Name:   

Social Security Number:

Occupation:

U.S. Home of Record:

Date of Birth :   

Address Overseas:

Work Phone:

Home/Cell Phone:

e-mail:

Spouse's Name:

Spouse's SSN/ITIN:

Spouse's Occupation:

Spouse's U.S. State of Residence:

Spouse's Date of Birth:   

Marital Status

Dependent Information:

Number of dependents :   

Names of Dependents, Relationship, SSN/ITIN, Date of Birth and Citizenship:

* Important:

Income Information:

How many jobs did you and/or your spouse have last year?

Do you have a W-2 for each job held?

Were any of your jobs with a government contractor or Foreign company?

Were you or your spouse self-employed (including home child care)?

Do you have any retirement income (including Social Security)?

Investment Information:

Did you earn any interest on savings accounts during the year?

Do you have any accounts at a foreign bank?

Did you invest in a mutual fund or hold stock for any company?

Do you have an IRA?

General Information:

Did you pay for child care while you went to work or to school?

Did you have any education expenses or make student loan payments?

Do you own a home?

Filing Information:

If you receive a refund do you want it deposited into a bank account?

Additional Comments:

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