Tax Form – Tax America Services

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Current Tax Year

Did you file with us last year?

Yes No

Filing Status

Nombre

Last

Teléfono

Social Security Number

Mailing Address

City

State

Zip Code

Date of Birth

Are you a U.S. Citizen or green card holder?

Yes No

Occupation

Are you filing an eligible spouse on your return?

Yes No

Are you a full-time student?

Yes No

Are you totally and permanently disabled?

Yes No

Are you legally blind?

Yes No

Is this individual dependent of other?

Yes No

Spousal Information

Spouse Name

Spouse's Social Security #

Date of Birth

Did you and if applicable (your spouse & any dependents) live in the US more than 6 months of the 2023 Tax Year?

Yes No

(if applicable) Did you provide more than half of the support for every dependent person on your tax return for the 2023 tax year (including any spouse (if applicable)

Yes No

(if applicable) Did you and your spouse live in the same home for more than 6 months of the tax year?

Yes No

Date of Birth

Are you legally blind?

Yes No

Are you totally and permanently disabled?

Yes No

Are you claiming any dependents?

Yes No

Is this individual dependent of other?

Yes No

Are you a full-time student?

Yes No

Income Related Questions

Employment Status

Employed Unemployed Self-employed

Are you contributing to 401k or other pre-tax account?

Yes No

Does your dependent(s) have tuition expenses?

Yes No

Do you have any expenses for child care?

Yes No

Are you currently renting?

Yes No

Do you own your home?

Yes No

Income

Please select all forms of income in the current tax year:

Dividend/Sale of Stocks Interest Income The form lists several other income types that remain unselected: Wages or Salary (W2 Income) Unemployment Pension/Retirement Income Rental Income Farm Income Self-Employment-Business Income (Sch.C) Alimony Received Lottery or Gambling Income W-2G Public/State Aid Income Social Security Income Tips

Please upload all relevant tax documents:

Child Support

Yes No

House Assitance

Yes No

Cash Aid

Yes No

Food Stamp

Yes No

General Expenses

Please select which other expenses pertain to you:

IRAs Property Tax Mortgage Points (closing points) Business Owner/Self Employed Tax Prep Expenses Union Dues Education Expenses Charity or Religious Contributions Mortgage Investment Medical Expenses Bought or Sold Home

Upload expense evidence here:

At any time during 2023, did you:

Receive (as a reward, award, or payment for property or services)

Yes No

Sell, exchange, or otherwise dispose of a digital asset (or a financial interest in a digital asset)

Yes No

FEDERAL LAW REQUIRES U.S. CITIZENS AND RESIDENT ALIENS TO REPORT FOREING INCOME

Do you receive any Worldwide income; Income from foreign trusts and foreign bank?

Yes No

Owns rental property outside the United States

Yes No

Do you receive any - Foreign pensions?

Yes No

Had participation in Foreign Business and other financial accounts?

Yes No

I confirm that all information I entered here is accurate and true.
I allow you to capture my sensitive data like personal ID, government ID, Social Security Number (SSN), and other information
I have read the terms and conditions and privacy policy.
By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.

Taxpayer Signature*

Date

Spouse Signature*

Date