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Prospect Client Check-In Information
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Filing Status:
*
Single
Married Filing Joint
Married Filing Separately
Qualifying Widow(er)
Head of Household
Are you claiming any Dependents this year?
*
Yes
No
Events in the year 2024 only:
Married
Divorced
Taxpayer Death
Spouse Death
Please Provide Date of Any Checked 2024 Events Above:
TAXPAYER INFORMATION
First Name
*
Last Name
*
Social Security #:
*
Date of Birth:
*
+
Street Address
*
City
*
State
*
Zip Code
*
Email Address
*
Occupation
Cell Number
*
Work Number
Best Time to Call:
Morning
Afternoon
Evening
Disabled?
*
Yes
No
Blind?
*
Yes
No
Address on Last Year's Tax Return IF DIFFERENT:
SPOUSE INFORMATION
First Name
*
Last Name
*
Social Security #:
*
Date of Birth:
*
+
Email Address
Occupation
Cell Number
Work Number
Best Time to Call:
Morning
Afternoon
Evening
Disabled?
*
Yes
No
Blind?
*
Yes
No
CHILDREN INFORMATION
Age 18 or younger
(age 19-23 if attending school full time for at least five months during the year)
who lived with you more than half the year and who did not provide more than half of their own support
(or a permanently and totally disbled child)
Is it possible that a different taxpayer might claim a child listed below?
*
Yes
No
Check here if you are divorced & either signed or received Form 8332 (release of exemption for child):
Yes (Provide Form 8332)
Child 1
FULL NAME
Date of Birth:
+
Social Security #:
Child 2
FULL NAME
Date of Birth:
+
Social Security #:
Child 3
FULL NAME
Date of Birth:
+
Social Security #:
Child 4
FULL NAME
Date of Birth:
+
Social Security #:
OTHER DEPENDENTS
Other Dependent 1
FULL NAME
Relationship
Social Security #:
Is 2024 Gross Income less than $4,300?
Yes
No
# of months resided in your home in 2024
% of support received from you:
Other Dependent 2
FULL NAME
Relationship
Social Security #:
Is 2024 Gross Income less than $4,300?
Yes
No
# of months resided in your home in 2024
% of support received from you: