Tax Questionnaire

Personal Information

Filing Status*

Taxpayer Legal Name*

First Last

Spouse Legal Name

First Last

Taxpayer Occupation

Spouse Occupation

Taxpayer DOB

Spouse DOB

Taxpayer SS Number*

Spouse SS Number

Taxpayer Address

Street Address Address Line 2 City State ZIP Code

Taxpayer Phone

Spouse Phone

Taxpayer Email

Spouse Email

Taxpayer License

State

License Number

Date of issue

Expiration date

Doc # on back

Spouse License

State

License Number

Date of issue

Expiration date

Doc # on back

Dependents

Use the plus button to add as needed

Dependents

Name

DOB

SSN

ADJUSTMENTS TO INCOME

Did you or will you make a contribution to one of the following accounts before the due date?

Traditional IRA

Spouse Traditional IRA

Roth IRA checkbox

Roth IRA

Spouse Roth IRA

SEP checkbox

SEP

Spouse SEP

Untitled

None

Did you pay any interest on a student loan?

Yes

Amount

Spouse Amount

Form 1098-E

Drop files here or

Max. file size: 256 MB.

Did you pay any educator expenses?

Yes

Amount

Spouse Amount

ITEMIZED DEDUCTIONS

Medical

Medications and drugs

Doctor's & dentists

Premiums

Property taxes

Amount

Interest

Home Mortgage Interest (from form 1098)

Please attach form 1098 (mortgage interest & property tax statement)

Drop files here or

Max. file size: 256 MB.

Charity

Amount of contributions

Please attach your health insurance form if applicable (1095-A, 1095-B, or 1095-C)

Drop files here or

Max. file size: 256 MB.

CREDITS

Did you pay for Childcare?

Tuition for kindergarten and younger.
Day camp.
Before and after school care.

Childcare Center 1

Center 1

Amount Paid for Child 1

Child's Name

Amount Paid for Child 2

Child's Name

Amount Paid for Child 3

Child's Name

Amount Paid for Child 4

Child's Name

Amount Paid for Child 5

Child's Name

Amount Paid for Child 6

Child's Name

Amount Paid for Child 7

Child's Name

Amount Paid for Child 8

Child's Name

Amount Paid for Child 9

Child's Name

Amount Paid for Child 10

Child's Name

Total paid to Center 1 (for services listed above)

Add another Childcare Center

Childcare Center 2

Center 2

Amount Paid for Child 1

Child's Name

Amount Paid for Child 2

Child's Name

Amount Paid for Child 3

Child's Name

Amount Paid for Child 4

Child's Name

Amount Paid for Child 5

Child's Name

Amount Paid for Child 6

Child's Name

Amount Paid for Child 7

Child's Name

Amount Paid for Child 8

Child's Name

Amount Paid for Child 9

Child's Name

Amount Paid for Child 10

Child's Name

Total paid to Center 2 (for services listed above)

Total paid for Child

Total childcare paid for

Total Amount

Doctor's or School letter

Please Provide a Doctor's or School Letter (each child should be referenced in at least one letter)

Drop files here or

Max. file size: 256 MB.

Tuition for post high school education

Please attach form 1098-T below

Student Name

Amount Paid

School Attended

School Tax ID

Form 1098-T

Drop files here or

Max. file size: 256 MB.

BANK INFORMATION

For direct deposit of refund or direct draw of taxes due

Name of Bank

Type of Account

Routing Number

Account Number

ESTIMATED TAX PAYMENTS

Tax Authority

Date Paid

Amount Paid

Add another Tax Authority

Add another Tax Autority

Tax Authority

Date Paid

Amount Paid

Add another Tax Authority

Add another Tax Autority

Tax Authority

Date Paid

Amount Paid

Please submit your 2021 tax return and any required documentation!

Drop files here or

Max. file size: 256 MB.

Personal Information

Taxpayer License

Spouse License

Dependents

Income

SELF-EMPLOYMENT

Expenses

Home Office Deduction

Please detail expenses associated with home office

Vehicle Expenses

Actual Expenses

RENTAL INCOME

Please list your expenses by category

ADDITIONAL RENTAL PROPERTY

Please list your expenses by category

ADJUSTMENTS TO INCOME

ITEMIZED DEDUCTIONS

CREDITS

Did you pay for Childcare?

Childcare Center 1

Childcare Center 2

Total paid for Child

Doctor's or School letter

Tuition for post high school education

BANK INFORMATION

ESTIMATED TAX PAYMENTS