Taxpayer Questionnaire Form PDF Details

Filling out the Taxpayer Questionnaire form is an important step for anyone preparing to file their taxes. This form gathers comprehensive personal information starting with the basics—names, social security numbers, contact details, and your current occupation. But it goes beyond just the basics, asking if you're dependent on another's return, or have any conditions such as being legally blind or disabled that could affect your filing status. The form then dives into your filing status, offering different options based on marital status as of the last day of the tax year and other specific circumstances that might affect how you file. For married couples, it inquires about living situations and itemized deductions to accurately determine the best filing option. Dependents are another critical area covered, asking for detailed information to understand your eligibility for various credits and deductions like the Child Tax Credit or Earned Income Credit (EIC). It even includes sections for direct deposit banking details, income sources, adjustments, credits, and detailed itemized deductions to ensure every aspect of your financial life is documented. Finally, it wraps up with questions regarding the Earned Income Credit eligibility, choice of tax preparation method, and a review statement confirming the accuracy and completeness of the information provided. This detailed questionnaire is designed to guide the preparation of your tax return, accounting for every potential influence on your tax obligations and refund opportunities.

QuestionAnswer
Form NameTaxpayer Questionnaire Form
Form Length6 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 30 sec
Other namestax return questionnaire 2021, tax preparer client questionnaire template, tax questionnaire, tax preparer client questionnaire

Form Preview Example

Taxpayer Questionnaire

PERSONAL INFORMATION

Primary Taxpayer

 

First Name:

Last Name:

 

 

 

M.I.:

 

 

 

 

 

 

 

 

S.S.N. :

Birthdate:

 

 

Taxpayer's PIN:

 

 

 

 

 

 

 

 

 

Home Phone:

Work Phone:

 

 

Cell Phone:

 

 

 

 

 

 

 

 

 

Occupation:

Dependant on

Yes

No

Legally Blind?

Disabled?

 

 

another return?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Email Address:

 

Text Message

Yes No

Cell Phone Carrier

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Filing Status (Circle which Status number applies)

 

1 = Single

If: You were NOT married on or before December 31, 2011

 

 

 

 

 

 

Your dependents lived with you less than 6 months during the year.

 

 

2 = Married Filing Joint

If: You were married as of December 31, 2011 or your spouse died during 2011.

 

 

3 = Married Filing Separate

If: You were married on or before December 31, 2011 and your spouse is

 

 

 

 

filing a tax return using this filing status.

 

 

 

 

 

 

* If MFS, did you live together at ANY time during the tax year?

 

Yes

No

 

 

 

If yes, did you live together during the final 6 months?

 

Yes

No

 

 

 

* If MFS, did your spouse itemize his/her deductions?

 

Yes

No

 

 

 

NOTE: If spouse itemized deductions, taxpayer must also Itemize deductions.

 

 

4 = Head of Household

If: You were NOT married as of December 31, 2011

 

 

 

 

 

 

Your child, foster child, or grandchild lived with your more than 6 months.

 

 

5 = Qualified Widow(er)

If: Your spouse died during either 2009 or 2010, and

 

 

 

 

 

 

Your child, stepchild or foster child lived with you for 12 months in 2011.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Spouse

 

 

 

 

 

 

First Name:

Last Name:

 

 

 

 

M.I.:

 

 

 

 

 

 

 

 

 

 

 

S.S.N. :

 

Birthdate:

 

 

Spouse's PIN:

 

 

 

 

 

 

 

 

 

 

 

 

Home Phone:

Work Phone:

 

 

Cell Phone:

 

 

 

 

 

 

 

 

 

 

 

 

Occupation:

Dependant on

Yes

No

Legally Blind?

 

Disabled?

 

 

 

another return?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

Care-of (oradditional) Address Information

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street Address:

 

 

 

 

 

Apt. #:

 

 

 

 

 

 

 

 

 

 

 

City:

 

State:

 

Zip Code:

 

 

 

 

 

 

 

 

 

 

 

 

Military Address Info:(1=APO/FPO, 2=Stateside, 3=Foreign or Blank)

Combat Zone:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bank Information

 

 

 

 

 

 

(for Direct Deposit intoTaxpayers Personal Acct.)

 

 

 

 

Bank Name:

 

Account Type:

Savings

Checking

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Routing Number:

 

Account Number:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Will this refund go to an account outside of the US?

 

Yes

No

 

 

 

Page 1

Dependents

First Name

Last Name

Birthdate

SSN

Relationship

#of

Months

Dep.

Code

EIC

Children who lived with you and are being claimed on another return

Enter the dependents name, birthdate, SSN, Relationship, number of months lived with the taxpayer, starting with the youngest dependent. Refer to the information below for Dep. and EIC Codes.

 

Dependent Codes

EIC Codes

 

 

 

1

= Lived with Taxpayer

E = Eligible as of December 31, 2011, under the age of 19

 

 

 

2

= Lived Elsewhere

S = Student as of December 31, 2011, under the age of 24 and full-time student

 

3

= Taxpayer's parent

D = Disabled as of December 31, 2011, Permanently & totally disabled, at any age

 

4

= Other Dependent

K = Qualifing Child was Kidnapped

 

 

 

 

 

N = Not eligible

 

 

 

 

 

Child Tax and Earned Income Credit

 

 

 

 

 

Number of Children under age 17 (CTC)

 

 

 

 

 

Number of Children under age 19 (EIC)

 

 

 

 

 

 

 

 

This Information is included in the

Number of Children between age 17 & 24, full time student (EIC)

 

 

 

 

 

 

 

Dependents Table above

 

 

 

 

 

 

Number of Children Totally Disabled (EIC)

 

 

 

 

 

 

 

 

 

 

 

Include Form 8862 - Information to Claim EIC After Disallowance?

Yes

No

 

 

 

 

 

Total Amount Paid:

CHILD CARE CREDIT

Number Cared for:

 

 

 

 

 

 

 

 

 

 

 

 

A.

If married, did both, Taxpayer and Spouse work during the time of dependent care?

Yes

No

 

B.

If no to A, was Taxpayer or Spouse disabled or a full-time student for more than 5 months?

____ No

 

 

____ Yes, Disabled

 

 

 

 

If no to A and B, this return is not eligible for dependent care credit

____ Yes, Student

 

Care Provider #1 Information

Name

Address

___SSN or

___EIN

Amount Paid

$

Care Provider #2 Information

 

Name

 

 

___SSN

or

 

 

 

 

___EIN

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

Amount Paid

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

DEPENDENT CARE EXPENSES

 

 

 

 

 

List dependents cared for

 

 

 

First Name

Last Name

SSN

 

Expenses

$

$

$

$

Page 2

WAGES and SALARIES

(Use Actual Form W-2 for Data Entry)

Taxpayer

Employer's Name

Wages

Federal Withholding

St Withholding

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Spouse

Employer's Name

Wages

Federal Withholding

St Withholding

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INTEREST AND DIVIDEND INCOME

(Use Actual Forms 1098, 1099B, 1099-INT, 1099-DIV for Data Entry)

Payer's Name

Interest

Dividends

Withholding

Earned

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER INCOME

Unemployment Income (Other Income wkst, Line 19)

Social Security, from Form 1099SSA (Other Income wkst, Line 20b)

Other Income:

Scholarship income not included onForm W-2

Prior Year's State and Local Income Tax Refund

Alimony Received

Gambling Income

Other Income Subject to Self-employment Tax

Schedule C - Business Income/(Loss)

IRA OR Pension Distribution from 1099R

Railroad Retirement from Form 1099RRB

 

 

ADJUSTMENTS

 

Student Loan Interest Deduction

 

 

 

 

 

 

IRA Contributions (Limit of $5,000 per taxpayer, if over 50 limit is $6,000)

 

 

 

 

 

 

Tuition and Fees Deduction

 

 

 

 

 

 

 

Alimony Paid

 

 

 

Recipient's SSN

Recipient's Name

 

 

 

 

 

CREDITS

Education Credits

American Opportunity Credit

Life Time Learning qualified expenses

First Time Home Buyer Credit

Other Federal Tax Payments

Page 3

ITEMIZED EXPENSES

 

Sch-A

Medical and Dental Expenses

 

 

Miles

Number of Miles driven to Doctor / Dental Visits during the year

 

(line 1)

 

 

 

 

 

Medical / Dental Expense Description

 

 

Amount

 

 

 

 

Medical / Dental Expense Description

 

 

Amount

 

 

 

 

Taxes Paid

 

 

Amount

State Taxes Paid on last year's state return

 

(line 5, wkst)

 

 

 

 

 

Real Estate Property Taxes Paid

 

(line 6)

 

 

 

 

 

Personal Property Taxes Paid (i.e. vehicle registration)

 

(line 7)

 

 

 

 

 

Other Taxes Paid (i.e. Non-resident State Taxes Paid)

 

(line 8)

 

 

 

 

 

Interest Paid

 

 

Amount

Home Mortgage Interest, from Form 1098

 

(line 10)

 

 

 

 

Points Paid (Principle Purchase of Residence OR Qualified Refinance)

(See Form Instructions)

 

 

 

 

 

Gifts to Charity

 

 

Miles

Number of Miles driven for Volunteer Work with Charitable Organization

(line 16)

