1040 U.S. Individual TAX INPUT Sheet 


We will need all this information to prepare your taxes.
If possible fill this out and bring with you or email it to us at Bill@ReynoldsCares.com

If Prior Customer and you have prefilled form - Update Client Profile on reverse and skip to lower half of this form (Part B)

New Customers- Pick up Last year’s return and State refund information $$ __________.  
Referred by?____________

                                          First name and Initial   Last Name  Date of Birth SS#

Full Name of Taxpayer: _____________ _____________     __/ __/___      ____-____-____

Spouse Name:                   ____________ _____________     __/___/___     ____-____-_____

Mailing Address (where you want the check sent)            Phones: (where we can reach you now) define pls:

POB or Street: ____________________ Cell: ______________Text Y/N_   Home: _______

       City/Zip:___________________        Email:_______________________________

Marital Status: _________________, legally? ___ #of mths lived with spouse in ‘2023?_____

Occupation: ___________________, Spouse Occupation: _______________________

Dependents:           Please photo SS Cards and list birth dates and months lived at home

Name(first,initial, and last name)  DOB  Social Security #  Relationship  #mths in home in 2023  W2 Income      F/T College?

­­­­­­­­­­­­­­­­­­­­­­­­­­­_________________________    __/__/__    ____-___-_____  _________  _____  $_______  _______

_________________________    __/__/__     ____-___-_____  _________  _____ $_______   _______ 
_________________________   __/__/__      ____-___-_____  _________  _____ $_______ _______ 

_________________________   __/__/__      ____-___-_____  _________  _____ $_______ _______ 

_________________________   __/__/__       ____-___-_____  _________  _____ $_______ _______ 

       Any Child over 18 needs to be a full-time student for EIC benefits                                                                                                                                         

Part B: Fill out for ALL Customers.

Pick up W2 Forms etc: (confirm “Is this the only place you worked last year?”)  # places worked:____

Number of W2s attached: ______, 1099s_______, 1095A/B/C______, Other_____________

Health Ins?_____, Marketplace?______  From Job? ____                     

Any Cryptocurrency Income:_____       

Any Interest received from Bank Accts? Y/N__   $_______

    Any W2s from other States??_____ IF SO-DATE moved into NY?_____________

ASK: Did you/spouse receive ANY other income? 

    Lottery______; Unemployment: _______, SSI: ______, Pension: _____, Rental Etc:____.

      Any working or income from dependents? _____, $$_______, W2s?_____. 

      Do you support or help out your parents? ________

If a long form last year, did you itemize?___ If so LIST

Do you Own or Rent? ____ How much is your mthly rent? ____

Are you a Fire Dept or Ambulance Volunteer? _________

Name of Department and address: ___________________

ASK: Give any $$ to charities or churches? ______< how much________

Bags of clothes to charities in 2023?________-

Ask: $$ paid to daycare or Babysitters$__________

How many kids were watched: ____ Names: ______________________________

Name of sitter               Full address                    SS# or TIN number

Name /Address of College: ___________________________EIN#_____________________

$$ Tuition Paid OR LOAN Incurred & Name of Child: ______________________________

E-File last year? _______, Did you pick up check in tax preparer’s office? __________

Please forward legal ID copy:

DMV Lic:_______________________, US Passport/Resident Alien ID:________

ID Issue Date: _______/Expiration Date: _______ State Issued: ________________


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