Exquisite Tax Service Client Form

General Information

Full Name *

SSN
Date of birth: (MM/DD/YYYY)
Address
City/State/Zip:
Phone/Email:

Spouse Name

SSN
Date of Birth: (MM/DD/YYYY)
Address
City/State/Zip
Phone/Email

Are the taxpayer and spouse legally married?

Filing Status *

Dependents Name, Date of Birth, SSN, Relationship, Months in home

Tax Documents (all tax forms, social security cards, etc.) *

Banking Account Information (routing and account #) *

TAX DECLARATION

All Returns:

Have you provided correct identification numbers (photocopies if possible)?

Do the names on the return match Social Security records, children included?

Are you legally married based on your state's legal definition of marriage?

Can someone else claim you/spouse as a dependent?

Did you/spouse receive any kind of military pay earnings?

Did you/spouse receive any kind of housing allowance or government assistance?

Did you/spouse live with anyone with a higher adjusted gross income?

Dependents and or qualifying children:

Have you verified your dependents birthday information as entered into the return?

Did you/spouse provide over 50% of total support for each dependent?

Does your EIC qualifying children meet any one of these requirements:

Under age 19 and live in the taxpayer's home for more than 1/2 of the year?

Underage 19 a foster child of a taxpayer and lived in taxpayers home full year?

Full time student aged 19 to 23?

Exquisite Tax Service will prepare your individual tax return from the information you have provided. We will NOT audit or verify the information you have provided. YOU, the taxpayer, are ultimately responsible for the preparation of the required information for your tax return.

I, the taxpayer's name above, have provided to Exquisite Tax Service the attached tax information and to the best of my knowledge is true, correct, and complete. I declared that I understand the above questions and answered them truthfully to the best of my ability.

Signature *

Clear

Date *

Spouse Signature

Clear

Spouse Signature Date

Disclaimer: It is important to use the correct filing status when filing your tax return. It can impact the tax benefits you receive and the amount of your standard deduction and the amount you may be required to pay or be refunded.