 

 

 

 

 

Charitable Cash or Check Contributions

 

 

Amount

Description

 

(line 16)

 

 

 

 

 

Description

 

 

 

 

 

 

 

Description

 

 

 

 

 

 

 

Description

 

 

 

 

 

 

Non-Cash Charitable Contributions (if more than $500 must attach Form 8283)

 

Amount

Description

 

(line 17)

 

 

 

 

 

Description

 

 

 

 

 

 

 

Description

 

 

 

 

 

 

 

Job Expenses and Other Miscellaneous Expenses

 

 

Amount

Un-reimbursed employee expenses (i.e. union dues, uniforms, tools specific to work)

(line 21)

 

Prep Note: all other Un-reimbursed employee expenses must be filed on Form 2106

 

 

 

Tax Preparation Fees

 

(line 22)

 

 

 

 

 

Other Expenses (safe deposit box, attorney fees for production of income, etc.)

 

 

 

Description

 

(line 23)

 

 

 

 

 

Description

 

 

 

 

 

 

 

Other Miscellaneous Deductions

 

 

Amount

Other Miscellaneous Expenses (I.e. gambling losses-no more than reported winnings)

(line 28)

 

 

 

 

 

Other Expenses

 

 

Amount

Description

 

(line 28)

 

 

 

 

 

Description

 

 

 

 

 

 

 

Description

 

 

 

 

 

 

 

Page 4

EARNED INCOME CREDIT

Part I: Qualifications

Could you, or your spouse if filing jointly, be considered a "Qualifying Child" on another persons tax return during tax year 2011?

Yes

No

NOTE: If you answered "Yes" , you are not able to qualify for the earned income credit (skip Part II and Part III).

 

Part II: Qualifying Children

 

Child 1

 

Child 2

 

 

Is the Child:

 

(line 9)

Name

 

Name

 

 

 

 

 

 

The Taxpayer's Son, Daughter, or adopted child

OR

 

 

 

 

 

 

 

 

 

 

 

 

A child of the Taxpayer's son, daughter or adopted child OR

 

 

 

 

The Taxpayer's stepchild OR

 

 

Yes

No

Yes

No

 

 

 

 

 

 

 

 

The Taxpayer's eligible foster child?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If the child is married, are you claiming this child as a dependent?

 

Yes

No

Yes

No

 

 

 

 

 

(If child is not married, then simply mark yes)

 

(line 10)

 

 

 

 

 

 

 

 

 

 

Did the child live with you in the United States for over half of the year,

OR

No

Yes

No

 

 

 

 

Yes

 

The full year if the child is an eligible foster child?

(line 11)

 

 

 

 

 

 

 

 

 

 

 

Was the child, at the end of the year:

 

(line 12)

 

 

 

 

Under age 19 OR

 

 

Yes

No

Yes

No

 

 

 

 

 

Under age 24 and a full-time student OR

 

 

 

 

 

 

 

Any age and permanently and totally disabled?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Could any other person check "Yes" on lines 9 through 12 for the child?

 

Yes

No

Yes

No

 

 

 

 

Prep Note: If yes, questions on line 13bb. through 13c must also be answered.(line 13a)

If you checked "No" on any of the first four questions above, then:

The child is not the taxpayer's qualifying child. If the taxpayer does not have a qualifying child, go to "Part III" to see if the taxpayer can clain the EIC for people who do not have qualifying children

Part III: Earned Income Credit for Taxpayers without a Qualifying Child

 

 

Was your main home, and your spouse if filing jointly, in the United States for more than half the year?

Yes

No

 

 

(Military personnel on extended active duty outside the U.S. are considered to be living in the U.S. during that period.)

 

 

 

 

 

 

 

 

NOTE: If you answered "No" , you are not able to qualify for the earned income credit (skip Part II and Part III).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Form 8879 Information

 

 

 

 

 

 

 

 

 

 

 

 

( 1 )

= Check mailed from IRS

( 4 )

= Balance Due

 

 

Tax Payer's PIN

Spouse's PIN

 

(

2

)

= Direct Deposit to TP's Acct.

( 5 )

= RAC (14 Days) *

 

 

 

 

 

 

(

3

)

= RAL (2 Days) *

 

 

 

 

 

 

 

 

 

* Please complete Pg. 6 - FINANCIAL PRODUCTS if selected.

 

 

 

 

 

 

 

 

 

 

 

 

 

Was the return prepared by the Taxpayer (self-prepared)?

Yes

No

 

 

 

Was the return prepared by an external Paid-Preparer?

