Phone Today's Date * Taxpayer Title - None - Mr. Mrs. Ms. Dr. Taxpayer First Name * Taxpayer Last Name * Taxpayer Occupation * Taxpayer Date of Birth * Taxpayer Home Phone Taxpayer Cell Phone * Taxpayer Address * Taxpayer City * Taxpayer State * Taxpayer Zip * Spouse Title - None - Mr. Mrs. Ms. Dr. Spouse First Name Spouse Last Name Spouse Occupation Spouse Date of Birth Spouse Cell Phone Dependent 1 Name Dependent 1 Relationship Dependent 1 Date of Birth Dependent 1 Time Lived With You Dependent 2 Name Dependent 2 Relationship Dependent 2 Date of Birth Dependent 2 Time Lived With You Dependent 3 Name Dependent 3 Relationship Dependent 3 Date of Birth Dependent 3 Time Lived With You Dependent 4 Name Dependent 4 Relationship Dependent 4 Date of Birth Dependent 4 Time Lived With You Dependent 5 Name Dependent 5 Relationship Dependent 5 Date of Birth Dependent 5 Time Lived With You Are any of your dependents over 18 and a full time student? - None - Yes No If Yes, Did you pay tuition? - None - Yes No How many years has the student been in college? INCOME: (check all that apply) * W2 Interest/Dividends Farm 1099 MISC Retirement or Unemployment Self Employment/1099 Business Ownerships Rental Property Sale Assets/Stock (capital gains) Gambling K-1 IRA Social Security ITEMIZED DEDUCTIONS: (check all that apply) * Real Estate Tax Personal Property Tax Dues, License, Uniform Mortgage Interest Employment Business Expense RX Medical Medical Insurance Medical Miles Cash Donations Other Donations Charity Miles Safe Deposit Box Gambling Tax Preparation Fee Home Office