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Online Tax Questionnaire

    Primary

    Name (First, MI, Last)
    Date of Birth
    Occupation

    Spouse

    Name (First, MI, Last)
    Date of Birth
    Occupation

    Information

    Mailing Address/Street Address
    City
    State
    Zip
    Daytime Phone
    Evening Phone
    Cell Phone
    Email Address

    Please bring Social Security Cards for both you and your spouse, your Picture ID and all tax information documents to your appointment.

    Questions

    Please answer all questions.
    Did we do your taxes last year? (If no please provide a copy of last year's return.) YesNo
    Did you receive your full refund last year? YesNo
    Did you receive a letter of any type from the IRS or any state last year? YesNo
    Have you ever been denied Earned Income Tax Credit or had a child disallowed as a dependent on your tax return by the IRS (IF YES PLEASE EXPLAIN) YesNo
    Explain
    Are you claiming any dependents on your tax return? (If so you must provide a copy of their social security card and birth certificate, additional documents may be required to qualify for Earned Income Tax Credit.) YesNo
    Has your marital status or filing status changed during 2019? YesNo
    Marital status MarriedSingleDivorcedSeparatedWidower
    If you selected "Separated", provide the date of separation
    Did you receive any unemployment compensation in 2019? (if yes provide 1099-G) YesNo
    Have you put any money INTO or taken any money OUT OF any Tax deferred account during 2019? (Such as IRA's, 401K's, Pension, Annuities, 529 plan, HSA, MSA) YesNo
    Have you paid any daycare expenses in 2019 for a child under age 13 or a disabled spouse or other disabled dependent? YesNo
    Have you, your spouse or your dependents taken any college or tech school courses in 2019? (You must provide the 1098-T from the educational institution) YesNo
    Have you paid interest on any student loans in 2019? YesNo
    Have you bought, sold, or had your Home foreclosed on in 2019? YesNo
    Have you had any Cancellation of Debt in 2019? (Such as credit cards, auto loans, forgiveness of debt, repossession, etc) YesNo
    Have you made any SOLAR or GEOTHERMAL improvements to your personal residence? YesNo
    Did you make any out of state purchases (by phone, internet, mail order, etc) that the seller did not collect state sales or use tax on? (ex: Amazon, Ebay, etc) YesNo
    Did you sell stock, timber, real estate, or any other assets in 2019? (if yes please provide your 1099-SSA form) YesNo
    Did you receive Social Security benefits in 2019? (if yes please provide your 1099-SSA form) YesNo
    Did you receive any lottery winnings, jury duty pay or alimony in 2019? YesNo
    Did you have any Virtual Currency (Bitcoin, Litecoin, Ethereum, etc.) or any Foreign Bank Accounts or Trusts? YesNo
    Did you have a casualty loss due to Hurricane damage from 2015 to present? YesNo
    For the year 2019 did you have health insurance for you and your family? (Thru either Individual Policy, Employer, Government Agency (Medicaid or State) or Health Care Market Place (1095-A required).) YesNo
    Please note in the section below any other items you would like to discuss with your tax preparer:
    Date you would prefer to visit MorningAfternoonLate Afternoon
    Our fees are based on the size, complication and forms on your tax return. These fees cannot be accurately determined until the completion of the return. However, if price is a concern, please ask the preparer for a cost estimate prior to the start of your return. The estimate will be within 10% of the final fee. Once the return is started you will be responsible for the fee.

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