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Please complete and submit this Secure Client Census form. Only a few pieces of information are required, however the more information you can provide now, the faster we can process your request.

 







Basic Information


 

Spouse Information

Spouse’s Full Name: (if married)

Spouse’s E-mail:

 

Address Information

Address Line 2:

Office Phone:

 

Tax Information

Last year tax returned was filed with IRS?

Maritial Status as of December 31st:

Filing Status:

Can you be claimed as a dependent on someone else’s tax return?

Taxpayer Occupation:

Spouse Occupation:

Comments:

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