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Services
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Taxmind Academy
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About Us
Contact Us
(407) 761 6235
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Personal Information
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Name
*
Social Security Number (SSN) or ITIN
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Date of birth
Filing status
Filing status
Single
Married Filing Jointly
Married Filing Separately
Head of Household
Qualifying Widow(er))
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Email Address
*
Phone Number
*
Address
*
Address Line 1
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
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Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
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State
Zip Code
Driver’s license or state ID number, issue date, and expiration date (some states require for e-filing)
Dependent Information
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Name
*
Date / Time
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SSN
Relationship to taxpayer
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Lived with you all year?
Lived with you all year?
YES
NO
Claimed by another person?
Claimed by another person?
YES
NO
Provided more than half of their own support?
Provided more than half of their own support?
YES
NO
Employment & Income Information
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Bank Name
Routing number
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Account number
Account type
Account Type
Checking
Savings
Photo ID (driver’s license or passport)
*
Social Security cards for all household members
All income forms (W-2s, 1099s, etc.)
Prior year’s tax return (optional but helpful)
Supporting receipts or records
I certify that the information provided is true and complete.
I certify that the information provided is true and complete.
I authorize [Your Business Name] to prepare my tax return.
I authorize [Your Business Name] to prepare my tax return.
Signature
Clear Signature
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Home
Services
Claim Offer
Taxmind Academy
Get Started
About Us
Contact Us
(407) 761 6235