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APPOINTMENT
and DROP-OFF SHEET
NAME
(s)
__________________________________________
Date Dropped____________
Contact
_________________________
Day Phone Number __________________________
Evening
Phone Number _______________________
Filing
Status:
____
Single ____ Married (filing jointly)
____
Married (filing separately)
____ Head of Household ____
Qualifying widow (er) with dependent child
ALL
FAMILY MEMBERS TO CLAIM ON RETURN
First
Name
Initial Last
Name
Date Of
Birth
Social Security No.
__________________
_____
______________________
____/____/____ _____-______-_____
__________________
_____
______________________
____/____/____ _____-______-_____
__________________
_____
______________________
____/____/____ _____-______-_____
__________________
_____
______________________
____/____/____ _____-______-_____
__________________
_____
______________________
____/____/____ _____-______-_____
_____
Are there any new dependents? If
so, add above. yes
___ no___
MAJOR
CHANGES FROM LAST YEAR
_____________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
_____
Are ALL W-2’s here?
_____ Are ALL Pension Statements here?
IF
ANY INVESTMENTS (STOCKS, BONDS, ETC.) WERE SOLD, WE NEED THE COST
BASIS:
DATE PURCHASED______________
PURCHASE PRICE______________
How
to File? _______________
_______________
_______________
______________
Mail
E-File
PIN – Taxpayer
PIN – Spouse
_______________ _________________
_________________
_______ ______
Direct Deposit:
Bank Name
Account #
Checking Savings
If
they do not hear from us, they
should call US on _________________
Preparer
Comments:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
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