Smartaxx

Customer Details:

Smartaxx Attestation Form
Thank you for Choosing Smartaxx! We have a total of 26 years of experience and we are excited to offer you great customer service. Please complete the form below.
Full Name *

First Name Last Name
Occupation and DOB *

Occupation Date of Birth
Address (one person can file head of household at an address) (more than one can file single) *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
Secondary Phone Number *

Area Code Phone Number
E-mail
How did you hear about us? *
Other *
Who would you like to prepare your return? Put anyone if it does not matter *
How much you received on your 1st stimulus only? *
How much you received on your 2nd stimulus only? *
Did you receive unemployment? *
File Status: Married filing Joint, Single, Head of House Hold
Do you owe any debt that could possibly affect your refund? If so, Explain

Please list Dependents

First Name

Middle name

Last name

Date of Birth

Relationship

Dependent 1

Dependent 2

Dependent 3

Dependent 4

License or ID

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Cancel of
Social Security Card

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Cancel of
Social Security Cards for Dependents

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Cancel of
W2 info or 1099 contractor

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Cancel of
Mortgage info

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Cancel of
Student 1098t

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Cancel of
Utility Bill

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Receipts, Tag info, Medical info, extra

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Birth Certificates for Dependents

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Please take a Selfie and attach

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Please attach important unemployment pay out off portal or mailed to you

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Please give us two people you want to refer to gain up to $100

First Name

Contact Number

Routing and Account Number

Bank info below

Account #

Routing #

Customer Details: