Tax Questionnaire

Name *

First

Middle

Last

Birthdate *

Profession *

Do you have a SSN/ITIN# *

Yes
No - Please help me register one.

SSN / ITIN Number

This is a secure form sent with encryption. If you prefer to supply this information over the phone call 425-212-5950.

ITIN Renewed?

Email *

Phone Number

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Spouse

Are you Legally Married? *

Spouse Name *

First

Middle

Last

Spouse Birthdate *

Does your Spouse have a SSN/ITIN# *

Yes
No - Please help me register one.

Spouse SNN / ITIN Number

This is a secure form sent with encryption. If you prefer to supply this information over the phone call 425-212-5950.

Is Your Spouse's ITIN Renewed?

Spouse Email *

Dependents

Do You Have Dependents? *

Name of your First Dependent *

(as it appears on Social Security or ITIN)

Relationship (First Dependent) *

Date of Birth (First Dependent) *

Renewed ITIN? (First Dependent) *

Yes
No
I need ITIN for this dependent

Dependent 1 SNN / ITIN Number

This is a secure form sent with encryption. If you prefer to supply this information over the phone call 425-212-5950.

Lives with You at Home (First Dependent) *

ADD ANOTHER: Do You Have a Second Dependent *

Name of your Second Dependent *

(as it appears on Social Security or ITIN)

Relationship (Second Dependent) *

Date of Birth (Second Dependent) *

Renewed ITIN? (Second Dependent) (copy) *

Yes
No
I need ITIN for this dependent

Dependent 2 SNN / ITIN Number

This is a secure form sent with encryption. If you prefer to supply this information over the phone call 425-212-5950.

Lives with You at Home (Second Dependent) *

ADD ANOTHER: Do you have a Third Dependent? *

Name of your Third Dependent *

(as it appears on Social Security or ITIN)

Relationship (Third Dependent) *

Date of Birth (Third Dependent) *

Renewed ITIN? (Third Dependent) *

Yes
No
I need ITIN for this dependent

Dependent 3 SNN / ITIN Number

This is a secure form sent with encryption. If you prefer to supply this information over the phone call 425-212-5950.

Lives with You at Home (Third Dependent) *

ADD ANOTHER: Do you have a Fourth Dependent? *

Name of your Fourth Dependent *

(as it appears on Social Security or ITIN)

Relationship (Fourth Dependent) *

Date of Birth (Fourth Dependent) *

Renewed ITIN? (Fourth Dependent) *

Yes
No
I need ITIN for this dependent

Dependent 4 SNN / ITIN Number

This is a secure form sent with encryption. If you prefer to supply this information over the phone call 425-212-5950.

Lives with You at Home (Fourth Dependent) *

ADD ANOTHER: Do you have a Fifth Dependent? *

Name of your Fifth Dependent *

(as it appears on Social Security or ITIN)

Relationship (Fifth Dependent) *

Date of Birth (Fifth Dependent) *

Renewed ITIN? (Fifth Dependent) *

Yes
No
I need ITIN for this dependent

Dependent 5 SNN / ITIN Number

This is a secure form sent with encryption. If you prefer to supply this information over the phone call 425-212-5950.

Lives with You at Home (Fifth Dependent) *

ADD ANOTHER: Do you have a Sixth Dependent? *

Name of your Sixth Dependent *

(as it appears on Social Security or ITIN)

Relationship (Sixth Dependent) *

Date of Birth (Sixth Dependent) *

Renewed ITIN? (Sixth Dependent) *

Yes
No
I need ITIN for this dependent

For security reasons, we will request your dependent's ITIN or SSN over the phone with you after you submit this form.

Dependent 6 SNN / ITIN Number

This is a secure form sent with encryption. If you prefer to supply this information over the phone call 425-212-5950.

Lives with You at Home (Sixth Dependent) *

Do You Have more Dependents to add?

Yes - we will add them to your records during our phone call. 425-212-5950

Tax Refund Options

How would you prefer your tax refund be sent to you?

Mailed by Check from the IRS to my Home Address
IRS Direct Deposit to my Bank Account

If you choose direct deposit, you can enter your bank details here or call 425-212-5950 to give us those account numbers over the phone.

Bank Name

Bank Account Number

Routing Number

Did you receive a Stimulus Check?

Total Amount Received in Stimulus $

Upload Any Additional Documents for your Taxes Here.

Click or drag files to this area to upload. You can upload up to 10 files.

Call (425) 212-5950 to find out what additional documents we may need.

Signature *

By signing this questionnaire, I declare that all information is true to the best of my knowledge and I give authorization to SERVICENTRO LATINO to use it to prepare my tax return.