subject_line
Are you a new client?
*
Yes
No
Prior Year Filing Status:
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Single
Married Filing Married
Married Filing Separate
Head of Household
Widower
Full Name
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DOB
*
SSN/ITIN
*
Occupation
*
Are you assigned an Identity Protection PIN (IP PIN) ? Letter CP01A will be required
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Yes
N/A
Spouse Full Name
DOB
SSN/ITIN
Occupation
Are you assigned an Identity Protection PIN (IP PIN) ? Letter CP01A will be required
Yes
N/A
Street Address
*
Address Line 2
City
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State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
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Phone Number
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Email Address
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Dependent Full Name
DOB
SSN/ITIN
Months lived with you for 2023?
Full Time College Student?
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Yes
No
Disabled?
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Yes
No
Dependent Information #2
Dependent Full Name
DOB
SSN/ITIN
Months lived with you for 2023?
Full Time College Student?
*
Yes
No
Disabled?
*
Yes
No
Dependent Full Name
DOB
SSN/ITIN
Months lived with you for 2023?
Full Time College Student?
*
Yes
No
Disabled?
*
Yes
No
Did you pay child care?
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Yes
No
Did you receive unemployment?
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Yes
No
Are you a homeowner?
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Yes
No
Did you attend college?
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Yes
No
Do you have Rental Income?
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Yes
No
Did You pay for Health Coverage With Covered CA/ Market Place? (If yes, 1095-A/CA 3895 tax form will be required)
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Yes
No
Are You Current With Your Taxes?
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Yes
No
At any time during 2023, did you receive, sell, exchange, or otherwise dispose of any financial interest in any virtual currency?
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Yes
No
If you sell stocks, bonds, derivatives or other securities through a broker, you can expect to receive one or more copies of Form 1099-B in January. This form is used to report gains or losses from such transactions in the preceding year. Did you have any activity in 2023?
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Yes
No
*
*
Service payment options.
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Pay nothing out of pocket with Refund Transfer
We always accept cash, credit card, and debit card.
BANK ROUTING #
BANK ACCOUNT #
To the best of my knowledge the information enclosed in this client tax intake is correct and includes all income, deductions, and other information necessary for the preparation of this years income tax returns for which i have adequate records.
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clear
To the best of my knowledge the information enclosed in this client tax intake is correct and includes all income, deductions, and other information necessary for the preparation of this years income tax returns for which i have adequate records.
clear