Client Questionnaire

Please check the appropriate box and include all necessary details and documentation.

Name*
First Last
Phone*
Email*
Enter Email Confirm Email
Personal Information
Did your marital status change during the year?*
- Yes
- No
If yes, please explain:
Did your address change from last year?*
- Yes
- No
Can you be claimed as a dependent by another taxpayer?*
- Yes
- No
Are you covered by a Group Health Coverage, or self-insured?*
- Yes
- No
Did you change any bank accounts that have been used to direct deposit (or direct debit) funds from (or to) the IRS or other taxing authority during the tax year?*
- Yes
- No
Dependent Information
Were there any changes in dependents from the prior year?*
- Yes
- No
If yes, please explain:
Do you have any children under age 19 or a full-time student under age 24 with unearned income in excess of $1,900?*
- Yes
- No
Do you have dependents who must file a tax return?*
- Yes
- No
Did you provide over half the support for any other person(s) during the year?*
- Yes
- No
Did you pay for child care while you worked or looked for work?*
- Yes
- No
Did you pay any expenses related to the adoption of a child during the year?*
- Yes
- No
If you are divorced or separated with child(ren), do you have a divorce decree or other form of separation agreement which establishes custodial responsibilities?*
- Yes
- No
Purchases, Sales and Debt Information
Did you start a new business or purchase rental property during the year?*
- Yes
- No
Did you acquire a new or additional interest in a partnership or S corporation?*
- Yes
- No
Did you sell, exchange, or purchase any real estate during the year?*
- Yes
- No
Did you purchase or sell a principal residence during the year?*
- Yes
- No
Did you foreclose or abandon a principal residence or real property during the year?*
- Yes
- No
Did you acquire or dispose of any stock during the year?*
- Yes
- No
Did you take out a home equity loan this year?*
- Yes
- No
Did you refinance a principal residence or second home this year?*
- Yes
- No
Did you sell an existing business, rental, or other property this year?*
- Yes
- No
Did you incur any non-business bad debts this year?*
- Yes
- No
Did you have any debts canceled or forgiven this year?*
- Yes
- No
Did you purchase a new hybrid, alternative motor, or electric motor energy efficient vehicle this year?*
- Yes
- No
Did you pay any student loan interest this year?*
- Yes
- No
Income Information
Did you have any foreign income or pay any foreign taxes during the year?*
- Yes
- No
Did you receive any income from property sold prior to this year?*
- Yes
- No
Did you receive any lump-sum payments from a pension, profit sharing or 401(k) plan?*
- Yes
- No
Did you make any withdrawals from or contributions to an IRA, Roth, Keogh, SIMPLE, SEP, 401k, or other qualified retirement plan?*
- Yes
- No
Did you make any withdrawals from an education savings or 529 Plan account?*
- Yes
- No
Did you receive any distributions from a Health savings account (HSA), Archer MSA, or Medicare Advantage MSA this year?*
- Yes
- No
Did you receive any Social Security benefits during the year?*
- Yes
- No
Did you receive any unemployment benefits during the year?*
- Yes
- No
Did you receive any disability income during the year?*
- Yes
- No
Did you receive tip income not reported to your employer this year?*
- Yes
- No
Did any of your life insurance policies mature, or did you surrender any policies?*
- Yes
- No
Did you cash any Series EE or I U.S. Savings bonds issued after 1989?*
- Yes
- No
Itemized Deduction Information
Did you incur a casualty or theft loss during the year?*
- Yes
- No
Did you pay out-of-pocket medical expenses (Co-pays, prescription drugs, etc.)?*
- Yes
- No
Do you have evidence to substantiate charitable contributions?*
- Yes
- No
Did you make any noncash charitable contributions (clothes, furniture, etc.)?*
- Yes
- No
Did you donate a vehicle or boat during the year? If yes, attach Form 1098-C.*
- Yes
- No
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Did you have an expense account or allowance during the year?*
- Yes
- No
Did you use your car on the job, for other than commuting?*
- Yes
- No
Did you work out of town for part of the year?*
- Yes
- No
Did you have any expenses related to seeking a new job during the year?*
- Yes
- No
Did you make any major purchases during the year (cars, boats, etc.)?*
- Yes
- No
Did you make any out-of-state purchases (by telephone, internet, mail, in person) that the seller did not collect state sales or use tax?*
- Yes
- No
Miscellaneous Information
Did you make gifts of more than $15,000 to any individual?*
- Yes
- No
Did you have any educational expenses during the year?*
- Yes
- No
Did you make any contributions to an education savings or 529 Plan account?*
- Yes
- No
Did you make any contributions to a Health savings account (HSA) or Archer MSA?*
- Yes
- No
Did you pay long-term health care premiums for yourself or your family?*
- Yes
- No
Did you pay any COBRA health care coverage continuation premiums?*
- Yes
- No
If you are a business owner, did you pay health insurance premiums for your employees this year?*
- Yes
- No
Did you utilize an area of your home for business purposes?*
- Yes
- No
Did you engage in any bartering transactions?*
- Yes
- No
Are you an active participant in a pension or retirement plan?*
- Yes
- No
Did you retire or change jobs this year?*
- Yes
- No
Did you incur moving costs because of a job change AND are in the military?*
- Yes
- No
Did you, your spouse, or your dependents attend a post-secondary school during the year, or plan to attend one in the coming year?*
- Yes
- No
Did you pay any individual as a household employee during the year?*
- Yes
- No
Did you make energy efficient improvements to your main home this year?*
- Yes
- No
Were you a grantor or transferor for a foreign trust, or do you have an interest in or a signature or other authority over a bank account, securities account, or other financial account in a foreign country?*
- Yes
- No
Did you receive correspondence from the State or the Internal Revenue Service?*
- Yes
- No
If yes, please explain:
Do you want to designate $3 to the Presidential Election Campaign Fund? If you check yes, it will not change your tax or reduce your refund.*
- Yes
- No
Anti-spam Verification

Client Questionnaire

Client Questionnaire

Personal Information

Dependent Information

Purchases, Sales and Debt Information

Income Information

Itemized Deduction Information

Miscellaneous Information