Tax Questionnaire 2021

Tax Questionnaire 2021

Required – Complete, sign and return.

At a minimum, we ask that you complete this brief tax questionnaire and return to us in an envelope along with your PAPER TAX FORMS AND ANY OTHER PAPER DOCUMENTS. We will return all documents to you.
Please return no later than April 15th , 2021.

Step 1 of 10

  • Personal Information

  • *If Yes to any questions, please provide us with any related tax forms & details.

Tax Form Reference Guide

Please send us all tax forms you receive. Send us your original paper forms.

Income/DeductionTax Form
WagesForm W-2
Interest and DividendsForm 1099-INT and 1099-DIV
Sales of Stocks, Securities, Capital AssetsForm 1099-B
Miscellaneous IncomeForm 1099-MISC and 1099-NEC
Retirement/Pension DistributionsForm 1099-R
Pass-Thru Income (LLC’s, S Corp., Partnership, Trust, Estate)Schedule K-1
Unemployment CompensationForm 1099-G
Social Security IncomeForm SSA-1099
Mortgage InterestForm 1098
Health Savings Account (HAS or MSA)Form 1099-SA and 5498-SA
Healthcare Coverage or InsuranceForms 1095-A
Student Loan InterestForm 1098-E
TuitionForm 1098-T

Now Offering Refund Advance Loans!*

$150, $500, $1,000
NO FEE** 0.0%APR

$1,250-$6,000
Additional fees apply

*The Refund Advance is an optional tax-refund related loan provided by MetaBank, N.A., Member FDIC (it is not the actual tax refund) at participating locations. The amount of the loan and applicable interest will be deducted from tax refunds and reduce the amount that is paid directly to the taxpayer. Fees for other optional products or product features may apply. Tax returns may be filed electronically without applying for this loan. Loans offered in amounts of $150, $500, and $1,000 have an Annual Percentage Rate (APR) of 0.00%. Loans in the amounts of 25%, 50%, or 75% of our expected tax refund have an APR of 36.0% with a minimum loan of $1,250. For example, $2,500 loan representing 50% of expected refund borrowed over 29 day term, total amount payable in a single payment is $2,571.51 including interest. Availability is subject to satisfaction of identity verification, eligibility criteria, and underwriting standards.
**Certain Refund Advance Loans are available at no cost to taxpayer, however other options include a consumer fee.