Income Tax Checklist
Name (T)
DOB (T)
Social Security (T)
Name (S)
DOB(S)
Social Security (S)
Current Address
City
State
Zip Code
Contact Number
Dependents Name
Social Security
DOB
Relationship
Dependents Name
Social Security
DOB
Relationship
Dependents Name
Social Security
DOB
Relationship
Dependents Name
Social Security
DOB
Relationship
Was everyone covered all year with Insurance? (explain)
1095-A?
Please Select
Yes For Everyone.
Yes For Some People on Return (explain in notes)
No, but insurance was provided by my work for everyone.
No because we were not covered.
Estimated Tax Payments:
Dates Paid/Amounts
Income:
Types of Income (please provide us with forms as well)
W-2
1099-DIV
1099-INT
1099-R
1099-SSA (Social Security)
1099-MISC
W-2G (Gambling)
1099-G (Unemployment)
Submit
Should be Empty: