Client Data Form

CLIENT DATA '24

FORM TY23 [SM]

Agent *
N/A
Taxpayer Information
Name
N/A

Required First Middle Required Last
Phone *
N/A
Email *
N/A
Address
N/A

Required
Street Address Required City Required State/Region/Province Required
Postal / Zip Code

Required
Country

Taxpayer Identification
Social Security Number *
N/A
Date of Birth *
N/A

MM/dd/yyyy
Driver's License/ID Number *
N/A
State Issued *
N/A
Date Issued *
N/A

MM/dd/yyyy
Exp. Date *
N/A

MM/dd/yyyy

Educational Institution Information
Is the taxpayer a student? *
N/A
Full-time or Part-time
N/A
Tuition/Expenses USD
N/A
Institution Name
N/A
Institution EIN#
N/A
Institution Address
N/A

Street Address City State/Region/Province
Postal / Zip Code
1098T/1098E
N/A
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Taxpayer Income
Occupation *
N/A
W2s/1099s/Other Income *
N/A
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SSN Card *
N/A
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Color Copy DL/Valid ID *
N/A
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Personal Expenses
Do you have any Personal Expenses to Report? *
N/A
Personal Expenses
-- No Fields Available --

Student Loan Interest

Post-Secondary Tuition & Fees

Church Tithes & Offering/Charity/Donations

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Add Entry
- Student Loan Interest USD
  N/A
- Post-Secondary Tuition & Fees USD
  N/A
- Church Tithes & Offering/Charity/Donations USD
  N/A
- Accident/Fire/Natural Disaster Expenses USD
  N/A
- Investment Interest USD
  N/A
- State Income Taxes USD
  N/A
- Tax Return Preparation Fees USD
  N/A
- Gambling Loss USD
  N/A
- Legal Fees USD
  N/A
- Employment Seeking /Job Training Expenses USD
  N/A
- Work Tools USD
  N/A
- Union Purchare & Cleaning USD
  N/A
- Union Dues USD
  N/A
- Safety Shoes & Gloves USD
  N/A
- Prescription Drugs USD
  N/A
- Medical Mileage USD
  N/A
- Orthopedic Shoes/Canes/Crutches/Brces/Wheelchairs USD
  N/A
- Dental Insurance USD
  N/A
- LongTerm Care Insurance/Cost USD
  N/A
- Hospital & Emergency Bills USD
  N/A
- Lab & X-ray Expenses USD
  N/A
- Visiting Nurses/In-Home Care USD
  N/A
- Glasses & Contact Lenses USD
  N/A
- Hearing Aids & Batteries USD
  N/A
- Supporting Documents
  N/A
  Upload file Capture image using webcam
N/A

I certify that all info is correct and true. * I certify that all info is correct and true. Required

Business Income & Expenses
Do you have Business Income or Expenses to Report? *
N/A

Self-Employment or 1099 Expenses
Business Income & Expenses
-- No Fields Available --

Business Name

Business Address

Tell us about your business:

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Add Entry
- Business Name
  N/A
- Business Address
  N/A
  
  Required
  Street Address
  Address Line 2 Required City Required State/Region/Province Required
  Postal / Zip Code
  
  Required
  Country
- Tell us about your business: *
  N/A
- Total Business Income (Cash/Gross Receipts) USD
  N/A
- Advertising Expenses USD
  N/A
- Supplies USD
  N/A
- Car/Truck Repair Expenses USD
  N/A
- Business Mileage
  N/A
- Commission & Fees/Contract Labor USD
  N/A
- Office Epenses USD
  N/A
- Rent & Lease Payments USD
  N/A
- Business Meals & Entertainment USD
  N/A
- Utilities/Telephone USD
  N/A
- Taxes & Licenses USD
  N/A
- Legal & Professional Services USD
  N/A
- Repairs & Maintenance (Office Equipment) USD
  N/A
- Business Travel USD
  N/A
- Employee Benefits USD
  N/A
- Insurance expense (other than Health Insurance) USD
  N/A
- Other Business Interest / Business Loan Interest USD
  N/A
- Other Miscellaneous Expenses USD
  N/A
- Did you purchase any equipment?
  N/A
- Business Receipts/Bank Statements/Other Supporting Documents
  N/A
  Upload file
Add an entry for each business you own.
Did you purchase equipment?
N/A
Equipment Purchase (Depreciation)
Equipment Purchase Price USD
N/A
Purchase Date
N/A

MM/dd/yyyy
New or Used
N/A
Equipment Description
N/A
Mileage (If Applicable)
N/A
N/A

I certify that all info is correct and true. * I certify that all info is correct and true. Required

Mortgage Interest & Expenses, Taxes (2024)
Do you have any Mortgage Interest or Expenses to Report? *
N/A
Home Mortgage Interest USD
N/A
Points Paid at Closing USD
N/A
Closing Costs Paid USD
N/A
Real Estate Taxes USD
N/A
Personal Property Taxes USD
N/A
Supporting Documents
N/A
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Qualifying Questions
Is the taxpayer blind? *
N/A
Is the taxpayer a dependent of someone else? *
N/A
Is the taxpayer filing with an ITIN? *
N/A
Are you in the military? *
N/A

