Shoebox Client Data Sheet

Taxpayer Name________________________________________ Spouse Name____________________________________________

SSN:______________________ Birthdates: _______________ SSN: _________________________ Birthdate: _____________________

Occupation: ____________________________ Occupation: _____________________________

Address: ____________________________________________City:__________________________ State: ______ Zip: _________________

Phone (Day) ___________________________________ Phone (Eve) _______________________________

E-mail Address: (Optional) _________________________________________________________________

Filing Status: ____Single ____Married filing Jointly ____Married filing Separate _____Head of Household

Dependents: (List Youngest First) Month, Day & Dependent’s Relationship to Months Lived in Your
Name(First, Initial and Last Name) Year of Birth SSN You Home

CHECK ALL THAT APPLY

Someone else can claim you as a dependent.
You and your spouse lived apart during the year.
You paid estimated Federal or State taxes last year. Federal $_________State____ State $________
You itemized last year. If yes, amount of Refund from / Balance Due to State $________________
You or your spouse were a resident of another state or earned income in another state during the last year.
You use your personal vehicle for work and were not reimbursed (excluding commuting).
You paid state and local real estate taxes.

Would you like your refund deposited into your bank account (not available for RAL Advance) ___YES ___NO

Routing Number_________________________Account Number__________________________________

Shoebox Accounting & Bookkeeping Service Guarantee

 SATISFACTION GUARANTEE – We guarantee our service 100%.
 ACCURACY GUARANTEE – We will give you the most accurate return and the largest possible refund.
 FREE CONSULTATION – We offer you a 30 minute consultations FREE to discuss your needs & our
services with Shoebox Accounting & Bookkeeping.
 AUDIT ASSISTANCE – If the IRS audits you for items we prepared for you, we will be happy to assist.
 CORRESPONDENCE ASSISTANCE – We will help you handle your IRS correspondences &
recommend a tax attorney if you should need one.
I certify that I would like to have my Accounting & Bookkeeping Services prepared according to the information I have supplied.

`Taxpayer’s Signature________________________________________________________ Date________________________________

Spouse’s Signature__________________________________________________________ Date________________________________