R&W Financial Services – Taxes, Accounting, Financial Services, Insurance and Real Estate

Your First Name *

Your Last Name *

Occupation *

Social Security Number *

Birthdate *

Spouse First Name

Spouse Last Name

Occupation

Spouse Social Security Number

Spouse Birthdate

Address 1 *

Address 2

City *

State *

Zipcode *

Home Phone Number *:

Work Phone Number:

Cell Phone Number*:

Spouse Cell Phone Number:

Your Email *

Total of Dependents

Number of Children

Non-Children

>>>>>>>> Dependents <<<<<<<<

Dependent #1 First Name

Dependent #1 Last Name

Dependent #1 SSN

Dependent #1 Birthdate

Dependent #1 Relation

Dependent #2 First Name

Dependent #2 Last Name

Dependent #2 SSN

Dependent #2 Birthdate

Dependent #2 Relation

Dependent #3 First Name

Dependent #3 Last Name

Dependent #3 SSN

Dependent #3 Birthdate

Dependent #1 Relation

Dependent #4 First Name

Dependent #4 Last Name

Dependent #4 SSN

Dependent #4 Birthdate

Dependent #4 Relation

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>><<<

Did you receive Unemployment?:

How many W-2's received?:

Any 1099's?:

How many 1099's?:

Cash out a retirement?:

Health care all year?:

Employer paid health?:

Health care stmt attchd?:

>>>>>>> CHILD CARE <<<<<<<<

Name:

Address:

City

State

Zipcode

TaxID

Amount Paid

Phone

>>>>>>>> DONATIONS / CHURCH <<<<<<<<

Name:

Address:

Amt donated:

>>>>>>>> SCHEDULE C INFORMATION (Sole Proprietor) <<<<<<<<

Business Name:

Business Address:

Bus. Tax ID:

>>>>>>>> Landlord (If you rent) <<<<<<<<

Landlord Name:

Landlord Address:

Landlord phone:

>>>>>>>> BANK INFORMATION FOR DIRECT DEPOSIT <<<<<<<<

Bank Name:

Bank Account#:

Bank Routing#:

Account Name:

Deposit into?:

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2020 Tax Info Sheet