2019 TaxInformation Form Start your 2019 tax return online by filling out the form below. Your name Social Security Number Your Address City State/Province Zip/Postal Code Country Email Address Phone Number Date of Birth ID Expiration Date Occupation Spouse's Name Spouse's Social Security Number Spouse's Email Address Spouse's Phone Number Spouse's Date of Birth Spouse's Driver's License or Government ID Number Spouse's ID Issue Date Spouse's ID Expiration Date Spouse's Occupation Marital Status Never MarriedMarriedLegally SeparatedDivorcedWidowed List all dependents (include full name, social security number, date of birth, and relationship) Ex. Jane A. King, 03/12/2003, 333-11-2222, Daughter Did your dependent(s) live in your home for more than 6 months of the year? YesNo Which documents can you provide to prove your relationship to the dependents listed? Birth Certificate(s)Social Security Card(s)Benefit Letter(s)Medical Record(s)Other Which documents can you provide to prove financial responsibility and residency for the dependents listed? Lease AgreementMedical RecordsSchool or Daycare RecordsGovernment Assistance RecordsOther If any of your dependents are NOT your son or daughter, why are the parents not claiming the child? If any of your dependent's are disabled - list their name, the nature of the disability, and whether they are permanently and totally disabled, or temporarily disabled. Did you, your spouse, or any of your dependents receive an Identity Protection PIN (IP PIN) from the IRS for this tax year? * YesNo If yes, please list each IP PIN and the name of who it belongs to. Did you pay any childcare expenses for dependents under the age of 13 or for your spouse or dependent who is not able to care for their self? This includes the total cost of daycares, babysitters, camps, sports programs, and other providers you paid in order to work or look for work. YesNo Name of Provider Provider's EIN or SSN Provider's Address Amount of expenses you paid List Additional Provider Information Here Type of Income (check all that apply) Employed W-2Household Employee W-2, HSH IncomeSelf-Employed 1099,Business Income, Rental Income,etcFixed Income (Unemployment, Social Security, Disability, Pension, etcRaditional Investment Income Interest, Dividends, Distributions, etc.Digital Investment Income (Crypto, Foreign Exchange, NFT, DeFi, etcNo income Self Employed Only - What is your total amount of business income for 2021? List the total amount of income you received in your business this year. If you own multiple businesses, please list the income for each separately. Self Employed Only - Please list your business name, business start date, business address, and EIN (if applicable) Self Employed Only - If you have a home office, list the total sqaure footage of your home and the approximate square footage of your home office space. Also, list your home expenses such as rent or mortgage payment, utilities, property taxes, and maintenance costs Did you receive any Advance Child Tax Credit payments between July 1, 2021 and December 31, 2021? YesNo Please enter the total amount of your Advance Child Tax Credit payments: Were you diagnosed with COVID-19 at any point during the period between December 31, 2020 and October 1, 2021? YesNo Were you responsible for taking care of a family member who was diagnosed with COVID-19 at any point during the period between December 31, 2020 and October 1, 2021? YesNo Was your child's school closed due to a COVID related mandatory state shut down at any point during the period between December 31, 2020 and October 1, 2021? YesNo If you responded yes to any of the above COVID-19 questions, please list the specific dates to which each applies: Did you attend a University, College, or Technical School at any point in 2021? YesNo Self Employed Only - If you have a home office, list the total sqaure footage of your home and the approximate square footage of your home office space. Also, list your home expenses such as rent or mortgage payment, utilities, property taxes, and maintenance costs. Did you buy or sell any property this year? YesNo Did you receive the Stimulus Payment? YesNo Please enter the amount of your Stimulus Payment Were you diagnosed with COVID-19 at any point during the period between April 1 and December 31, 2020? YesNo Were you responsible for taking care of a family member who was diagnosed with COVID-19 at any point during the period between April 1 and December 31, 2020? YesNo Was your child's school closed due to a COVID related mandatory state shut down at any point during the period between April 1 and December 31, 2020? YesNo If you responded yes to any of the above COVID-19 questions, please list the number of days and specific dates to which each applies Did you attend a University, College, or Technical School at any point in 2020? YesNo Health Insurance Coverage I was covered by an employer for at least 9 months during the yearI was covered by Medicaid or Medicare for at least 9 months during the yearI was covered by an ACA plan for any period of time during the yearI did not have health insurance coverage at any time during the yearOther Did you purchase or sell your home this year? * YesNo If yes - please list the details of the transaction(s) here: Homeowners Only - How much were your property taxes this year? Renters Only - Please list the address where you paid rent, your landlord's name and business address, the monthly rent amount, and the number of months rented. If you rented at more than one address during the year, list each separately. Michigan Residents Only - Do you have a DTE or other energy service provider account in your name? YesNo Do you currently owe any student loans, child support, or garnishments that may offset your refund? YesNo Would you like to apply for a refund advance? * YesNo Direct Deposit Bank Name Direct Deposit Bank Type CheckingSavings Direct Deposit Routing Number Direct Deposit Account Number Additional Info Preferred Tax Preparer Laura HowardTawana TeamerAny How did you hear about us? GoogleCraigslistInstagram/FacebookDirect Referral (Enter Name Below)Other (Enter Name Below) Please tell us who referred you: Submit Form
