Fact Finder Form

Please fill in your responses as best you can. We will begin with taxpayer’s info.












Your Info

Your Spouse’s Info

Preferred method of communication. Please list the number or email you prefer to be
contacted in reference to your taxes.

Delivery Option

Our firm will provide you with either a paper copy or an electronic copy saved to your
client portal upon completion and receipt of full payment. Should you request both options
then there will be a minimal additional fee of $10.00. However if you request a copy later
in the year the fee is $25.00 and it is paid at the time extra copy is requested.

Dependents

Please list all dependents you plan to claim for 2017. If we have dependents on-file from
the previous year that you are not taking this year, please let us know to remove them.

Child Care Deductions

Direct Deposit

Direct Debit

Payment is due by April 15th, even if you file an extension. Payments made after the 15th
are considered late and will incur penalties and interest.