Fillable INTAKE FORM Filing status: Single Married ling joint

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INTAKE FORM Filing status: Single Married ling joint

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The INTAKE FORM Filing status: Single Married ling joint form is 1 page long and contains:

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  • 8 check-boxes
  • 50 other fields

Country of origin: OTHERS
File type: PDF

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304 7TH AVENUE, BROOKLYN, NY 11215 TEL 718.788.3308 FAX 718.832.4924 INFO@COLACINOTAXPARTNERS.COM
INTAKE FORM
Filing status: Single Married filing joint Married filing separate Head of household
1 2 3 4
Taxpayer Spouse (if applicable)
SS#
First name
Last name
Occupation
Date of birth
Daytime phone #
Cell phone #
Email address
If filing status is married filing joint, and taxpayer and spouse mailing addresses are different, both addresses are required.
Taxpayer address Apt#
City County State ZIP
Spouse address Apt#
City County State ZIP
Checking Savings
Bank information
Bank name
Account # Routing #
Please provide SS# for new dependents only; existing dependents indicate “# on file”
3rd stimulus payment received $
Advance child care tax credit received JUL $ AUG $ SEP $ OCT $ NOV $ DEC $
529 contribution total amount $ State issued
First name Last name DOB SS# Relationship
New client? Y N
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INTAKE FORM Filing status: Single Married ling joint

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Completed 6 April 2022

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