EmailMeForm
2017 Tax Estimate
Split tax preparation time in half by filling this form prior to your visit. Please be advised you will still need to approve our estimate. Make sure to add all tax related forms and answer all questions.
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Please name the person who is filling out this form.
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William Perez
Yaleisy Valenciano
Lemay Matos
I am filling out the form myself.
Full Name
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First
MI
Last
Social Security Number
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Date of Birth
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MM
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DD
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YYYY
Occupation
Email
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Home/Cell Phone Number
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Please select the type of Identification you will use to be able to submit your Tax Return.
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State I.D.
Driver's License
U.S. Passport
Foreign Passport
Resident Alien Card
Matricula Consular
For the type of Identification you selected above please fill out the corresponding information.
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ID #
State or Country
Date of Issuance
Date of Expiration
Home Address
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Street Address
City
State / Province / Region
Postal / Zip Code
Complete question ONLY if you are legally married.
Spouse's Full Name
First
Last
Spouse's Social Security Number
Spouse's Date of Birth
MM
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DD
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YYYY
Spouse's Home/Cell Phone Number
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Spouse's Occupation
PLEASE ENTER YOUR DEPENDENTS HERE...
You Spouse is not a dependent. Dependents are only children up to the age of 24 and only if you are full time students. You must have power of attorney in order to declare a person as a dependent.
Dep #1 Full Name
First
MI
Last
Social Security Number
Date of Birth
MM
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DD
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YYYY
Relatioship
Example, Son, Daughter, Mother etc
Dep #2 Full Name
First
MI
Last
Social Security Number
Date of Birth
MM
/
DD
/
YYYY
Relatioship
Example, Son, Daughter, Mother etc
Dep #3 Full Name
First
MI
Last
Date of Birth
MM
/
DD
/
YYYY
Social Security Number
Relatioship
Example, Son, Daughter, Mother etc
Please add any additional dependents here.
PLEASE READ CAREFULLY.
* If you have a qualifying dependent(s) who lived with you then please select Head Of Household, Unless you are Married*
Filing Status
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Single
Married Filing Joint Return (Even if only one had income)
Married Filing Separate Return
Head Of HouseHold
Qualifying Widow(er) with dependent child
Did everyone in your tax household have qualified health insurance coverage for all 12 months of 2017?
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Yes
No
DO NOT MARK YES IF ANYONE HAD INSURANCE COVERAGE FOR LESS THAN THE 12 MONTHS.
Did you purchase health insurance through a goverment sponsored Marketplace such as ObamaCare in 2017?
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Yes
No
IF YOU HAD INSURANCE COVERAGE THROUGH THE MARKET PLACE YOU MUST BRING FORM 1095-A. IF YOU FAILED TO DO SO YOUR TAX RETURNS WILL BE DELAYED.
Did anyone in your tax household have any other Goverment Health Insurance (Such as Medicaid or Medicare)?
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Yes
No
Do you or your spouse have any IRS debt, or currently have a payment plan?
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Yes
No
Are you or your spouse delinquent with Child Support, Student Loans or any other Goverment related debt?
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Yes
No
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