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* Tax Year:
* Filing Status:

* Last Name:
* First Name:
* Phone:
Email:
Birth Date:
Taxpayer SSN:
- -
 
Spouse Last Name: Spouse First Name:
Spouse Birth Date: Spouse SSN: - -

Dependents:    
Dependent #1 Relationship:
Dependent #2 Relationship:
Dependent #3 Relationship:
Dependent #4 Relationship:
Dependent #5 Relationship:
Dependent #6 Relationship:
Dependent #7 Relationship:
Dependent #8 Relationship:

Children:    
Child #1 Birth Date:
Child #2 Birth Date:
Child #3 Birth Date:
Child #4 Birth Date:
Child #5 Birth Date:
Child #6 Birth Date:
Child #7 Birth Date:
Child #8 Birth Date:
 
Wages: Withholdings
Spouse's Wages: Spouse's Withholdings

Comments:  
 
 
Important: If you received Form 1099 or you might itemize deductions, business expenses, or you have received rental income, investments, or any sort of additional income, etc., please contact our office to better estimate your refund.
 
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