Tax Preparation Client Form
Please Fill Out Accuratley
Filing Status
Single
Head of Household
Married Filing Separate
Married Filing Joint
Qualifying Widower
Taxpayer Information
Name
*
First Name
Middle Name
Last Name
Social Security Number
*
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
Are you totally and permanently disabled?
Yes
No
In The Past What Other Tax Services Did You File With ?
Turbo Tax
Tax Slayer
Tax Act
Other
Spouse Information
Name
First Name
Last Name
Social Security Number
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
Are they a full-time student?
Yes
No
Are they totally and permanently disabled?
Yes
No
Are they legally blind?
Yes
No
Are they your dependent?
Yes
No
Dependents
Enter your dependents here
Rows
Name
Date of Birth
Relationship
SSN
1
2
3
4
5
6
Does you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it?
Rows
Yes/No
Employer
Spouse Ins
Exchange/ Marketplace
Direct with Insurer
Medicare
Medicaid
Taxpayer
Yes
No
Spouse
Yes
No
Dependent 1
Yes
No
Dependent 2
Yes
No
Dependent 3
Yes
No
Dependent 4
Yes
No
Dependent 5
Yes
No
Tax Related Questions
Employment Status
Employed
Unemployed
Self-employed
Are you contributing to 401k or other pre-tax account?
Yes
No
Is this your first time opening a pre-tax account?
Yes
No
Please select what state return are you requesting?
State return
School
Local
RITA
Country returns
Does your dependents have tuition expenses?
Yes
No
Do you have any expenses for child care?
Yes
No
Do you have energy star rated improvements to your home?
Windows
Doors
Furnace
Other
Are you currently renting?
Yes
No
What is the monthly rental amount?
How long have you lived at the property?
# of months
1099 Form
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Proof of Self Employment
Browse Files
Drag and drop files here
Choose a file
Cancel
of
W2
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Do you have your own home?
Yes
No
Do you have documents that shows you paid for property taxes?
Yes
No
Did you sell any stock?
Yes
No
Did you take money from your 401?
Yes
No
Did you pay your vehicle tax?
Yes
No
Do you have mortgage interest?
Yes
No
Do you have real estate tax?
Yes
No
Did you receive a federal tax last year?
Yes
No
Are you a victim of identity theft?
Yes
No
Do you owe the IRS, Child Support or in default with student loans?
*
Expenses
Please fill-up the information within the current year only.
General Expenses
Rows
Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses
Income ... (Please Select all forms of income in the current tax year)
Wages or Salary (W2 Income)
Dividend/Sale of Stocks
Public/State Aid Income
Unemployment
Intrest Income
Social Security Income
Pension/Retirement Income
Self-Employment Business Income
Rental Income
Tips
Alimony Received
Farm Income
Lottery or Gambling Income W-2G
Other
Total Expenses
Acknowledgment & Signature
I confirmed that all information I entered here is accurate and true.
I allow T&P Financial to capture my sensitive data like personal ID, government id, and other information.
I have read the terms and conditions and privacy policy of T&P Financial.
Release of Liability-I agree that T&P Financial Services tax preparers shall not be held responsible for penalties,intrest,or audits resulting from imcomplete,inaccurate,or omitted information provided by me.
I acknowledge that I am authorizing filing at the time of preparation and that no additional approval,confirmation,or signature request will be required prior to submission once this agreement is signed.
By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Date Signed
*
-
Month
-
Day
Year
Date
Taxpayer Signature
*
Date Signed
-
Month
-
Day
Year
Date
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