Individual Questionnaire – Collins Financial Services

Individual Tax Questionnaire

New Client

Tax Year(s) *

Taxpayer First and Last Name *

Occupation *

Social Security Number *

Date of Birth *

E-Mail *

Telephone *

By including your banking information you can request Direct Deposit of your Tax Refund(s).

Bank Routing #

Bank Account #

Spouse Name

Spouse Occupation

Spouse SSN

Spouse Date of Birth

Spouse E-Mail (must be separate e-mail)

Telephone

Street Address *

City *

State *

Zip Code *

Dependent 1 Name

Date of Birth

Social Security Number

Relationship

Dependent 2 Name

Date of Birth

Social Security Number

Relationship

Dependent 3 Name

Date of Birth

Social Security Number

Relationship

Dependent 4 Name

Date of Birth

Social Security Number

Relationship

Dependent 5 Name

Date of Birth

Social Security Number

Relationship

Method of Payment (Must Choose One) *

Submission acknowledges you are requesting CFS Consult, and or Prepare tax returns using information provided by you. You also acknowledge fees for services provided are due regardless of any calculated income tax refund/(liability).

CFS uses this information to create a free SmartVault Document Sharing account for you.

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