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Tell us how we can help you today?
Quick note: To skip a question scroll up. Items with the red * are essential and can’t be skipped. Let us get started.
What is your name?*
Hey {What is your name?:1.3:}, nice to meet you.

First

Last
Your email?*
{What is your name?:1.3:}, what is your email address?
Reason for visiting?*

Personal Information

We would need some more information about you.
Date of Birth*
{What is your name?:1.3:} tell us your date of birth please.

Date Format: MM slash DD slash YYYY
SSN#*
Your address*
{What is your name?:1.3:}, tell us where you live?

Street Address

Address Line 2

City

State

ZIP Code
Cell Phone*
Home Phone
Work Phone
Occupation
Marital Status*
{What is your name?:1.3:} are you single or married? Please choose one.
- Single
- Married
- Divorced

Spouse Information

{What is your name?:1.3:}, we would ask you to enter your spouse information now.
What is your spouse name?*

First

Last
{What is your spouse's name?:15.3:}'s Date of Birth*
{What is your name?:1.3:} tell us {What is your spouse’s name?:15.3:}’s date of birth also.

Date Format: MM slash DD slash YYYY
{What is your spouse's name?:15.3:}'s SSN#*
Do you {What is your spouse's name?:15.3: your spouse} live with you?*
{What is your name?:1.3}, do you and {What is your spouse’s name?:15.3:your spouse} live together at {Your address?:7.1}, {Your address?:7.2}. {Your address?:7.3}, {Your address?:7.4} {Your address?:7.5} {Your address?:7.6}?
- Yes
- No
{What is your spouse's name?:15.3:Spouse}'s Address*

Street Address

Address Line 2

City

State

ZIP Code

Personal Identification

{What is your name?:1.3:Visitor}, we would need your state issued identification card or your drivers license.
Your ID Issued State:*
Your ID NO:*
Your ID Issued Date:*

Date Format: MM slash DD slash YYYY
Your ID Expire Date:*

Date Format: MM slash DD slash YYYY
{What is your spouse's name?:15.3:Spouse}'s ID Issued State:*
{What is your spouse's name?:15.3:Spouse}'s ID NO*
{What is your spouse's name?:15.3:Spouse}'s ID Issued Date:*

Date Format: MM slash DD slash YYYY
{What is your spouse's name?:15.3:Spouse}'s ID Expiration Date:*

Date Format: MM slash DD slash YYYY

Other Informations

{What is your name?:1.3:}, we would now ask you to enter some other information such as dependents, babysitter and more.
Dependents

Name Date of Birth Social Security
Others

Name Relationship Address Phone Number
Babysitter

Name SSN / EIN Expenses Amount Address

Lastly
Is this your first time here?*
{What is your name?:1.3:}, is this your first time at Superior Tax Services?
- Yes
- No
How did you hear about us?*

Name	Date of Birth	Social Security

Name	Relationship	Address	Phone Number

Name	SSN / EIN	Expenses Amount	Address

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