TTC Individual: Client Data Application

Are you a:*
How did you hear about us?*
Who is your tax preparation specialist?*
Who referred you?*
Which do you prefer on finalizing your tax return?*
What years are you needing to file?

Year 2021Year 2022Year 2023Year 2024Year 2025Or other prior years
SSN/ITIN*
XXX-XX-XXXX
Date of Birth*

MonthDayYear
MM-DD-YYYY
Name*

First NameMiddle NameLast Name
Occupation | Title*
Are you a dependent listed on your parent or any other return?*

YesNo
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*
Are you listing any dependents on your tax returns?:*
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
How much was your refund or balance 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?*
Which do you prefer on finalizing your tax return?*
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!
Did you make an energy efficient purchases?*
Is your credit score currently below 720, and are you ready to take intentional steps to strengthen it so it works for you instead of against you?*
Do you know what’s impacting your credit score, or would you like help creating a plan to improve it?*
If the IRS reviewed your business today, would you feel confident — or would you want to put proper structure in place so you can move forward with peace of mind?*
As a business owner, are your expenses aligned with your business entity — or are you ready to clean things up so your finances are clear, compliant, and working in your favor?*
Did you buy a hybrid or electric vehicle?*
Did you go to school?*
Are you a business owner, self employed, have a side hustle, have any 1099s, or do you have any odd jobs*
What type of Medical Coverage do you have?*
Do you owe the IRS?*
If you are unsure if you owe the IRS, call (800) 304-3107.
Do you have any federal debt? *
If unsure call Treasury Off set line 1-800-304-3107.
How much do you owe?*
If you are unsure please call (800) 304-3107.
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 2025, did you live/work in more than one state?
In 2025, 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):*

Cancelof
Income Forms:*

Please use field if you have multiple income forms (Ex. Unemployment, 1099s, w2, etc.)
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Income Forms:

Please use field if you have multiple income forms (Ex. Unemployment, 1099s, w2, etc.)
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Income Forms:

Please use field if you have multiple income forms (Ex. Unemployment, 1099s, w2, etc.)
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Upload Last tax year documents here:

Ignore if you don't have these documents.
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Lease Agreement:

If filing head of household, please upload a document that reflects the address on your tax return.
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Utility bill, bank statement, property tax statement, etc. :

If filing head of household, please upload a document that reflects the address on your tax return.
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Proof of Dependent(s):

If carrying dependents, please upload a document such as SSN cards, report cards, medical records, daycare statement, birth certificates.
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Additional Documents:

Please use field if you have any additional information you’d like to provide.** (IRS letters, forms you’re unsure of, etc.)
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Additional Documents:

Please use field if you have any additional information you’d like to provide.** (IRS letters, forms you’re unsure of, etc.)
Cancelof
Additional Documents:

Please use field if you have any additional information you’d like to provide.** (IRS letters, forms you’re unsure of, etc.)
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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*

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Date Signed*

MonthDayYear
Date
Spouse: Signature *

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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
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