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Full First Legal Name

Last Name

Spouse First Name

Last Name

Social Security Number

Spouse Social Security Number

Date of Birth

Spouse Date of Birth

Email Address

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TAX RETURN DETAILS

What Tax Year are you Preparing for?

2025

2024

2023

Any Other Year? If so, What other Year?

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Please be advised that if there's any years prior to the current year filing which is 2025 there's an upfront review fee for $100 for past years taxes that's not refundable due upfront with submission however if you file your taxes with us you will get a credit for that amount towards your final payment!

Did you file taxes last year?

Yes

No

Did you receive any IRS letters or notices this year?

Yes

No

Did you have income in more than one state?

Yes

No

Type of Income Received (Check all that apply):

W-2 Employment

1099 / Self-Employment

Gig Work (Uber, Lyft, DoorDash, etc.)

Unemployment Income

Social Security

Other

Explain Other

Current Address

Did you live at this address all year?

Yes

No

If no, previous address:

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FILING STATUS

Status

Single

Married Filing Jointly

Married Filing Separately

Head of Household

Qualifying Widow(er)

Can someone else claim you as a dependent?

Date

If you left the state what state did you go to and when did you leave?

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DEPENDENT INFORMATION (If Applicable)

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Dependent #1

RELATIONSHIP

FULL NAME:

DATE OF BIRTH

For Extra Dependents Fill in Below

LIVED WITH YOU MORE THAN HALF THE YEAR

Do you need credit repair assistance?

Yes

No

Preparer Signature:

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(Attach additional page if needed)

Date:

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Prepared By: Latasha Taylor

Credit Reset Pros

Client Signature:

Do you owe any outstanding balances for the IRS/State/EDD/Student Loans or Child support?

Yes

No

Amount Owed: How do you usually pay your tax preparation fees through your refund or out-of-pocket?

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CLIENT AUTHORIZATION & CERTIFICATION

I certify that all information provided is true, correct, and complete to the best of my knowledge. I authorize Credit Reset Pros to prepare and electronically file my tax return once I review and approve the final numbers.

Signature

Today's Date:

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Fill In the Form Below if you are looking for Direct Deposit.

Checking or Savings

Bank Name

Routing Number

Account Number

Credit Reset Pros | www.creditresetpros.com | Serving All 50 States

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