Personal Info

Thank you for filling out the form below. We respect your privacy and the privacy of your personal information. We only collect, store and use your information for defined purposes. The purposes include supplying service and support for filing Federal and State Tax Returns. To ensure the highest levels of security and confidentiality, we use the services of Tax Act. Tax Act is the web site of 2nd Story Software, Inc. 2nd Story Software is committed to protecting your privacy and data. To review. 2nd Story Software privacy statement visit their web site at www.taxact.com or by telephone at (319) 373 3600. Tax2Go, LLC do not disclose your information to third parties except as stated in this privacy statement. Charles L. Williams Owner/Tax Professional.

		PERSONAL INFO

	TAXPAYER'S FIRST NAME AND INITIAL: *
	LAST NAME: *
	TAXPAYER'S DATE OF BIRTH: *
	YOUR SOCIAL SECURITY NUMBER: *
	IF A JOINT RETURN,SPOUSE'S FIRST NAME AND INITIAL:
	SPOUSE'S LAST NAME:
	SPOUSE'S SOCIAL SECURITY NUMBER:
	SPOUSE'S DATE OF BIRTH:
	HOME ADDRESS (APT.#IF APPLY): *
	PRESIDENTIAL ELECTION CAMPAIGN: DO YOU OR YOUR SPOUSE IF FILING JOINT RETURN,WANT $3 TO GO TO THIS FUND: *	Yes No
	CHECK YOUR FILING STATUS.(CHECK ONLY ONE BOX): *
	CHECK ALL BOXES THAT APPLY:	YOURSELF.If someone can claim you do not check this box SPOUSE
	DEPENDENT'S FIRST AND LAST NAME:
	DEPENDENT'S SOCIAL SECURITY NUMBER:
	DEPENDENT'S RELATIONSHIP TO YOU:
	DEPENDENT'S DATE OF BIRTH:
	DEPENDENT'S FIRST AND LAST NAME:
	DEPENDENT'S SOCIAL SECURITY NUMBER:
	DEPENDENT'S RELATIONSHIP TO YOU:
	DEPENDENT'S DATE OF BIRTH:
	DEPENDENT'S FIRST AND LAST NAME:
	DEPENDENT'S SOCIAL SECURITY NUMBER:
	DEPENDENT'S RELATIONSHIP TO YOU:
	DEPENDENT'S DATE OF BIRTH:
	DEPENDENT'S FIRST AND LAST NAME:
	DEPENDENT'S SOCIAL SECURITY NUMBER:
	DEPENDENT'S RELATIONSHIP TO YOU:
	DEPENDENT'S DATE OF BIRTH:
	TAXPAYER DISABLE: *	Yes No
	SPOUSE DISABLE: *	Yes No
	TAXPAYER'S OCCUPATION:
	SPOUSE OCCUPATION:
	TAXPAYER'S TELEPHONE NUMBER: *
	SECOND TELEPHONE NUMBER:
	TAXPAYER'S E-MAIL ADDRESS:
	SPOUSE E-MAIL ADDRESS:
	ADDITIONAL INSTRUCTION:
	EARN A 10% DISCOUNT:	Once you submit your personal information,all that is left is for you to bring in or call and we will pick up your W-2’s, 1099’s, 1098’s and any other information you feel will assist with the preparation of your Income Tax Return. This head start will earn you a 10% DISCOUNT.

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