Thank you for connecting with us. We will respond to you shortly. 11https://www.jjkmpro.com/wp-content/plugins/nex-formsfalsehttps://www.jjkmpro.com/wp-admin/admin-ajax.phphttps://www.jjkmpro.com/federal-information-sheetyes1fadeInfadeOut Federal Information WorksheetTaxpayer InformationSpouse Information*Last Name Middle IntialFirst Name*Social Security #Spouse Last NameSpouse Middle IntialSpouse First NameSpouse Social Security # *Date of BirthDate of DeathDate of Birth*Mobile NumberAdditional Number Email AddressHome Address Apt #*City*State *Zip CodeFax NumberHow did you hear about us?Previous ClientFriendGoogleFlyerIf Referral, Name:*Filing Status SingleMarried Filing JointMarried Filing SeparatedHead of HouseholdQualifying Widow(er) Presidential Election Campaign Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below will not change your tax or refund. TaxpayerSpouseIf someone (such as client's parent) can claim client as dependent, please select:YESNOCheck the box for Health Coverage TaxpayerSpouseStimulus Received in 2021: $ Advanced Child Tax Cr Letter 6419:$Do you pay rent? YESNOIf yes, the amount: $ Per MonthYearDependent InformationFirstMiddle Last SSN #DOB Relashionship FirstMiddle Last SSN #DOB Relashionship FirstMiddle Last SSN #DOB Relashionship FirstMiddle Last SSN #DOB Relashionship Information for the Earned Income Credit OnlyDo you have a qualifying child who is also a qualifying child of another person with a higher modified AGI? YesNoAre you or your spouse a qualifying child for EIC for another person?YesNoWas your home in the United States for more than half of 2021 ?YesNoHave you been notified by IRS that EIC cannot be claimed in 2021 ? YesNoCheck "BOX" if child claimed under pre-85 agreement.BoxIndicate (Electronic Filing) (Fast Fund) (Fast Check) (Cash Card) BoxDirect Deposit or Electronic Funds Withdrawal Information Name of Financial institutionSelect oneCheckingSavingRouting Number Account Number Child Care InformationNameSSN or FEINPhone NumberFull AddressAmount $If You have more statements, please write them then sign below: N.B. IT IS MANDATORY TO REPORT ALL INCOME RECEIVED DURING THE FISCAL YEARINCLUDING: UNEMPLOYMENT, PENSION, BANK INTEREST, SOCIAL SECURITY INCOME* By signing this sheet, I, the taxpayer, certify that all the above statements are true and answered by me during the interview with the tax preparer in order to file my tax return for the current year. If you apply for fast Fund or Fast Check, and IRS decides not to honor the direct deposit because you have a past due balance with IRS or forwhatever your situation may be such as Child Support, Student Loan etc..., It will be your obligation to pay all theFees Charged for your TAX Preparation. Please note that once work is done, payment is due...File Upload doc docx mpg mpeg mp3 mp4 odt odp ods pdf ppt pptx txt xls xlsx File Upload doc docx mpg mpeg mp3 mp4 odt odp ods pdf ppt pptx txt xls xlsx File Upload doc docx mpg mpeg mp3 mp4 odt odp ods pdf ppt pptx txt xls xlsx File Upload doc docx mpg mpeg mp3 mp4 odt odp ods pdf ppt pptx txt xls xlsx You need the "Digital Signatures for NEX-forms" Add-on to use digital signatures! Buy NowSubmit WorksheetPowered by NEX-Forms