TTC Individual: Client Data Application

Are you a:*
How did you hear about us?*
Who is your tax preparation specialist?*
What years are you needing to file?

Year 2021Year 2022Year 2023Year 2024
Promo Code:
SSN/ITIN*
XXX-XX-XXXX
Date of Birth*

MonthDayYear
MM-DD-YYYY
Name*

First NameMiddle NameLast Name
Occupation | Title*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Identity Theft Pin? (If applicable/not required)
Filing Status*
“To be eligible for the Head of Household credit, please be sure to provide either a lease agreement or a recent utility bill (electric, gas, or water bill). We require the social security card for each taxpayer, and/or birth certificate”
SSN/ITIN*
XXX-XX-XXXX
Name*

PrefixFirst NameLast Name
Date of Birth*

MonthDayYear
MM-DD-YYYY
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Occupation | Title*
SSN/ITIN*
XXX-XX-XXXX
Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
MM-DD-YYYY
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Occupation | Title*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
How would you like your refund?*
Bank Name*
Type of Account*
Routing Number*
Account Number*
Do you have dependents? If so, tell us how many you're able to claim:*
Did you have a baby in 2024 or are you adding any children you DID NOT receive advance Child Tax Credits for?*
Name*

First NameMiddle NameLast Name
SSN/ITIN*
XXX-XX-XXXX
Date of Birth*

MonthDayYear
MM-DD-YYYY
Relationship*
Months dependent lives with you?*
Months
Is the dependent permanently disabled?*
Yes or No
Is this dependent a student? *
Yes or No
Name*

First NameMiddle NameLast Name
SSN/ITIN*
XXX-XX-XXXX
Date of Birth*

MonthDayYear
MM-DD-YYYY
Relationship*
Months dependent lives with you?*
Months
Is the dependent permanently disabled?*
Yes or No
Is this dependent a student? *
Yes or No
Name*

First NameMiddle NameLast Name
SSN/ITIN*
XXX-XX-XXXX
Date of Birth*

MonthDayYear
MM-DD-YYYY
Relationship*
Months dependent lives with you?*
Months
Is the dependent permanently disabled?*
Yes or No
Is this dependent a student? *
Yes or No
Name*

First NameMiddle NameLast Name
SSN/ITIN*
XXX-XX-XXXX
Date of Birth*

MonthDayYear
MM-DD-YYYY
Relationship*
Months dependent lives with you?*
Months
Is the dependent permanently disabled?*
Yes or No
Is this dependent a student? *
Yes or No
Name*

First NameMiddle NameLast Name
SSN/ITIN*
XXX-XX-XXXX
Date of Birth*

MonthDayYear
MM-DD-YYYY
Relationship*
Months dependent lives with you?*
Months
Is the dependent permanently disabled?*
Yes or No
Is this dependent a student? *
Yes or No
Name*

First NameMiddle NameLast Name
SSN/ITIN*
XXX-XX-XXXX
Date of Birth*

MonthDayYear
MM-DD-YYYY
Relationship*
Months dependent lives with you?*
Months
Is the dependent permanently disabled?*
Yes or No
Is this dependent a student? *
Yes or No
What was your refund amount last year?*
Do you agree to electronically file?*
Would you like to apply for a Cash Advance? *
Check all applicable income types: (Note: Upload marked income forms on the upload section below with your signature)*

W2 (employee)1099-MISC (contractor)1099-G (unemployment)SSI/SSA (social security)Shared Driver (Uber/Lfyt)Self-Employed1009-R (retirement/401k)W-2G (gambling)1099-DIV (dividend income)Other
If you are having any issues uploading your documentation and /or need further assistance, please email file@gotaxtime.com. A member of our team will be with you within 2 business hours. Thank you!
Who is your tax preparation specialist?*
Taxpayers SSN/ITIN*
Spouse SSN/ITIN (not required if not applicable)
Name*

First NameMiddle NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Has your filing status changed?*
If Yes select your filing status. If No select "NO"
SSN/ITIN*
XXX-XX-XXXX
Name*

PrefixFirst NameLast Name
Date of Birth*

MonthDayYear
MM-DD-YYYY
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Occupation | Title*
SSN/ITIN*
XXX-XX-XXXX
Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
MM-DD-YYYY
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Occupation | Title*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you have an identity theft pin?*
If Yes input your Identity Theft Pin. If No input "NO"
Has your dependents changed? If so, tell us how many you're able to claim:*
If Yes input how many "NEW" Dependents you're able to claim. If No Select "No".
Name*

First NameMiddle NameLast Name
SSN/ITIN*
XXX-XX-XXXX
Date of Birth*

MonthDayYear
MM-DD-YYYY
Relationship*
Months dependent lives with you?*
Months
Is the dependent permanently disabled?*
Yes or No
Is this dependent a student? *
Yes or No
Name*

First NameMiddle NameLast Name
SSN/ITIN*
XXX-XX-XXXX
Date of Birth*

MonthDayYear
MM-DD-YYYY
Relationship*
Months dependent lives with you?*
Months
Is the dependent permanently disabled?*
Yes or No
Is this dependent a student? *
Yes or No
Name*

First NameMiddle NameLast Name
SSN/ITIN*
XXX-XX-XXXX
Date of Birth*

MonthDayYear
MM-DD-YYYY
Relationship*
Months dependent lives with you?*
Months
Is the dependent permanently disabled?*
Yes or No
Is this dependent a student? *
Yes or No
Name*

