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Please complete using your name, spouse’s name, and dependent(s) as it is written on your social security card. IF you have a different name than what appears on your card, please indicate the reason for the change (I.E. Marriage, Divorce)

Your information will be saved as you fill in so you can easily come back to this page to complete.

First Name *

Middle Initial *

Last Name *

Phone *

Email *

Did you file with us last tax season? *

Occupation

Date of Birth

Social Security Number

Do you have multiple years to file?

Glad to see you again. We have shortened the process to keep it easy for you.

Has your address changed since last year?

Has your filing status changed?

Any changes to your dependents?

Any job changes for you or your spouse?

Do you want to use the same bank account for direct deposit?

Home Address

Let's make sure we have the right home address on file for you.

Street Address

City

State

Zip code

Mailing Address (if different)

How long have you been at your current address?

Filing Status

Spouse's Information

Spouse's Full Name

Spouse's Phone Number

Spouse's Email

Spouse's Date of Birth

Spouse's Driver's License

License or Government ID

Spouse's Social Security Number

Spouse's Occupation

Are you claiming any dependents?

DEPENDENT(S) if applicable

We have left space for up to 4. We will follow up with you if you mention that you have more after submitting. Again please leave blank and click next if you have no dependents.

Dependent 1 Name

Dependent 1 Relation

Dependent 1 Gender

Dependent 1 Date of Birth

Dependent 1 SSN

Dependent 1 Social Card

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Dependent 2 Name

Dependent 2 Relation

Dependent 2 Gender

Dependent 2 Date of Birth

Dependent 2 SSN

Dependent 2 Social Card

Upload image

Dependent 3 Name

Dependent 3 Relation

Dependent 3 Gender

Dependent 3 Date of Birth

Dependent 3 SSN

Dependent 3 Social Card

Upload image

Dependent 4 Name

Dependent 4 Relation

Dependent 4 Gender

Dependent 4 Date of Birth

Dependent 4 SSN

Dependent 4 Social Card

A little more about you...

Answer the following by selecting the correct option in the drop down provided.

Do you own a business? *

Do you own a personal home? *

Do you own a rental property? *

Do you have an IRS Identity Pin Number? *

Are you a student? *

What school did you attend?

Can anybody else claim you as a dependent? *

Are any of your dependents in school for year 2025? *

Did you have healthcare coverage? *

Did you receive a 1095A?

Do you have IRS/State debt obligations? *

Do you wish to receive Audit Protection Coverage? ($125 additional filing fee) *

Are you applying for the TAX ADVANCE LOAN? *

Do you want to apply for the HOLIDAY LOAN? (Up to $1,500 advance on your taxes) *

Chose method of payment: *

PLEASE submit the following:

Bank Name

Routing Number

Account Number

Please use this next section to upload a copy of the required documents to complete your filing process:

Government ID *

Social Security Card *

W2, 1099, or Last Paystub *

If you do not have one of those, please provide any additional supporting documents such as invoice payment or bank statement will suffice for now.

Did you work more than one W2 or 1099 job? *

W2, 1099, or Last Paystub (Job 2)

W2, 1099, or Last Paystub (Job 3)

W2, 1099, or Last Paystub (Job 4)

1095 A

Medical if you have

1098 for Rental Property

1099-NEC (Non-Employee Compensation)

1099-R (Retirement Distributions)

1098 Mortgage Interest

1098-T Education Credits

Any Additional Tax Document

ACKNOWLEDGEMENT OF SERVICES CONSENT

I HAVE ALLOWED HEAD START TAX SERVICE TO PREPARE MY FEDERAL AND STATE TAX RETURN. ALL DOCUMENTATION GIVEN BY ME TO HEAD START TAX SERVICE TO PERFORM ITS SERVICES IS TRUE AND ACCURATE INFORMATION. I HAVE BEEN PROVIDED THE PROPER KNOWLEDGE AND INFORMATION IN REFERENCE TO MY TAX RETURN. I FULLY UNDERSTAND THE FEES THAT I HAVE BEEN CHARGED, THE PROCESSING TIME IN WHICH IT TAKES TO RECEIVE MY RETURN, THE FEDERAL AND STATE GUIDELINES IN WHICH THIS OFFICE MUST OPERATE UNDER THAT HAS BEEN SET FORTH AND MANDATED BY THE GOVERNMENT, AND THAT ALL RETURNS ARE BASED UPON IRS APPROVAL.

I HAVE SIGNED AND RECEIVED A COPY OF MY FEDERAL AND STATE RETURN. I HAVE BEEN PROVIDED WITH PROPER CONTACT INFORMATION IF I SHOULD HAVE ANY FURTHER QUESTIONS OR CONCERNS ABOUT MY TAX RETURN.

Signature *

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Consent *

I Consent to Receive SMS Notifications, Email Notifications, Alerts & Occasional Marketing Communication from Head Start Biz Solutions. Message frequency varies. Message & data rates may apply. Text HELP to (757) 993-4334 for assistance. You can reply STOP to unsubscribe at any time.

Choose your tax preparer *

Did anyone refer you to us this tax year?

Name of Referrer (if applicable)

Comments/Questions

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