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									                   All US Tax Services
     Phone: (678) 339-3760 Email: george.1095@yahoo.com
                                      Tax Questionnaire
1 Personal Information:
                                    Taxpayer                             Spouse (if applicable)
     Last Name
     Middle initial
     First name
     Date of birth
                         (month)       (day)             (year)          (month)            (day)
     Occupation

     SSN or ITIN



     street name and number                     city                     state

                                                                                            @
     Cell phone             Home phone                             E-mail address

     Bank information is required only if Direct Deposit is needed
     Routing No                                                   Bank

     Account No                                                              Email Your ID/License

     Credit card information is required only if you are paying Preparer's fee by Credit card
     Credit Card Number (Visa, MC or Discover)                                       Exp Date       CVV/CVC code

     Dependants
                                                                                                    Day Care
           First Name, Initial, Last Name   MM/DD/YYYY            Relation          SSN or ITIN     Exp (If Any)




2 Employment Information ( Please Email all of your W-2)

3 Gambling Income (Email the form W2G)

4 Other Taxable Income

     Interest (if 1099 INT issued please enclose copy or email to our office and skip this item)
    Paying institution                          Amount              Paying institution                  Amount




    Total                                                    -   Total                                      -

    Dividends (if 1099 DIV issued please enclose copy or email to our office and skip this item
                        Ordinary           Qualified       Capital             Taxes
    Paying institution Dividend            Dividends        Gains               Paid                    Country




    Total                            -                       -           -                          -



    Additional Income                                                                    Taxpayer       Spouse
    Taxable refunds, credits, or offsets of state and local income tax
                        Unemployment compensation

    Pension, IRA and Social Security Distributions
    (if 1099 R issued please enclose copy or email to our office)

5 Deductions

    Deductions                                                                           Taxpayer       Spouse
    Health savings account (provide statement)
    Moving Expenses (give details when, where and how much)
    Self Employed health insurance
    Penalty on early on withdrawal od savings
    Alimony paid
    IRA contribution
    Student loan interest



6 Foreign Tax paid (Email supporting documents)

7 Itemized Deductions

    Interest Paid:
    Home Mortgage Interest   (if Form 1098 issued please enclose copy or email to our office)
            Mortgage Company                 Interest Paid          Interest rate Loan Balance
    1st)
2nd)


Second Home

Other Interest Paid


Total                               $0.00

Other Misc Itemized Deductions

Description                       Amount                  Description          Amount
State Taxes (not on W-2)                                       Real Estate Tax
Casualty & Theft                                         Personal Property Tax

Charitable Contributions          Amount        Church/Temple/Organization Name




Child & dependent care expenses
Care provider's name
Identification # (EIN)                      Day care exp paid
Address of provider

Medical and Dental Expenses       Amount        Description                    Amount
Premiums and Co Pay                         Wheel Chair, hearing aid
Medicine                                    Taxi/Cab/ Ambulance
Dental                                      Lab Fee
Eye Exams & eye glasses & lens              Other

Un-reimbursed Job Expenses        Amount       Un-reimbursed Job Expenses      Amount
Uniforms                                    Dues and Subscriptions
Work Shoes                                  Class and Seminar
License and Permits                         Professional books, magazines
Small tools                                 Job search exp

Last year Tax Preparation Fee                   Safe Deposit Box
Apt Rent(CA,MI,NJ,MA,IN & WI)
Any Questions or concerns
                      Terms and Conditions

                We will send you a confirmation Email

                once we received your file, please
                Wait 24 hrs to get the email from us

                We will give you a call
                to finalize your tax return
                (Normal processing time is one week)

       (year)
                We don't start your file until we get
                all the information such as W2, copy
                of Previous Year's (2009) tax return,
                1099 Misc etc

       zip
                If you are have Stock/share sales
                please submit the gainskeeper with
                1099 B ( you can print the gainskeepr
                from the trading company website)


                We don't give Free Estimate and our fee
                is posted on our website (allustaxservices.com)


CVV/CVC code            Our Promise

                We take all the legal credits and
Day Care        deductions to get you the maximum
Exp (If Any)    refund or least tax within the
                legal limits.
Amount




    -




Country




Spouse




Spouse
    Amount




tion Name




      Amount




      Amount

								
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