8 MILE

Client Interview Form

Full Name *

Address *

Street Address

City *

State *

Country *

Postal Code *

3. Tax Preparer *

4. COPY OF PREVIOUS YEAR TAX RETURN *

5. DO YOU HAVE AN ID.ME ACCOUNT? *

6. HAVE YOU RECEIVED ANY LETTERS FROM THE IRS OR STATE OF MICHIGAN? *

7. List ALL sources of income (including SSI benefits, W-2’s, self-employment, Unemployment Income or others) and how are you supporting yourself and your dependent(s)? *

8. Do you receive state assistance? Yes No If yes, write down the type of assistance and the amount you receive each month. Example: Cash assistance, Food assistance or housing assistance? How much do you pay? *

8a. Indicate the total number of people living in your household: *(DEPENDENTS). *

2. Do you receive state assistance? Yes No If yes, write down the type of assistance and the amount you receive each month. Example: Cash assistant, Food assistant, housing assistant? How much do you pay? *

9. Have your EIC (Earned Income Credit) ever been reduced or disallowed? Yes No. If Yes, when\what was the reason?

9a.HAVE YOU RECEIVED NOTIFICATION FROM THE IRS THAT ANY CREDITS HAS BEEN DISALLOWED? *

10. Did you or any dependents attend any educational institution that may qualify for the American Opportunity Credit or the Lifetime Learning Credit? *

11. Did you pay for student loans and did you receive form 1098 E (Student Loan Interest paid) *

12. Did you pay any student loan interest or receive a form 1098E? (Student Loan Interest paid) *

13.Do you have any garnishments such as IRS debt, child support, student loans, medical bills ETC. *

13. Did you receive a letter from unemployment stating that you owe or does your MIWAM state that you owe for overpayment? *

14a. Do you own or rent your personal residence? *

14b. Rent amount or taxes paid. *

14c. Landlord Name and Address or Mortgage Company *

15. ⁠Are you currently receiving Section 8 housing assistance? *

16. Did you receive unemployment benefits this year? *

17. Did you have any gambling winnings or win money from the lottery, including platforms like FanDuel, BetMGM, or similar? *

18. Did you withdraw funds early from your retirement accounts? *

19. Do you have an IRS Identity Protection (IP) PIN? *

20. Did you have health insurance through the Health Insurance Marketplace and/or are you expecting to receive a Form 1095-A for this tax year? *

21. Is ALL the information you provided accurate and complete to the best of your knowledge? *

22. Do you understand that you are responsible for providing truthful and correct documentation? *

23. Do you authorize our office to file your return with the irs electronically?

I agree to terms & conditions provided by the company. I confirm everything stated in the form is the truth to the best of my knowledge.T & C*I agree to terms & conditions provided by the company. I confirm everything stated in the form is the truth to the best of my knowledge.

Signature *

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