Pre Appointment Form-
Please fill out and bring with you the day of your appointment
_____ New Client _____ Existing Client
Filing Status
(1) Single, (2) Married Filing Joint, (3) Married Filing Separate, (4) Head of Household
Taxpayer Spouse
Please Print
Social Security #:________________________ ________________________
First Name: ________________________ ________________________
Last Name: ________________________ ________________________
Occupation: ________________________ ________________________
Date of Birth: ________________________ ________________________
Phone #: ________________________ ________________________
Cell #: ________________________ ________________________
E-mail Address: ________________________ ________________________
Current Mailing Address
Street Address ____________________________________ Apt. # __________
City ___________________________ State ___________ Zip ______________
County __________________________
Bank Information:
Routing #: ______________________ Acct. #: __________________________
Bank Name: _______________________ Checking/Savings: ______________
1st Stimulus Payment Received: _____________
2nd Stimulus Payment Received: _____________
Dependent Information
First Name
Last Name
D.O.B.
SS#
Relationship
**You must bring a copy of the front and back of your state photo ID with your documents.**
If married filing joint, please include the information for each.
Taxpayer Spouse
State Issued: ___________________________ ___________________________
ID#: ___________________________ ___________________________
Exp. Date: ___________________________ ___________________________
Issue Date: ___________________________ ___________________________
Doc. #: ___________________________ ___________________________