supplies? INCLUDE AS MUCH DETAIL AS POSSIBLE
Upload School Form 1098-T Here (If Received)
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Did you or your spouse work overtime? Attach your LAST check stub from 2025 to get credit for working overtime.
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Tax Payer Last Check Stub, W2's and/or 1099
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Spouse W2's and/or 1099
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Other Tax Related Documents(Including business expenses)
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Refund Method
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Check
Direct Deposit
Direct Deposit Info (Please include Routing and Account Number. This is ONLY if you want direct deposit)
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If Direct Deposit, Savings or Checking?
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Additional Comments, statements, questions that you think I should know?
Please include as much detail as possible. For example, if you had business expenses, list the type of expense and the amount right next to it.
Signature
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By signing this document you ensure that you are only submitting documents that pertain to your personal taxes and you give Porterie Tax Solutions the permission to give an estimate and/or file your taxes. You also agree to and have read the Consent to Use and Consent Disclosure.
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