Individual Tax Questionnaire

ALL FIELDS MARKED WITH AN ASTERISK (*) ARE REQUIRED. If you cannot attach a document to this form, please DO NOT EMAIL IT. We will provide you access to a secure portal for any additional documents that are required.

Tax Return Information

Taxpayer Information

Home Address

Dependent Information

Other Tax Information

Other Income

Please enter below any income you received from sources not reported on a Form W-2, 1099-R, or other document that will be attached below.

Adjustments to Income

Charitable Contributions

Health Insurance


Other Tax Document Uploads

Please attach additional documents below. If you received an electronic document from the issuer, please upload it. If you received a paper document, please scan the document or take a photograph of the document with your smartphone. Make sure the entire page can be read. If the document has multiple pages, please upload it as a pdf.

Filing and Refund Information

Direct Deposit Information

Additional Comments


I (We, if filing Jointly) acknowledge that the above information provided is true and accurate to the best of my/our knowledge. I/We hereby relieve this tax preparer, its agents and affiliates, from any liability whatsoever, regarding the preparation of this/these tax returns, and agree to hold them harmless from any damages I/We may suffer and understand that my/our sole relief is limited to the return of any fee paid for the preparation of these tax documents. I/we guarantee payment of the preparation fee and any related charges.

Sign this form by typing your name below.

Taxpayer Signature