Yes

No

 

 

TAXPAYER QUESTIONNAIRE REVIEW

The above information is true and correct, and I / we understand that the information given on this questionnaire will be used to complete my

/our 2011 tax return(s). I / We agree to hold this company harmless for any errors that they may make on my / our tax return. I / We also understand that error on my / our return will cause a delay in the processing of the return and the receipt of the refund, if any.

Customer Signature:

 

Date:

Spouse Signature:

 

Date:

Page 5

FINANCIAL PRODUCTS

Complete the following if refund type is a RAL or RAC

Identification Information: Bank Products require at least 1 of the following forms of ID

 

Drivers License

DMV/BMV State ID

Military ID

US Passport/Resident Alien ID

Matricular Consular

 

 

Taxpayer

ID NUMBER___________________ STATE___________________ EXP. DATE___________________

Spouse

ID NUMBER___________________ STATE___________________ EXP. DATE___________________

RAL Application Information:

If filing a joint return, who is borrower? T = Taxpayer Only; S = Spouse Only; B = Both Taxpayer & Spouse

RAL Application Military Personnel Questions:

Is the taxpayer a regular or reserve member of the Army, Navy, Marine Corps, Air Force or Coast Guard, serving on active

duty under a call or order that does not specify a period of 30 days or fewer?Yes

I am a dependent of a member of the Armed Forces on active duty as described above, because I am the member's spouse, the member's child under the age of eighteen years old or I am an individual for whom the member provided more than

one-half of my financial support for 180 days immediately preceding today's date.

Yes

No

No

With the IRS removing the Debit Indicator (DI), there is a chance that a RAL can be declined.

Some reasons for not getting a RAL are:

1.IRS says you owe back taxes

2.IRS says you have a current garnishment

3.Your tax return meets a certain profile that the bank finds unfavorable

4.IRS is auditing your Earned Income Credit

5.Earned Income Tax Credit (EITC) is claimed and an EITC qualifying child is a foster child

6.Dependent different from last year's return

7.Primary taxpayer is less than 18 years old

8.Refund amount minus EITC is less than $0

9.Refund amount is greater than $9999.99

10.You have an outstanding debt with any bank that provides RALs

PLEASE NOTE - WE DO NOT HAVE ANY CONTROL OVER THE ABOVE REASONS!

Taxpayer Initial _______________

Spouse Initial _______________

I understand that all information I have provided on this form is true. If any of this information is incorrect, I understand that a formal letter will be sent by the bank if I am denied for a RAL

In addtion, I understand that my refund may be provided to me in more than 1 check.

 

Taxpayer Signature:

 

 

Date:

 

 

 

Spouse Signature:

Date:

 

 

 

 

 

 

 

 

 

FOR OFFICE USE ONLY

 

 

 

 

Process Checklist (to be included in customer file)

 

 

 

Make copies of form of ID and Social Security cards

Interview sheet filled out

One copy of tax return, W-2s and/or 1099 (Taxpayer & Spouse, if applicable)

Signature on 8879/Pin # and Bank application

Page 6

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As for the fields of this precise form, here is what you should consider:

1. Before anything else, once filling out the taxpayer questionnaire taxes, beging with the part that features the following blanks:

Stage # 1 for submitting taxpayer questionnaire forms form

2. Right after filling in this step, go to the subsequent step and enter the essential details in all these blanks - First Name, SSN, Home Phone, Occupation, Spouse, Last Name, Birthdate, Work Phone, Dependant on another return, Address, Spouses PIN, Cell Phone, Yes No, Legally Blind, and Disabled.

Step # 2 in submitting taxpayer questionnaire forms form

A lot of people generally get some points incorrect while filling in Occupation in this area. Don't forget to re-examine everything you type in here.

3. This next step is going to be hassle-free - complete all of the blanks in First Name, Last Name, Birthdate, SSN, Relationship, Months, Dep Code, EIC, Children who lived with you and, Enter the dependents name, E Eligible as of December under, EIC Codes, Child Tax and Earned Income Credit, Number of Children under age CTC, and Number of Children under age EIC to finish this process.

EIC Codes, Birthdate, and First Name of taxpayer questionnaire forms form

4. This next section requires some additional information. Ensure you complete all the necessary fields - Total Amount Paid, Number of Children Totally, Include Form Information to, A If married did both Taxpayer and, B If no to A was Taxpayer or, If no to A and B this return is, Care Provider Information, Yes No, Number Cared for, Yes No, No Yes Disabled Yes Student, Name, Address, Name, and Address - to proceed further in your process!

taxpayer questionnaire forms form conclusion process outlined (stage 4)

5. To finish your form, this particular part involves several additional blank fields. Filling in Page should conclude the process and you'll be done very fast!

A way to fill out taxpayer questionnaire forms form step 5

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