Detail Tax Form

Please Complete Tax Form and Submit

Full Name *

first and last

Birth Date *

SSN / ITIN # *

Do you have IP pin?

Yes

Do you have Market Place Insurance?

Yes

Marketplace insurance certificate

IP Pin Number

Mobile Phone *

Marital Status *

Email Address *

Street Address *

Country

Marital status change this year? *

Yes

Upload Taxpayer Photo ID *

Dependent 1 Full Name *

Dependents/Qualifying Children

Dependent 1 SSN / ITIN

Depedent does have IP Pin

Yes

Dependent does have Marketplace Insurance?

Yes

Depedent IP Number

Relationship

Birthday

Months Lived with You

Provided over 50% support?

Claimed by anyone else?

Dependent market place insurance certificate

Dependent 2 Full Name *

Dependents/Qualifying Children

Dependent 2 SSN / ITIN

Depedent 2 does have IP Pin

Yes

Dependent 2 does have Marketplace Insurance?

Yes

Depedent 2 IP Number

Relationship 2

Birthday 2

Months Lived with You (2)

Provided over 50% support? (2)

Claimed by anyone else? (2)

Dependent market place insurance certificate (2)

Dependent 3 Full Name *

Dependents/Qualifying Children

Dependent 3 SSN / ITIN

Depedent 3 IP Number

Depedent 3 does have IP Pin

Yes

Dependent 3 does have Marketplace Insurance?

Yes

Relationship 3

Birthday 3

Months Lived with You (3)

Provided over 50% support? (3)

Claimed by anyone else? (3)

Dependent 3 market place insurance certificate

Dependent 4 Full Name *

Dependents/Qualifying Children

Dependent 4 SSN / ITIN

Depedent 4 IP Number

Depedent 4 does have IP Pin

Yes

Dependent 4 does have Marketplace Insurance?

Yes

Relationship 4

Birthday 4

Months Lived with You (4)

Provided over 50% support? (4)

Claimed by anyone else? (4)

Dependent market place insurance certificate (4)

Do you have income/expense records? *

Yes

Upload income documents *

files should be png, jpeg, or pdf

Upload business records *

files should be png, jpeg, or pdf

Are you a U.S. resident for the entire year? *

Yes

Have you provided all documents to support your EIC claim? *

Yes

Do you have qualifying children for the Child Tax Credit (CTC)? *

Yes

Did you pay more than half the cost of maintaining your home this year? *

Yes

Upload proof of household residency *

files should be png, jpeg, or pdf

List all household members who lived with you *

Did you receive a Form 1098-T (Tuition Statement)? *

Photo IDs (Taxpayer & Spouse) *

files should be png, jpeg, or pdf

SSN / ITIN Cards *

files should be png, jpeg, or pdf

Proof of Residency (Dependents) *

files should be png, jpeg, or pdf

Income Documentation *

files should be png, jpeg, or pdf

Education/Childcare Proof *

files should be png, jpeg, or pdf

Refund Delivery Method *

Prepaid Card

Refund Advance / Bank Product

Direct Deposit (Bank Account)

Paper Check (Mailed)

Bank Name *

Routing Number *

Account Number *

Account type

Apply for Bank Product / Refund Advance? *

Bank Product

Refund Advance

I confirm that all information is true and accurate. *

I agree and confirm

Who's your Tax Preparer?

Signature *

Reset Signature

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