AFRIDI INSURANCE SERVICES

                      714-229-1322  FAX 714-849-5497

                         INFO@L-NOTARY.NET 

                    INCOME TAX FILING QUESTIONNAIRE

 

NAME _______________________________________________

 

ADDRESS____________________________________________

 

______________________ TEL # _________________________

 

EMAIL ____________________ SS# ______________________

 

DATE OF BIRTH_________  SPOUSE,DOB_________________

 

SPOUSE NAME_____________________SS #________________

 

YOUR PROFESSION___________________________________

 

SPOUSE PROFESSION___________________________________

 

ANY DEPENDENTS,  1, __________________________________

 

DOB, ______________ RELATIONSHIP_______SS#__________

 

2,___________________________DOB, ______________________

 

RELATIONSHIP_____________ SS# _________________________

 

 

3,___________________________DOB_______________________

 

 

RELATIONSHIP________________  SS #______________________

 

DO YOU OWN HOUSE YES/ NO___________

IF YES, PLEASE FAX OR EMAIL 1098. AND TAX INFO

 

DID YOU WORK, Y/N  _____________________________

IF YES FAX OR EMAIL THE W2 OR 1099, etc.

 

DO YOU OWN BUSINESS, Y/N ______________

IF YES, FAX OR EMAIL ALL YOUR BUSINESS EXPENSES.

I GIVE PERMISSION TO AFRIDI INSURANCE SVC

TO PREPARE AND FILE  MY TAXES.

I certify that the above information is true and correct.

 

SIGNATURE __________________  DATE __________

 

PLEASE PROVIDE ANY OTHER INFORMATION,

THAT YOU WOULD LIKE US TO ADD IN YOUR TAXES.