First NameMiddle NameLast Name
SSN/ITIN*
XXX-XX-XXXX
Date of Birth*

MonthDayYear
MM-DD-YYYY
Relationship*
Months dependent lives with you?*
Months
Is the dependent permanently disabled?*
Yes or No
Is this dependent a student? *
Yes or No
Name*

First NameMiddle NameLast Name
SSN/ITIN*
XXX-XX-XXXX
Date of Birth*

MonthDayYear
MM-DD-YYYY
Relationship*
Months dependent lives with you?*
Months
Is the dependent permanently disabled?*
Yes or No
Is this dependent a student? *
Yes or No
Name*

First NameMiddle NameLast Name
SSN/ITIN*
XXX-XX-XXXX
Date of Birth*

MonthDayYear
MM-DD-YYYY
Relationship*
Months dependent lives with you?*
Months
Is the dependent permanently disabled?*
Yes or No
Is this dependent a student? *
Yes or No
Check all applicable income types: (Note: Upload marked income forms on the upload section below with your signature)*

W2 (employee)1099-MISC (contractor)1099-G (unemployment)SSI/SSA (social security)Shared Driver (Uber/Lfyt)Self-Employed1009-R (retirement/401k)W-2G (gambling)1099-DIV (dividend income)Other
How would you like your refund?*
Would you like to apply for a Cash Advance of up to $7,000.00?? *
Bank Name*
Type of Account*
Routing Number*
Account Number*
If you are having any issues uploading your documentation and /or need further assistance, please email file@gotaxtime.com. A member of our team will be with you within 2 business hours. Thank you!
Are you completely self-employed?*
Did you have health insurance through the marketplace?*
Do you owe the IRS?*
If you are unsure if you owe the irs, call xxx.xxx.xxxx.
How much do you owe?*
Do you have delinquent student loans?*
Do you authorize consent for Tax Time & Co. to verify you have no federal debt obligations?*
Do you owe back child support?*
Do you own a home? *
Do you plan to purchase a home within the next two years?*
In 2024, did you live/work in more than one state?
In 2024, did you, your spouse or dependent attend a college, trade school or university this past year?
Please express any questions, concerns or special details about your tax filing you'd like to discuss here:
NOTICE: It is important you attach all applicable income statements (e.g. W-2, unemployment, retirement statement, etc.) Failure to provide such documents could result in the delay of your refund and/or IRS audit. If you have read and understood this notice please sign and date below.

If you have an issue uploading your documents and/or need to send us additional docs please send an email to the following: file@gotaxtime.com

Attachment Checklist: Please attach the following (if applicable):

[ ] Identification (GOV ID: e.g. passport, DL & ID)
[ ] Income Forms
[ ] Proof of Dependent(s) (e.g. lease agreement, medical card, report card, anything with the dependent’s name illustrated)
[ ] Proof of Head of Household (e.g. are lease agreement, utility bill, bank statement, property tax statement, etc.)
Identification (GOV ID: e.g. passport, DL & ID):*

Email Additional Docs: file@gotaxtime.com
Cancelof
Lease Agreement:

Email Additional Docs: file@gotaxtime.com
Cancelof
Utility bill, bank statement, property tax statement, etc. :

Email Additional Docs: file@gotaxtime.com
Cancelof
Proof of Dependent(s):

Email Additional Docs: file@gotaxtime.com
Cancelof
Income Forms:*

Email Additional Docs: file@gotaxtime.com
Cancelof
Income Forms:

Email Additional Docs: file@gotaxtime.com
Cancelof
Income Forms:

Email Additional Docs: file@gotaxtime.com
Cancelof
Additional Documents:

Email Additional Docs: file@gotaxtime.com
Cancelof
Additional Documents:

Email Additional Docs: file@gotaxtime.com
Cancelof
Additional Documents:

Email Additional Docs: file@gotaxtime.com
Cancelof
Please see the attached file for a description of each add-on before selecting what add-on you want.
- Premier Path to Tax Confidence
- Entrepreneur's Edge
Select an Add-On

Premier Path to Tax Confidence For Only $49.00Entrepreneur's Edge For Only $97.00
PLEASE READ THE DISCLOSURE BELOW BEFORE SIGNING ANY DOCUMENT

By signing this form below, I certify that all information is true, complete and accurate. I understand that false information may be grounds for the federal government to seek criminal charges against me. I also release Tax Time & Co. from any liability related to the information provided. My signature authorizes Tax Time & Co. to prepare and electronically file Income Tax Return(s) including the current year and/or any prior tax year requested.
Signature*

Powered by Jotform SignClear
Date Signed*

MonthDayYear
Date
Spouse: Signature *

Powered by Jotform SignClear
Date Signed*

MonthDayYear
Date
If you have an issue uploading your documents and/or need to send us additional docs please send an email to the following: file@gotaxtime.com
By checking this box, I agree to receive text messages from Tax Time &Co. Message frequency varies. Message & data rates may apply. Phone numbers collected for SMS purposes will not be shared with third parties or affiliates for marketing purposes under any circumstances. Text HELP to 682-367-4296 for assistance. You can reply STOP to unsubscribe at any time.
Should be Empty: