Client Information Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 9Marital StatusSingleMarriedNew clients, how did you hear about us?Who referred you?Can someone claim YOU as an independent?YesNoDid you make CASH charitable donation(s)? totaling $300 or more during the year?YesNoDid you LIVE in more than one state in 2024?YesNoDid you receive any correspondence from the IRS or state department of taxation for 2024?YesNo you foreign Spouse Did ANYONE in you household have HEALTH INSURANCE through the marketplace?YesNoIf yes, do you have FORM 1099-G? We will need it to complete your tax return.NextTaxpayer's Full Name *FirstMiddleLastSSN *Driver's License/State ID Number *Driver's License/State ID Issue Date *Date Of Birth *ID Issuing state *Driver's License/State ID Expiration Date *OccupationDisabledYesCell Phone *May we contact you via text message?YesNoAlternate PhoneEmail *AddressAddress Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDid you live at this address all year?YesNoDid you pay property tax?YesNoNextSPOUSE'S INFORMATIONSpouse's Full Name *FirstMiddleLastSpouse's SSN *Spouse's Driver's License/State ID Number *Spouse's Driver's License/State ID Issue Date *Spouse's Date Of Birth *Spouse's ID Issuing State *Spouse's Driver's License/State ID Expiration Date *Spouse's OccupationDisabledYesSpouse's Cell Phone *May we contact your spouse via text message? YesNoSpouse's Alternate PhoneSpouse's Email *PreviousNext DEPENDENTS INFORMATION Full Name *Dependent's SSN & Date Of Birth *RelationshipNumber of Months in Home Add Remove NextDid you receive any of the following income or expenses? (Tick all that apply)Wages - W2'sUnemploymentSocial Security BenefitsSelf Employment (complete SE FORM)Pension & AnnuitiesInterestDividendsGambling WinningsSale Of Virtual CurrencySale of Real EstateSale of StocksChild Care ExpensesCollege TuitionStudent Loan InterestMedical ExpensesMortgage PaymentInterestReal Estate TaxesCharitable DonationsEnergy Efficient PurchasesRental HomePPP Loan Forgiveness (self employed only)Any foreign income/assets - List Total ValueNextADDITIONAL INFORMATION NOT LISTED IN OTHER SECTIONSNextMILITARY INFORMATION - TAXPAYERActive Duty?YesNoPlease indicate Home State of Record AddressAddress Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeMILITARY INFORMATION - SPOUSESpouse Active Duty?YesNoPlease indicate Spouse Home State of Record AddressAddress Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeNextPREVIOUS ADDRESSNumber of months you live there in 2024Move DatePrevious AddressAddress Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeNextREFUND AND PAYMENT INFORMATIONHow would you like to receive refund?Standard MailDirect depositIf you owe the IRS State or City taxes, how would you like to pay?CheckDepositBank InformationBank NameAccount NumberRouting NumberAccount TypeCheckingSavingsSubmit
