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Tax Organizer

Please complete this Questionnaire before your appointment. Prior year clients — only fill in changes in Section 1 & 2.

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Section 1: Personal Information * Required Fields

*Taxpayer Name:

*Soc. Sec. No:

*Date of Birth:

Spouse Name:

Soc. Sec. No:

Date of Birth:
*Street Address:

*City:

*Home Phone:


*State:

*Zip:

*Email:
Section 2: Dependents (Children & Others)

Dependent 1 Name:

Dependent 1 Soc. Sec. No:

Dependent 1 Date of Birth:

Dependent 1 Relationship:

Dependent 1 Months Lived With You:

Dependent 1 Full Time Student:

Dependent 1 Disabled:

Dependent 1 Gross Income:

Dependent 2 Name:

Dependent 2 Soc. Sec. No:

Dependent 2 Date of Birth:

Dependent 2 Relationship:

Dependent 2 Months Lived With You:

Dependent 2 Full Time Student:

Dependent 2 Disabled:

Dependent 2 Gross Income:
Dependent 3 Name:

Dependent 3 Soc. Sec. No:

Dependent 3 Date of Birth:

Dependent 3 Relationship:

Dependent 3 Months Lived With You:

Dependent 3 Full Time Student:

Dependent 3 Disabled:

Dependent 3 Gross Income:


Dependent 4 Name:

Dependent 4 Soc. Sec. No:

Dependent 4 Date of Birth:

Dependent 4 Relationship:

Dependent 4 Months Lived With You:

Dependent 4 Full Time Student:

Dependent 4 Disabled:

Dependent 4 Gross Income:

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