Drop Of Document Checklist
Welcome to H&R Block! To beter serve you and meet youR tax preparaion expectaions, we ask that you take a few minutes to ill out the informaion below. If you have any quesions while compleing this form, please do not hesitate to ask.
Three Easy Steps to Complete:
1.Fill out this form to the best of your knowledge.
2.You can choose to leave this form and your tax documents with the Client Service Professional at the front desk or you can choose to have a 10-15 minutes meeing with your tax professional.
3.Ater your tax return is ready, you can come back in to the oice to complete it, or choose our Approve Online opion to inish your return online.
• Are you a returning H&R Block Client? Y N
•If yes, do you have a preferred Tax Professional? (please provide name) _______________________________________
•What date would you like for your return to be ready? (typical turnaround is 3 days): ____________________________
Client Informaion:
Primary Taxpayer Name:__________________________ |
Spouse Name: __________________________________ |
Date of Birth: __________________________________ |
Spouse Date of Birth: ____________________________ |
Social Security # or ITIN: __________________________ |
Spouse Social Security # or ITIN:____________________ |
Marital Status: Single, Married, or Widowed |
Occupaion:____________________________________ |
Occupaion:____________________________________ |
Address (if diferent): ____________________________ |
Address: ______________________________________ |
______________________________________________ |
City, State, Zip:__________________________________ |
Best Phone Number:_____________________________ |
Preferred Contact Method: Email or Phone |
Email:_________________________________________ |
Best Phone Number:_____________________________
Email:_________________________________________
• |
Can you be claimed as a dependent by someone else? Y |
N |
• |
Are you an acive member or the spouse/dependent of an acive member of the military? Y N |
• |
Would you like to donate $3 to the presidenial campaign fund? |
Y N |
Dependents* (or person living in your household)
Social Security # or ITIN
*If any dependents listed did not live at the primary taxpayers address the enire year, please discuss this with your tax professional. This is criical to help us help you accurately report your residency and dependency to the tax authoriies.
6895
Drop Of Document Checklist
Document Checklist
Income: Check all that apply and include requested documents, if available
Income From: |
Yes |
|
Yes |
Employer (W-2) |
|
Self-Employment* |
|
|
|
|
|
Interest (1099-Int) |
|
Social Security/Reirement |
|
|
|
|
|
Dividends (1099-Div) |
|
Rental Property* |
|
Stock or Mutual Fund sale (1099-B) |
|
Unemployment |
|
|
|
|
|
Expenses: Check all that apply and include requested documents, if available |
|
|
|
|
Expenses From: |
Yes |
|
Yes |
|
|
|
|
Self Employment* |
|
Un-reimbursed by your employer |
|
Educaion |
|
Rental Property* |
|
|
|
|
|
Medical/Dental care |
|
Union Dues |
|
|
|
|
|
Credits and Deducions: Check all that apply and include requested documents, if available |
Did you or your spouse: |
Yes |
|
Yes |
|
|
|
|
Donate cash or goods to a charity? |
|
Pay Student Loan interest? |
|
|
|
|
|
Pay Child/Dependent Care expense? |
|
Have a Mortgage Payment? (1098) |
|
|
|
|
|
Make an IRA Contribuion |
|
Make a major taxable purchase? |
|
|
|
|
|
Pay Property Taxes? |
|
|
|
|
|
|
|
Miscellaneous*: Check all that apply |
|
|
|
|
|
|
|
Did you or your spouse: |
Yes |
|
Yes |
|
|
|
|
Sell a home? |
|
Take an IRA or 401(k) distribuion? |
|
|
|
|
|
Pay/Receive alimony? |
|
Adopt a child? |
|
|
|
|
|
Sufer catastrophic loss? |
|
Have gambling winnings/losses? |
|
|
|
|
|
*If this applies, we recommend you meet with your tax professional to discuss your tax situaion before dropping of your informaion.
Tax Professional or Client Service Professional Complete the secion below:
Legal Disclaimers
Client received Privacy Policy, Consent to Use and Consent to Disclose Service Provider documents, and the documents were explained and executed as applicable. Y N
Did the client review and sign the Client Service Agreement? Y N
Follow Up
How would the client like to review and approve their tax return?
•H&R Block Tax Oice – Appointment ime and date: ________________________________
•Approve Online: (Refund Anicipaion Loans and Emerald Card not available with this opion)
Tax Pro: If Approve Online is selected, you must verify Taxpayer and Spouse (if applicable) Ideniicaion
Taxpayer ID Type:_______________Exp. Date: __________
Place of Issuance, if any ____________________________
Date of Issuance, if any _____________________________
6895
Spouse ID Type:_________________Exp. Date: _________
Place of Issuance, if any ____________________________
Date of Issuance, if any _____________________________
DOP12006