Basic Information

Taxpayer First Name:*

Taxpayer Last Name:*

Contact Phone:*

Taxpayer Email:*

State:*

AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY

Spouse Information

Spouse’s Full Name: (if married)

Spouse’s E-mail:

Address Information

Address:

Address Line 2:

City:

Zip:

Cell Phone:

Office Phone:

Tax Information

Last year tax returned was filed with IRS?

Maritial Status as of December 31st:
SelectSingleMarriedSeparatedDivorcedWidow(er)

Filing Status:
SelectSingleHead of HouseholdMarried – Filing JointMarried – Filing Separate

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

Taxpayer Occupation:

Spouse Occupation:

Comments:

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