Client Information Sheet Filing Tax Year(s):
Name: SSN: DOB:
Address: City: State: Zip Code:
Home Phone: Work Phone: Cell Phone:
Occupation:
E-Mail Address:
Who May we Thank for Referring you to Abundant Returns?
Filing Status:
 Single Married Filing Joint Married Filing Separate Head of Household Qualifying Widow(er) with dependent child
Did you have Health Insurance All Year Long?  Yes No

Spouse Name: SSN: DOB:
Work Phone: Cell Phone:
Occupation: E-Mail Address:

Business Name: Type: LLC S Corp Partnership Corporation

Dependents Name SSN DOB Relationship
Business Address: EIN: Industry:

Income Expenses
 W-2  1099  Mortgage Interest  Estimated Taxes
 Interest/Dividents  Unemployment Benefits  Student Loan Interest  Donations
 Social Security  Gambling Wins  Child Care Expenses  College Tuition
 Alimony  K-1/S-Corp/Partnership  Property Taxes  Home Office
 Rental Property  Retirement/Pension  Health Savings Account  IRA Contributions
 Sold Stock  Self Employment  Unfiled Tax Returns  Purchased/Sold Home

Did You Do Any Of The Following? Do You Have Any Of The Following?
Move 50 Miles For Employment? Yes No Unfiled Tax Returns? Yes No
Receive Cancellation of Debt Notice? Yes No Student Loan Default? Yes No
Receive a State Refund Last Year? Yes No Bankruptcy? Yes No
Work as a Full-time Classroom Teacher? Yes No Unpaid Alimony? Yes No
Have a Casualty/Theft or Loss? Yes No Unpaid Child Support? Yes No
Buy or Sell Real Estate? Yes No Birth or Death: Birth Dead
Unrepaid Loan to Family/Friends? Yes No Marriage or Adoption: Marriage Adoption

Security Question (Answer Only One of These)
Oldest Child’s Name: Pet’s Name: High School Name:

Electronic Signature:
(Name)
Abundant Returns Tax Service will prepare your federal and state income tax returns based on the information you furnish. It is your responsibility to provide all information necessary to complete your tax returns. You represent to us that the information you provide is true, complete and accurate. In addition, you have retained all necessary written support and documentation should it be required by the IRS or state audit examination.I certify that all information I submitted to Abundant Returns Tax Service is true and correct to the best of my knowledge.

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