Client Form – POS Taxes

(954) 964-9205
Hollywood, FL

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Client Transmittal Form

Taxpayer Name

Last 4 SSN

Date of Birth

IP PIN?

Yes

Spouse Name

Last 4 SSN

Date of Birth

IP PIN?

Yes

Street Address (City, State, Zip)

Taxpayer Occupation

Daytime Phone

Evening Phone

Mobile Phone

Spouse Occupation

Daytime Phone

Evening Phone

Mobile Phone

Taxpayer Email

Spouse Email

Marital Status

Married Married filling separately Single Widow(er)

Taxpayer

Blind Disabled Full-time student Would you like to donate $3 to the Presidential Election Campaign Fund?

Spouse

Blind Disabled Full-time student Would you like to donate $3 to the Presidential Election Campaign Fund?

At any time in previous year, did you receive, sell, send, exchange or acquire any financial interest in any virtual currency?

Yes No

Dependant Name

Date of Birth

IP PIN?

Yes

Relationship

Mo(s) in home

Taxpayer

Disabled Full-time student

Childcare Expenses

Dependant Name

Date of Birth

IP PIN?

Yes

Relationship

Mo(s) in home

Taxpayer

Disabled Full-time student

Childcare Expenses

Dependant Name

Date of Birth

IP PIN?

Yes

Relationship

Mo(s) in home

Taxpayer

Disabled Full-time student

Childcare Expenses

List Dependants required to file a return

COVID-19 Implications
Did you receive an Economic Impact Payment (EIP)? If "Yes", provide Notices 1444 and 1444-B from the IRS.

Yes No

First EIP Amount

Second EIP Amount

Did you experience economic loss due to COVID-19 (loss of job, closed business, etc.?)

Yes No

Were you unemployed for any portion of the year due to COVID-19?

Yes No

Did you continue to receive wages from your employer even if you were unable to work?

Yes No

Did you receive a distribution from a retirement plan (401K, IRA, etc.) due to COVID-19?

Yes No

If you own a farm or business:
Did you continue to pay any employee while they were not working?

Yes No

Did you delay witholding FICA taxes from any employee's pay?

Yes No

Did you receive a Paycheck Protection Program (PPP) loan?

Yes No

If "Yes" was the loan forgiven or have you applied for forgiveness?

Were you unable to work due to COVID-19 and, if emplyed by somone other than yourself, would have qualified for sick or family leave?

Yes No

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Serving Hollywood, Florida & surrounding areas with professional tax & financial services for over 25 years.

Home
Our Services
Tax Tools
- Preparing For Tax Day
Client Form
About Us
- Our Team
Contact Us

Menu

Home
Our Services
Tax Tools
- Preparing For Tax Day
Client Form
About Us
- Our Team
Contact Us

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