Taxpayer Data Sheet

Name:

Tax Year:

Occupation:

Filing Status	Yes/No
Single
Married Filing Jointly
Married Filing Separately
Head of Household
Widower
Citizenship
If not US, Canada, Mexico, - Resident Alien
Number of Dependents

Address:

State:

City:

SSN:

Date of Birth:

Driver License #:

Issued Date:

Expired Date:

Email:

Client’s Signature:

Date:

Preparer/Office Personnel:

Upload Document:

Did you uploaded the document (Yes/No):

NoYes

Taxpayer attest that the information provided are TRUE and are to be use for the sole purpose of filing his/her Income Tax Return. Tax Preparer is required keep a copy of documents provided for up to three years and to safeguard taxpayer information in a secure location. The information is to be use for sole purpose of filing tax return.

Documents Present	Yes/No - How Many
W-2
Form 1099-NEC/Form 1099-Misc/1099-K
Business Information

STIMULUS

Have you received stimulus money?

NoYes

How Much?

Not Received$1,200$600

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