2024 Tax Questionnaire Your 2024 Tax Info Newsletter CLIENT INFORMATIONFirst NameMiddle InitialLast NameAddressAddressUnit NumberCityStateZip CodeTax ID (SSN)Date of BirthEmailPhoneOccupationMarital Status Single MarriedSPOUSE INFORMATIONSpouse First NameSpouse M.I.Spouse Last NameSpouse Tax ID (SSN)Spouse Date of BirthSpouse EmailSpouse PhoneSpouse OccupationPreviousNextDEPENDENT INFORMATIONDependent #1Full NameRelationship– Select –SonDaughterFoster ChildGrandchildStepchildGrandparentParentBrotherSisterAuntUncleNephewNieceNoneOtherSSNDate of BirthMonths In HomeMore Dependents? Yes NoDependent #2Full NameRelationship– Select –SonDaughterFoster ChildGrandchildStepchildGrandparentParentBrotherSisterAuntUncleNephewNieceNoneOtherSSNDate of BirthMonths In HomeMore Dependents? Yes NoDependent #3Full NameRelationship– Select –SonDaughterFoster ChildGrandchildStepchildGrandparentParentBrotherSisterAuntUncleNephewNieceNoneOtherSSNDate of BirthMonths In HomeMore Dependents? Yes NoPreviousNext2024 TAX INFORMATIONINCOMEPlease identify all income sources you received during 2024 Wages Interest Dividend Retirement Distribution Social Security Unemployment Disability Stock, Bonds or Other Investment Property Debt Cancellation Rental Real Estate Business (Sole Proprietorship) Income FarmOther income sources not listedDEDUCTIONPlease identify any payments you made during 2024 College Tuition & Fees Student Loan Interest Self-Employed Health Insurance Contribution to an IRA (Traditional or Roth) Major Medical / Vision / Dental / Prescription Drug Costs Mortgage Interest H.E.L.O.C. Interest Mortgage Refinance Real Estate Tax Personal Property Tax Sales Tax on Major Purchases Cash Charitable Contributions Non-Cash Charitable Contributions Child & Dependent Care Costs Energy Efficiency ImprovementsOther possible deductions not listedPreviousNextESTIMATED TAX PAYMENTSFEDERALFirst QuarterAmount PaidSecond QuarterAmount PaidThird QuarterAmount PaidFourth QuarterAmount PaidSTATE– Select State –AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificFirst QuarterAmount PaidSecond QuarterAmount PaidThird QuarterAmount PaidFourth QuarterAmount PaidAdditional State Click here to add another state– Select State –AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificFirst QuarterAmount PaidSecond QuarterAmount PaidThird QuarterAmount PaidFourth QuarterAmount Paid Previous Submit Form