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Registration
Contact
Meet Us
Free Consultation
Client Registration Form
Personal Information
First Name
*
Last Name
*
Address Line 1
*
Address Line 2
City
*
State
*
Select state
ZIP Code
*
Contact Information
Email
*
Phone Number
*
Employment & Personal Details
Job Title
*
Date of Birth
*
Pick a date
Filing Status
Filing Status
*
Single
Head of Household
Married Filing Joint
Married Filing Separately
Widowed
Dependents Information
Will you be claiming children or dependents?
*
Yes
No
Additional Information
Do you pay for child care?
*
Yes
No
Do you own a home or pay a mortgage (Form 1098)?
*
Yes
No
Did you attend College this year? (Form 1098T)
*
Yes
No
Did you purchase Health Insurance through the "Health Marketplace"?
*
Yes
No
Did you receive a 1095-A Medical Tax Form?
*
Yes
No
Banking Information
Bank Name
*
Routing Number
*
Account Type
*
Select account type
Account Number
*
Referred by
Required Documents
State ID (Front)
*
Drop your file here or click to browse
Supports: PDF, JPG, PNG (max 10MB)
State ID (Back)
*
Drop your file here or click to browse
Supports: PDF, JPG, PNG (max 10MB)
Tax Documents
Tax Document 1
Drop your file here or click to browse
Supports: PDF, JPG, PNG (max 10MB)
Tax Document 2
Drop your file here or click to browse
Supports: PDF, JPG, PNG (max 10MB)
Tax Document 3
Drop your file here or click to browse
Supports: PDF, JPG, PNG (max 10MB)
Tax Document 4
Drop your file here or click to browse
Supports: PDF, JPG, PNG (max 10MB)
Tax Document 5
Drop your file here or click to browse
Supports: PDF, JPG, PNG (max 10MB)
Tax Document 6
Drop your file here or click to browse
Supports: PDF, JPG, PNG (max 10MB)
Tax Document 7
Drop your file here or click to browse
Supports: PDF, JPG, PNG (max 10MB)
Tax Document 8
Drop your file here or click to browse
Supports: PDF, JPG, PNG (max 10MB)
Tax Document 9
Drop your file here or click to browse
Supports: PDF, JPG, PNG (max 10MB)
Submit Registration
