Taxpayer Information

What is your first name? *

What is your last name? *

What is the best phone number to reach you? *

What is the best email address to contact you? *

How did you hear about us?

Were you referred by anyone?

Taxpayer Date of Birth

Social Security Number

State and Driver's License / ID #

ID / Driver's License Issue Date

ID / Driver's License Expiration Date

Document Number (NY License Only)

What is your job title?

Who is your employer?

Spouse Date of Birth

Spouse Social Security Number

Spouse State & Driver's License / ID #

Spouse ID / Driver's License Issue Date

Spouse ID / Driver's License Expiration Date

Spouse Document Number (NY Only)

Dependent #1 (if any)

Dependent #1: Full Name

Dependent #1 Date of Birth

Dependent #1 Social Security Number

Dependent #1 Relationship To You

Dependent #2 (if any)

Dependent #2 Full Name

Dependent #2 Date of Birth

Dependent #2 Social Security Number

Dependent #2 Relationship To You

Dependent #3 (if any)

Dependent #3 Full Name

Dependent #3 Date of Birth

Dependent #3 Social Security Number

Dependent #3 Relationship To You

Dependent Information

Any Additional Dependents?

Did all of your dependents live with you for at least 6 months?

Yes

Did you file these same dependents last year?

Yes

Will any of your dependents be filed with someone else?

Yes

Did your dependents have health insurance through either your employer, state, or obamacare?

Yes

Was any of your children enrolled in daycare?

Yes

Did you live at the address given for 6 months or more this year?

Yes

Did you file your taxes last year?

Yes

If yes, did you receive a refund?

Yes

How did you file your taxes last year?

W-2

1099

Small Business

Corporation

Can you get a copy of your prior year's tax return if needed?

Yes

Do you need to file IRS form 8862 (e.g. Disallowance of credits)?

Yes

Did you have health insurance during the tax year?

Yes

How many jobs did you work during the tax year?

3 or more

Did you receive any unemployment income?

Yes

Did you attend college, night school, internet schooling, or any post-secondary educational facility to gain a skill or degree?

Yes

Do you have a 1098-T from your school?

Yes

Are you currently paying or owe any student loans?

Yes

Do you own your home?

Yes

Do you owe for home buyers credit?

Yes

Do you lease out any of the property you own?

Yes

Did you pay any church tithes or other large charitable contributions?

Yes

Do you owe back-payments for child support?

Yes

Do you owe the IRS?

Yes

How would you like your Federal and State Tax Refund Check issued?

Check by Mail

Direct Deposit

Are you interested in using your refund to pay for your tax prep services? Fees apply.

Yes

Terms and Conditions

BY CLICKING THE CHECKBOX BELOW, YOU HEREBY AGREE THAT THE FOREGOING INFORMATION IS TRUE AND ACCURATE TO THE BEST OF YOUR KNOWLEDGE AND RECOLLECTION. YOU ALSO AGREE THAT YOU HOLD NO BEARINGS UPON PREPARERS OR COMPANY STAFF. YOU ALSO AGREE TO THE TERMS AND CONDITIONS OF SERVICES SET FORTH BY ECHO TAX, LLC.

Terms and Conditions *

I agree to the terms and conditions set forth by my tax professional for the provided tax preparation services.

BY CLICKING THE CHECKBOX BELOW AND FILLING OUT MY FULL NAME AND DATE BELOW, I AM PROVIDING MY WRITTEN CONSENT AND SIGNATURE AUTHORIZATION THAT I HEREBY AGREE THAT MY ELECTRONIC SIGNATURE HOLDS VALID IN THE COURT OF LAW AND AGREE TO ALL THE TERMS AND CONDITIONS SET FORTH BY ECHO TAX, LLC.

Electronic Signature Authorization *

I consent that my written name and electronic signature is truly signed by me, the signatory, and that my signature holds legal and valid for any applicable courts.