Taxpayer Information Form

Name *

Email address *

Phone number

Current Tax Year *

Did you file with us last year?

Yes

No

Filing Status *

Single

Married Filing Separate

Qualifying Widower

Head of Household

Married Filing Joint

Social Security Number *

Mailing Address *

Date of Birth *

Are you a U.S. Citizen or green card holder? *

Yes

No

Marital Status *

Never Married

Married

Divorced

Legally Separated

Widowed

Occupation

Are you filing an eligible spouse on your return? *

Yes

No

Are you a full-time student? *

Yes

No

Are you totally and permanently disabled? *

Yes

No

Are you legally blind? *

Yes

No

Is this individual dependent of other? *

Yes

No

Spousal Information

Please select at least one option.

Spouse Name

Spouse Phone

Spouse Email

Spouse’s Social Security #

Spouse Date of Birth

Spouse Date of Death (if deceased in the current tax year)

Are you a full-time student?

Yes

No

Are you totally and permanently disabled?

Yes

No

Are you legally blind?

Yes

No

Is this individual dependent of other?

Yes

No

Are you claiming any dependents?

Yes

No

Dependent Information

Please select at least one option.

Dependent 1

Name: First

Last:

Date of Birth:

Upload dependent tax documents like W2, Tuition Statement etc

Relationship:

How many months did they live in your home for the current year?

Did this dependent attend college this year?

Yes

No

Dependent 2

Please select at least one option.

Name: First:

Last:

Date of Birth:

Upload dependent tax documents like W2, Tuition Statement etc

Relationship:

How many months did they live in your home for the current year?

Did this dependent attend college this year?

Yes

No

Dependent 3

Please select at least one option.

Name: First:

Last:

Date of Birth:

Upload dependent tax documents like W2, Tuition Statement etc

Relationship:

How many months did they live in your home for the current year?

Did this dependent attend college this year?

Yes

No

Tax Related Questions

Please select at least one option.

Employment Status:

Employed

Unemployed

Self-employed

Are you contributing to 401k or other pre-tax account?

Yes

No

Is this your first time opening a pre-tax account?

Yes

No

What state return are you requesting?

State return

Local

Country returns

School

RITA

Does your dependent(s) have tuition expenses?

Yes

No

Do you have any expenses for child care?

Yes

No

Are you currently renting?

Yes

No

Do you own your home?

Yes

No

Do you have documents that show you paid for property taxes?

Yes

No

Add any other tax related questions pertaining to the current tax year here:

Income (Please select all forms of income in the current tax year)

Wages or Salary (W2 Income)

Dividend/Sale of Stocks

Lottery or Gambling Income W-2G

Unemployment

Interest Income

Public/State Aid Income

Pension/Retirement Income

Self-Employment – Bus. Income (Sch.C)

Social Security Income

Rental Income

Tips

Farm Income

Alimony Received

Other

Upload Income documents here:

General Expenses (Please select which other expenses pertain to you)

IRAs

Education Expenses

Alimony Paid

Property Tax

Significant Loss or Theft

Bought or Sold Home

Mortgage Points (closing points)

Charity of Religious Contributions

Job Related Expenses

Business Owner/Self Employed

Mortgage Investment

Other

Tax Prep Expenses

Moving Expenses

Union Dues

Medical Expenses

Upload expense evidence here:

Declaration & Signatures

Please select at least one option.

I confirm that all information I entered here is accurate and true.

I allow you to capture data like personal ID, government ID and tax documents uploaded

I have read the terms and conditions and privacy policy.

By Submitting below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.

Harava Group