Name *
Email *
Phone *
1) # of W-2s:
2) Any self-employment Income YesNo
If Yes, # of 1099-MISC forms:
3) # of K-1 forms:
4) Please list any States lived and / or worked in besides N.Y. :
5) Do you itemize deductions? YesNoNot Sure
6) Do you own your own home? YesNo
7) Did you receive $ 1,500 or more of interest income and / or dividends? YesNo
8) Did you SELL any stocks and / or bonds? YesNo
9) Did you receive any rental income from real estate? YesNo
If Yes, how many properties and what states are they in? n/a
10) Did you have $10,000 or more in foreign bank accounts? YesNo
11) If you are not a U.S. Citizen or Permanent Resident, what is your immigration status and / or type of Visa:
12) Please list any other income and/or deductions not mentioned above: n/a