Spouse Information
Filing Status *
N/A
Spouse Name
N/A

First Middle Last
Spouse's Date of Birth
N/A

MM/dd/yyyy
Spouse's Social Security Number
N/A
Spouse's Driver's License/ID Number
N/A
State Issued - Spouse ID
N/A
Date Issued- Spouse ID
N/A

MM/dd/yyyy
Exp. Date - Spouse ID
N/A

MM/dd/yyyy
Spouse Income
Occupation
N/A
SSN Card *
N/A
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W2s/1099s/Other Income *
N/A
Upload file Capture image using webcam
Color Copy DL/Valid ID *
N/A
Upload file Capture image using webcam

Dependent Information
Do you have dependents? *
N/A
Number of Dependents age 16 and under at the end of 2024: *
N/A
Number of Dependents age 13 and under at the end of 2024: *
N/A
Number of disabled Dependents at the end of 2024: *
N/A
Are any dependents in college?
N/A
Can you provide documentation to verify dependent eligibility? *
N/A
Were any EIC credits disallowed or reduced last year?
N/A

Yes
No
County where your child's school is located.
N/A
Supporting Documents
N/A
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Dependents
-- No Fields Available --

Name:

Date of Birth:

Social Security Number:

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Add Entry
- Name:
  N/A
  
  Required First Middle Required Last
- Date of Birth: *
  N/A
  
  MM/dd/yyyy
- Social Security Number: *
  N/A
- Relationship to Taxpayer: *
  N/A
- # of months living with Taxpayer: *
  N/A
- Did this dependent earn more than $4200 income? *
  N/A
- Dependent SSN Card:
  N/A
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If you have more than one dependent, add each one.
Do you pay Daycare Expenses for either of your Dependents? *
N/A
Amount paid for Daycare Costs: USD
N/A
Dependent Care Institution Info
-- No Fields Available --

Do You Have any Care Costs for Dependent?

Amount of Care Cost:

Dependent Care Institution Name

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Add Entry
- Do You Have any Care Costs for Dependent? *
  N/A
- Amount of Care Cost: USD
  N/A
- Dependent Care Institution Name
  N/A
- Dependent Care Institution EIN#:
  N/A
- Dependent Care Institution Address:
  N/A
  
  Required
  Street Address
  Address Line 2 Required City Required State/Region/Province Required
  Postal / Zip Code
  
  Country
If you pay more than one institution for care, add each one.
Are either of your Dependents in college? *
N/A
Dependent Educational Institution
-- No Fields Available --

Name of Institution

Institution EIN#:

Institution Address

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Add Entry
- Name of Institution
  N/A
- Institution EIN#:
  N/A
- Institution Address
  N/A
  
  Street Address
  Address Line 2 City State/Region/Province
  Postal / Zip Code
  
  Country

Health Insurance Information
Do you have Health Coverage? *
N/A
Was Your Insurance Purchased via the Marketplace? *
N/A
Do you have a 1098A, B or C? *
N/A
1098A, B or C
N/A
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Filing Options
Would you like to E-File your return? *
N/A
How would you like to pay for service? *
N/A

Refund Disbursement
How would you like your refund disbursed? *
N/A
Account Type *
N/A
Bank Name *
N/A
Routing Number *
N/A

If Direct Deposit is Chosen
Account Number *
N/A

If Direct Deposit is Chosen
Voided Check *
N/A
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Credit/Debit Card Info*
Card Type* *
N/A
Name on Card*
N/A

First Last
Card Number* *
N/A
Card Exp* *
N/A
Billing Address*
Billing Street Address* *
N/A
Billing City* *
N/A
Billing State* *
N/A
Billing Zip* *
N/A

Additional Information
Additional Documents
N/A
Upload file Capture image using webcam
Please Include the following forms if you have them: 1098-T for School Tuition 1095 for ACA credits 1099-R for distributions from retirement accounts Schedule A for itemized deductions Schedule C for profit or loss from business
Additional Documents
N/A
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Were you referred by someone or a source not listed? Let us know. We would love to thank them! We will pay you $25 for each referral when they get their tax refund.
N/A

Don't miss out on additional cash! You will receive a $25 referral fee paid to you when your referral's tax refund is disbursed to them from the IRS😁💵.
Terms and Conditions *
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I accept the Terms and Conditions.
Signature *
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E-Signature Field
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CLIENT DATA '24

Taxpayer Information

Taxpayer Identification

Educational Institution Information

Taxpayer Income

Personal Expenses

Business Income & Expenses

Equipment Purchase (Depreciation)

Mortgage Interest & Expenses, Taxes (2024)

Qualifying Questions

Spouse Information

Spouse Income

Dependent Information

Health Insurance Information

Filing Options

Refund Disbursement

Credit/Debit Card Info*

Billing Address*

Additional Information

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Form Summary

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