5 Starr Tax Professionals

1804-A Barataria Blvd Marrero LA 70072

504-345-2354

www.5starrtaxpros.com

Thank you for trusting us with the preparation of your tax return. It is crucial that you provide all the information requested in this form to assist our certified staff in completing your return accurately. If you have any questions, please do not hesitate to ask. Kindly ensure you have the following details ready:

Tax information such as Forms W-2, 1099, 1098
Social security cards or ITIN letters for you and all persons on your tax return.
Proof of identity (government issued photo ID such as driver's license, state ID or other photo ID).

This section pertains to information about your spouse. If you are not legally married, please skip this portion.

Spouse First Name

Spouse Last Name

Spouse SSN/ITIN

Spouse Date of Birth

Spouse Phone Number

U.S. Citizen

Yes

No

Legally Blind

Yes

No

Permanently Disabled

Yes

No

Spouse Occupation

Part 2: Dependent Information

Please provide a list of all individuals whom you supported during the last tax year, both inside and outside of your home. If you require additional space, please indicate so and use an additional page for supplementary information.

Number of Dependents *

Dependent 1

First Name
Last Name
SSN/ITIN

Date of Birth

Months Living In Home

Full Time Student

Yes

No

Daycare Expenses

Dependent 2

First Name
Last Name
SSN/ITIN

Date of Birth

Months Living in Home

Full Time Student

Yes

No

Daycare Expenses

Dependent 3

First Name
Last Name
SSN/ITIN

Date of Birth

Months Living in Home

Full Time Student

Yes

No

Daycare Expenses

Dependent 4

First Name
Last Name
SSN/ITIN

Date of Birth

Months Living in Home

Full Time Student

Yes

No

Daycare Expenses

Please provide the necessary information for any additional dependents in the space below.Additional Dependent Information

Part 3: Bank Information

Direct Deposit Information

Bank Name
9-Digit Routing Number
Bank Account Number

Select Account Type

Checking

Savings

Upload all supporting documents sign, and hit submit located at the end.

Upload Documents

Signature *

Clear

Spouse Signature

Clear

Date *

STOP

Only answer the next set of questions if you are self-employed. If not slide to the end and hit Submit.

5 STARR TAX PROFESSIONALS

Sole Proprietor Information Sheet

Business Name

I certify that I incurred the following expenses and received the revenue for tax year

Total Revenue

Expenses

Advertising
Bad Debts
Commissions Paid
Fees Paid
Depletion
Depreciation/Section 179
Insurance (other than health)
Mortgage Interest
Other Interest
License
Professional Services
Payments Legal Services
Office Expenses
Phones
Business Line
Cellular
Pager
Rent
Vehicle
Machinery
Equipment
Other Business Rent
Supplies
Taxes
Real Estate
Personal Property
Employee
Other
Travel
Meals/Entertainment (enter total, 50% deductable)
Wages
Pension and Profit Sharing

Additional Expenses

Cost of Goods Sold
Beginning Inventory
Purchases
Personal Use Total
Other Costs
Ending Inventory
Equipment Purchased or Sold (List)
Car Expenses
Mileage
Commuting
Other
Actual Expenses
Gas
Oil
Tires
Repairs
Tolls/Parking

Supporting Documents

Signature

Clear

Date