New Client Form New Tax Client Information Form Name Email Occupation Phone Number Spouse's Name Spouse's Phone Number Mailing Address Mailing Address Dependent names & ages Childcare expenses? Yes No College tuition expenses? Yes No Health savings account? Yes No Do you pay student loan payments? Yes No Do you own your own business? Yes No If so, what type? -Select One- Sole Proprietorship Partnership Limited Partnership Corporation Limited Liability Company Other Do you own a rental property? Yes No If so, how many? Do you have investment accounts or CD's? Yes No If so , how many? Do you receieve Social Security income? Yes No Do you receive retirement income? Yes No Does your spouse receive Social Security income? Yes No Does your spouse receive retirement income? Yes No Do you own your home? Yes No Do you have out of pocket medical expenses? Yes No Do you have a mortgage payment? Yes No Do you make charitable contributions? Yes No Do you make non-cash charitable contributions? (Goodwill, etc.) Yes No Do you use your personal vehicle for business? Yes No Do you have a home office that you use for business? Yes No What are the best days of the week for an appointment? - select one - -Select One- Monday Tuesday Wednesday Thursday Friday Saturday What are the best times of day for an appointment? -Select One- 9:00am 10:00am 11:00am 2:00pm 3:00pm 4:00pm 5:00pm Any specific questions or other information? Send
