Form

Taxpayer Pre-Appointment Interview Form

ALL SUBMISSIONS SUBMITTED AFTER 4/14 (5PM), WILL BE PROCESSED AFTER THE DEADLINE 4/18.
Name*

First NameLast Name
Date Of Birth*

MonthDayYear
SS#*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Filing Status*
How many dependents are you filing?*
Identity Protection Pin (if applicable)
E-mail*
License or State ID #
Occupation?
Self-Employed *
Did you or your spouse receive unemploument for the 2022 tax year? If s, we will need your 1099G*
Phone Number*

Area CodePhone Number
Did you, your spouse, or dependent(s) have healthcare through The Marketplace (Obamacare)? We will need your 1095A form to process your return. *

Business Information (if applicable)
Name of Business (if applicable)
Business EIN (if applicable)
Business Address (if applicable)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Website (if applicable)

Spouse Information (if applicable)
Spouse’s Full Name

First NameLast Name
Spouse’s SS#
Spouse's Date of Birth

MonthDayYear
Date

Upload Your Tax Documents
Copy of allIncome Information (W2, 1099, Unemployment, Etc.)

tax documents upload

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Copy of allIncome Information (W2, 1099, Unemployment, Etc.)

tax documents upload

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Copy of allIncome Information (W2, 1099, Unemployment, Etc.)

tax documents upload

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Dependent name Social Security Number & Date Of Birth
Did this dependent live in your home more than 6 months?
Did this dependent live in your home more than 6 months?
Dependent name Social Security Number & Date Of Birth
Did this dependent live in your home for more than 6 months?
Dependent name Social Security Number & Date Of Birth
Did this dependent live in your home more than 6 months?
Name of Bank
Dependent name Social Security Number & Date Of Birth
DIRECT DEPOSIT :ROUTING#*
DIRECT DEPOSIT: ACCOUNT #*
Copyof your Driver’s License or State ID*

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Copyof Social Security Card for YOU and YOUR dependents*

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Proof of Residency for dependents (birth certificates/lease/school/medical records)

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Form1098 From Mortgage (if applicable)

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Form1098 From School for Credit (if applicable)

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Which documents can you provide?

Lease including dependent's namesMedical Records for dependentsSchool Records for all dependentsBenefits Statements/Awards lettersOther
Are there any dependents on this return that are not your son or daughter?
If "YES" why are the oarents not claiming the child?
SelfEmployment Income/Expenses (if applicable)

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Sign and Submit
I (We) authorize Tax Maxx to file and process the federal/and or state income tax return. I (We) also authorize Tax Maxx to deduct all preparation fees and any other associated fees from the return for payment for services rendered. I (We), declare and affirm under penalty of perjury that all personal, itemized deduction and Schedule C statements are true, complete, and correct to the best of my (our) knowledge, information, and belief. I (We) understand that it is my (our) responsibility to provide proof to the IRS or any other governmental agency in the event of an audit. I (We) also acknowledge and understand the Tax Maxx payment policy. OUR PAYMENT POLICY: Fees are not always able to be deducted from your tax return. These issues are out of our control. If for some reason, your return is held due to student loans, child support, or any other debt or reason, your payment is still due for services rendered within 15 days. If payment isn’t received, our payment policy will stand as a legal document to represent us in small claims court. - Tax Maxx
Signature*

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Taxpayer Pre-Appointment Interview Form