Tax Service Client Information Sheet

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ProSeries Updated _______/_____
Date
By
Client Code:
H & R Pye’s Tax Service
P.M. Updated:
__________/___
Client Information Sheet
Date
By
Date: _________________________
Client: __________________________________________________________ SS#__________________________ DOB__________
Spouse: _________________________________________________________ SS#__________________________ DOB__________
Who are you claiming:
Dependent 1:____________________________________________________ SS#__________________________ DOB__________
Dependent 2:____________________________________________________ SS#__________________________ DOB__________
Dependent 3:____________________________________________________ SS#__________________________ DOB__________
Dependent 4:____________________________________________________ SS#__________________________ DOB__________
Home Phone: __________________________ Home Address: _________________________________________________________
Mailing Address: ______________________________________________________________________________________________
Employer: Client: _____________________________________ Spouse: ________________________________________________
Occupation: Client: ____________________________________ Spouse: ________________________________________________
Work Telephone: Client: ________________________________ Spouse: ________________________________
Cell Phone: Client: _____________________________________ Spouse: ________________________________
E-mail: Client: _______________________________________________ Spouse: ___________________________________________
Client
Spouse
Do you have a will?
Yes ______ No _______
Yes ______ No _______
Are you concerned about Nursing Home Expenses?
Yes ______ No _______
Yes ______ No _______
Do you currently have investments?
Yes ______ No _______
Yes ______ No _______
If yes, investment company
Do you currently have a retirement plan?
Yes ______ No _______
Yes ______ No _______
If yes, investment company
Do you have life insurance
Yes ______ No _______
Yes ______ No _______
Bank Information for Electronic Filing of Tax Return
(we will need proof of account information)
Name of Bank ______________________________________ NOTE: If same as last year, simply write “on file”
Routing #: _________________________________________ Acct # ___________________________ Checking ____ Savings____
New Clients
How did you get our name? ______________________________________________________________________________________
File name: \\Pyeserver\d\My Documents-Tax Masters\Tax Masters– Client Information Sheet
Revised 10/20/2011

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