First Name

Last Name

Address

Address Line 2

City

State

Postal code

Date of birth

Occupation

Social Security Number (SSN)

Spouse First Name

Spouse Last Name

Spouse Address

Spouse Address Line 2

Spouse City

Spouse State

Spouse Postal Code

Spouse Date of Birth

Spouse Phone Number

Spouse Email

Spouse Social Security

1st Dependent First Name

1st Dependent Last Name

1st Dependent Social Security Number (SSN)

Birth Date of 1st Dependent

Relationship to 1st Dependent

2nd Dependent First Name

2nd Dependent Last Name

2nd Dependent Social Security Number (SSN)

Birth Date of 2nd Dependent

Relationship to 2nd Dependent

3rd Dependent First Name

3rd Dependent Last Name

3rd Dependent Social Security Number (SSN)

Birth Date of 3rd Dependent

Relationship to 3rd Dependent

If you have additional information add here. Example: is your dependent (Blind, Disable, can the dependent be filed on another return etc): If so which dependent and list below.

Self-Employment: Business Name, EIN#(if you have one), Business Type-Examples: Hair Dresser, Lawn Care, Dancer, Consulting etc.

Upload Business Income/Expenses Reports

Do you owe debt to any government agency such as Child Support, IRS or Student Loans Etc. ?

Yes

Was your earned income credit (EIC), child tax credit (CTC)/additional child tax credit (ACTC), credit for other dependents (ODC) or American opportunity credit (AOTC) reduced or disallowed for any reason other than a math or clerical error Last year?

Yes

Have you been audited within the last 3 years ?

Yes

Are you trying to buy a new home within the next 2 years ?

Yes

Do you receive unemployment? (If so upload document below)

Yes

Unemployment Document

Do You have an Identity Protection PIN (IP PIN) If Yes, Put The PIN number.

Did You or Your Dependant(s) attend a Post Secondary School? If Yes, how much did you spend on school expenses and upload the 1098-T Form below. If No Put No In The Box. Note( You can not claim this credit more than 4 times)

Yes

1098T Form

Upload ALL W2'S

Upload a copy of Last Year Tax Return Note: Get Transcript Online to immediately view the AGI. Taxpayers must pass the Secure Access identity verification process. Select the “Tax Return Transcript” and use only the “Adjusted Gross Income” line entry.Use Get Transcript by Mail or call 800-908-9946. (Use this option if you don't have a copy of you tax return.)

Upload All Socials Security Cards for EVERYONE on the return, Valid Driver Licenses, or identification for each adult on the return

Did You Have Marketplace or Affordable Health Care Insurance At ANYTIME This Year ? If you answered yes to this question please upload supporting documents below :

Yes

Upload MarketPlace Form 1095 A: ( Marketplace Is Insurance such as obama care etc )

Upload Any Misc. Documents ( Childcare, Healthcare, 1099's, 401K, Birth Certificates, Unemployment, Self-employment documents, proof of residency (utility Bill or Some type of mail to prove your address, etc.).

Would you like to apply for cash advance?

Yes

Direct Deposit Information : Bank Name , Routing & Account Number. Please verify that this information is correct!

By signing this application you have confirmed that all information entered here is accurate and true. You are giving Myra J. Tax Services LLC. permission to submit your information to the IRS.

Clear

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

How Did You Hear About Us?