Latinos Income Tax
Pre-Registration Form
Are you a NEW or a FORMER client?
New Client
Former Client
Name (First & Last)
Date of Birth
Social Security No.
Spouse Name (First & Last)
Spouse Date of Birth
Spouse Social Security No.
Street Address
City
State
Zip Code
Country
Phone Number
Is this a Cell Phone?
Yes
No
EMail Address
Occupation
Spouse Occupation
Filing
Married
Married but separated
Head of Household
Single
Widowed
Dependents
(Please scroll down if you have NO dependents)
Dependent 1.
Name
DOB
SSN
Relationship
Dependent 2.
Name
DOB
SSN
Relationship
Dependent 3.
Name
DOB
SSN
Relationship
Dependent 4.
Name
DOB
SSN
Relationship
Dependent 5.
Name
DOB
SSN
Relationship
Dependent 6.
Name
DOB
SSN
Relationship
Dependent 7.
Name
DOB
SSN
Relationship
Dependent 8.
Name
DOB
SSN
Relationship
Would you like to get bank product (10-14 days)?
Yes
No
Did you receive a notice from the IRS bank interest?
Yes
No
Amount?
Did you receive or have other income?
Yes
No
Amount?
Please Check All Information Given
All information for tax purposes here given is true and correct agreed for my concern.
Tax Payers Name
Annotation
Fee covers only paid for services rendered today. I understand that any other related processed will have additional fees agreed to process.
Tax Payers Name
Please include any other comments or information that you think is relative to the information provided.