Personal Tax Questionnaire

Tax Questionnaire - General Information

Thank you for taking a few minutes to provide some valuable information to help ensure this year's tax preparation is a breeze. We are very excited to be working with you, and never hesitate to reach out with any questions.

1. What is your filing status for 2021? *This question is required.

In order to file as Head of Household (HOH), please ensure you meet the following criteria:

You paid for more than half of the household expenses
You must be considered unmarried for the tax year
You must have a qualifying child or dependent
- The qualifying child or dependent must have lived within your home for more than 6 months during the year
- As of the end of the tax year, the child must be under 19 if he/she is not a student, or under 24 if he/she is a full-time college student
- The child must not have paid for more than half of his/her living expenses during the tax year

If you chose Married Filing Separately (MFS), will Journey Advisors & CPAs, PLLC be preparing your spouse's tax return for 2021? *This question is required.

Please share the link to this survey with your spouse (if they haven't already completed), or provide their e-mail address and we will send a link directly to them. *This question is required.

Please enter an 'other' value for this selection.

Please explain why you are unsure:

2. Please provide the following information for the TAXPAYER:

Legal First Name (Full) *This question is required.

Middle Initial

Legal Last Name *This question is required.

Date of Birth (MM/DD/YYYY) *This question is required.

Street Address *This question is required.

Apt/Suite/Office

City *This question is required.

State *This question is required.

Zip *This question is required.

Occupation *This question is required.

Best Email Address to contact you (for follow-up questions, as necessary) *This question is required. This question requires a valid email address.

Best Phone Number to contact you, with area code (for follow-up questions, as necessary) *This question is required.

Valid driver's license or state-issued ID? (Yes/No) *This question is required.

Please provide the following information for the SPOUSE:

Legal First Name (Full) *This question is required.

Middle Initial

Legal Last Name *This question is required.

Date of Birth (MM/DD/YYYY) *This question is required.

Street Address *This question is required.

Apt/Suite/Office

City *This question is required.

State *This question is required.

Zip *This question is required.

Occupation *This question is required.

Best Email Address to contact you (for follow-up questions, as necessary) *This question is required. This question requires a valid email address.

Best Phone Number to contact you, with area code (for follow-up questions, as necessary) *This question is required.

Valid driver's license or state-issued ID? (Yes/No) *This question is required.

Who will be the primary contact (list name) for communications going forward? (This will be the person who receives the e-mail notifications from the Secure Portal as we begin to exchange information) *This question is required.

3. What was your State of residence for 2021? *This question is required.

4. Did anyone in the household live or work in another State during 2021? *This question is required.

Please enter an 'other' value for this selection.

Please briefly describe the details related to the above question (State, dates, nature, etc.): *This question is required.

5. If you resided in California, Massachusetts, New Jersey, Rhode Island, Vermont, or Washington D.C., did all members of the household have healthcare coverage during 2021? *This question is required.

Please describe the period for which you were/were not covered during 2021 *This question is required.

How was your healthcare coverage provided? *This question is required.

Please enter an 'other' value for this selection.

6. How many children (or others) are you claiming as dependents during 2021? *This question is required.

Did you receive any advanced Child Tax Credit payments in 2021?
*This question is required.

Please provide relevant details, including total amount received and number of dependents claimed:
(The IRS will issue a form called 'Letter 6419'; please provide once received) *This question is required.

How many children (or others) are you claiming as dependents during 2021? *This question is required.

For DEPENDENT #1, please provide the following information: *This question is required.

	First Name (Full)
	Middle Initial
	Last Name
	Relationship to Taxpayer
	Date of Birth
	# of Months in Home

For DEPENDENT #2, please provide the following information: *This question is required.

	First Name (Full)
	Middle Initial
	Last Name
	Relationship to Taxpayer
	Date of Birth
	# of Months in Home

For DEPENDENT #3, please provide the following information: *This question is required.

	First Name (Full)
	Middle Initial
	Last Name
	Relationship to Taxpayer
	Date of Birth
	# of Months in Home

For DEPENDENT #4, please provide the following information: *This question is required.

	First Name (Full)
	Middle Initial
	Last Name
	Relationship to Taxpayer
	Date of Birth
	# of Months in Home

For DEPENDENT #5, please provide the following information: *This question is required.

	First Name (Full)
	Middle Initial
	Last Name
	Relationship to Taxpayer
	Date of Birth
	# of Months in Home

For DEPENDENT #6, please provide the following information: *This question is required.

	First Name (Full)
	Middle Initial
	Last Name
	Relationship to Taxpayer
	Date of Birth
	# of Months in Home

For DEPENDENT #7, please provide the following information: *This question is required.

	First Name (Full)
	Middle Initial
	Last Name
	Relationship to Taxpayer
	Date of Birth
	# of Months in Home

For DEPENDENT #8, please provide the following information: *This question is required.

	First Name (Full)
	Middle Initial
	Last Name
	Relationship to Taxpayer
	Date of Birth
	# of Months in Home

For DEPENDENT #9, please provide the following information: *This question is required.

	First Name (Full)
	Middle Initial
	Last Name
	Relationship to Taxpayer
	Date of Birth
	# of Months in Home

For DEPENDENT #10, please provide the following information: *This question is required.

	First Name (Full)
	Middle Initial
	Last Name
	Relationship to Taxpayer
	Date of Birth
	# of Months in Home

7. Have you had any communications with the IRS or any other taxing authority throughout 2021 and up until now? *This question is required.

Please enter an 'other' value for this selection.

8. Did you change your marital status during 2021? *This question is required.

Please enter an 'other' value for this selection.

9. Were there any births or deaths in your household during 2021? *This question is required.

Please briefly describe: *This question is required.

Did any of your dependent children age 18 or younger (or under age 24 if a college student) have income (wages, interest, etc.) during 2021? *This question is required.

Please enter an 'other' value for this selection.

10. Did you PURCHASE any real estate during 2021? *This question is required.

Please briefly describe the specifics: *This question is required.

11. Did you SELL any real estate during 2021? *This question is required.

Please briefly describe the specifics: *This question is required.

12. Did you give a gift to an individual during 2021 of an amount greater than $15,000? *This question is required.

13. Do you anticipate any major life changes in 2022? *This question is required.

Retirement
Income changes
Dependent change
Marital status
Other Please enter an 'other' value for this selection.
None

Please briefly describe: *This question is required.

14. Did you (and your spouse, if applicable) receive Economic Impact Payments (aka "stimulus' or 'relief' payments) during 2021 in conjunction with the provisions of the CARES Act passed by Congress?
(Please note: these payments are not taxable, but may be needed for reporting.) *This question is required.

Please list how much was received and if there are other relevant details.
(The IRS will send you a form called 'Letter 6475'; please provide once received) *This question is required.

15. Any other comments, questions, or information we should know?

Personal Tax Questionnaire - 2021

Tax Questionnaire - General Information