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330-733-1040
TAXPAYER INFORMATION FORM
Did you file your taxes with us last year?
Yes
No
Select Form Type
Short Form
Long Form
Business
Rental(s)
Stocks
General Questions
Name
DOB
Email
Driver License
Issue Date
Expire Date
Do you have a spouse?
Yes
No
Spouse Name
DOB
Email
Driver License
Issue Date
Expire Date
Current Address
City
State
Zip
Contact Phone
What “City” if any, should we file for your local tax return.
Filing Status
MARRIED/Do it the best way!
MARRIED/JOINT
MARRIED/SEPARATE
HEAD OF HOUSEHOLD
SINGLE
PARENTS CLAIM ME (student)
Dependents
Do you have Dependents?
Yes
No
ALL CLIENTS
FIRST NAME
LAST NAME
Birth Date
Age On 12/31 last yr
Mths in home
SS##
Tax Form Questions
Did you receive a 1095 A form for your Affordable Care Act insurance?
Yes
No
Please Include Form if you received it
Did you receive any Advanced Health Care payments from the government?
Yes
No
Please Include Form if you received it
Were you notified by the IRS that you are required to complete a “Certification” for the Earned Income Credit? (EIC)
Yes
No
Please Include Form if you received it
Could any other person claim your children this tax year?
Yes
No
Please Include Form if you received it
Day Care? Form Enclosed? Whom to? Address? SS#? Amount
Yes
No
Please Include Form if you received it
Education Credit/Tuition Form Enclosed?
Yes
No
What year of school?
- Select -
1
2
3
4
5+
Please Include Form if you received it
Do you have a long form?
Yes
No
Long Form Only Questions
Mortgage Interest
Yes
No
Real estate taxes
Yes
No
Charity Donations
Yes
No
Other Notes
1,889
Personal Security Code
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