Questionnaire (For US)

• Married
• Not married
• Divorced

Tax filing status *SingleMarried Filing JointlyMarried Filing SeparatelyOtherName *FirstLastEmail *SSN *First time tax filing? *

• Yes
• No

Visa type *Visitor VisaStudent visaWork VisaGC/CitizenSpouse Name *FirstLastSpouse Email *Spouse SSN Dependant 1 NameDependant 1 SSN Your Relationship with Dependant 1 *Dependant 2 NameDependant 2 SSNYour Relationship with Dependant 2 *Dependant 3 NameDependant 3 SSN Your Relationship with Dependant 3 *Dependant 4 Name Dependant 4 SSN Your Relationship with Dependant 4 *Dependant 5 NameDependant 5 SSN Your Relationship with Dependant 5 *Dependant 6 NameDependant 6 SSN Your Relationship with Dependant 6 *Dependant 7 NameDependant 7 SSNYour Relationship with Dependant 7 *Dependant 8 NameDependant 8 SSNYour Relationship with Dependant 8 *Dependant 9 NameDependant 9 SSNYour Relationship with Dependant 9 *Dependant 10 NameDependant 10 SSNYour Relationship with Dependant 10 *Did you/spouse live in Multiple states? *

• Yes
• No

1. Name of State lived in *2. Name of State lived in3. Name of State lived in4. Name of State lived in 5. Name of State lived in 6. Name of State lived in7. Name of State lived in 8. Name of State lived in 9. Name of State lived in10. Name of State lived inDid spouse live with you in the US at any time in the year? *

• Yes
• No

Did you/spouse have any income in US? *

• Yes
• No

Income Type

• Employed
• Self employed
• Property income
• Capital gains

Choose *Cab DriverFood DeliveryContracting WorkerOtherHow many income properties *Description of capital gains *Did you/spouse have any income from outside US? *

• Yes
• No

Please Specify type of income & Country name *Did you/spouse do FBAR/FATCA reporting in 2022 tax filing? *

• Yes
• No

Select the options applies to you/spouse

• Had any employment income (Attach W2)
• Had any income from Partnership/S Corp/Trusts/Estates (Attach K-1)
• Earned income from Investments, Stocks or Crypto? ( Other than Roth IRA) (Attach 1099-INT, 1099-DIV, 1099-B or 1099-S)
• Sold real estate property (Contact us)
• Did have contracting income/freelance income (Attach 1099- Misc, 1099-NEC and other 1099 forms)
• Did you withdraw from 401K/457/Traditional IRA (Attach 1099-R)
• Incurred Medical expenses (Attach receipts)
• Paid for private health insurance (Attach 1095-A, 1095-B, or 1095-C)
• Contributed to HSA or MSA (Attach receipts)
• Contributed to 401K/457/IRA plans (Attach receipts )
• Paid college fee for self or dependant (Attach 1098-T, 1098-E and receipts)
• Incurred child care expenses (Attach receipts)
• Paid mortgage interest (Attach 1098)
• Paid property taxes (Attach receipts)
• Did charitable contributions (Attach receipts)

Do you want to enroll your bank account with IRS/State for Auto deposit? *

• Yes
• No

Bank Name *Account number *Routing Number *CommentsTerms and Conditions *

• I hear by declare that the above information is true to the best of my knowledge and I give my consent to Anumandla Accounting Inc. to read and retain the above information. *

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