January 21, 2016 wagnertax
New Client & Dependent Information
Please tell us who referred your or how You heard about us.

FILING STATUS

Choose your filing status for the current tax year being filed.
The Head of Household Status is for single parents or single qualified relatives raising child dependents alone. If a divorce was not final by 12/31 of the tax year being filed, you must not have lived in the same home as the separated spouse at any time during the last 6 months of the tax year.

TAXPAYER INFORMATION

(FIRST,MIDDLE INITIAL,LAST)
(current occupation. If unemployed or retired please indicate so.

SPOUSE INFORMATION

(FIRST,MIDDLE INITIAL,LAST)
(current occupation. If unemployed or retired please indicate so.

TAXPAYER'S CONTACT INFORMATION

This address will be used for government correspondence and will be listed as your tax returns mailing address.
If no home please list primary cell phone number

E-FILE TAX REFUND | DIRECT DEPOSIT BANKING INFORMATION.

Direct Deposit of your tax refund is the safest and most secure way of receiving your refund. If you end up with a refund and would like the funds automatically deposited into your account please provide your banks routing information here. All direct deposits are initialized and handled by the US Treasury.
This is your Banks 9 digit routing number. This number can be found at the bottom of one of your checks and is exactly 9 digits. DO NOT use any number off of a deposit slip as deposit slip routing numbers are not the same. If you are unsure what your ABA or Routing number is call your bank and ask.
Please list your bank account number. Any US checking, Savings, or Financial account that can receive a direct deposit can be used.

Child & Dependent Information #1

Full Name as it appears on Social Security Card.
The date of birth must match what is on file under the dependents social security card.
If the child / dependent uses a suffix such as Jr. or Sr. and it is used on thier social security card please list here.
(Son, daughter, parent, grandchild, brother, sister, other, niece, nephew, father, mother ect.)
Please type only the number of months the dependent lived with you during the year. College students under 25 going to school away from home qualify as if they were living with you all 12 months for tax dependent purposes.

Child & Dependent Information #2

Full Name as it appears on Social Security Card.
The date of birth must match what is on file under the dependents social security card.
If the child / dependent uses a suffix such as Jr. or Sr. and it is used on thier social security card please list here.
(Son, daughter, parent, grandchild, brother, sister, other, niece, nephew, father, mother ect.)
Please type only the number of months the dependent lived with you during the year. College students under 25 going to school away from home qualify as if they were living with you all 12 months for tax dependent purposes.

Child & Dependent Information #3

Full Name as it appears on Social Security Card.
The date of birth must match what is on file under the dependents social security card.
If the child / dependent uses a suffix such as Jr. or Sr. and it is used on thier social security card please list here.
(Son, daughter, parent, grandchild, brother, sister, other, niece, nephew, father, mother ect.)
Please type only the number of months the dependent lived with you during the year. College students under 25 going to school away from home qualify as if they were living with you all 12 months for tax dependent purposes.

Child & Dependent Information #4

Full Name as it appears on Social Security Card.
The date of birth must match what is on file under the dependents social security card.
If the child / dependent uses a suffix such as Jr. or Sr. and it is used on thier social security card please list here.
(Son, daughter, parent, grandchild, brother, sister, other, niece, nephew, father, mother ect.)
Please type only the number of months the dependent lived with you during the year. College students under 25 going to school away from home qualify as if they were living with you all 12 months for tax dependent purposes.

Child & Dependent Information #5

Full Name as it appears on Social Security Card.
The date of birth must match what is on file under the dependents social security card.
If the child / dependent uses a suffix such as Jr. or Sr. and it is used on thier social security card please list here.
(Son, daughter, parent, grandchild, brother, sister, other, niece, nephew, father, mother ect.)
Please type only the number of months the dependent lived with you during the year. College students under 25 going to school away from home qualify as if they were living with you all 12 months for tax dependent purposes.

Child & Dependent Information #6

Full Name as it appears on Social Security Card.
The date of birth must match what is on file under the dependents social security card.
If the child / dependent uses a suffix such as Jr. or Sr. and it is used on thier social security card please list here.
(Son, daughter, parent, grandchild, brother, sister, other, niece, nephew, father, mother ect.)
Please type only the number of months the dependent lived with you during the year. College students under 25 going to school away from home qualify as if they were living with you all 12 months for tax dependent purposes.
Drop a file here or click to upload Choose File
Maximum upload size: 104.86MB
Please Attach a copy of your previous years tax return for review. All new clients must submit a copy of thier prior year taxes before thier appointment. You may do so here or you can drop off a hard copy at our offices anytime please use the front Door Mail Slot if dropping off during non-business hours. If you choose to drop of a physical copy, please make sure to put it in a sealed envelope with your name and phone number or email address on the envelope.
Sending