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First Name *

Middle Name

Last Name *

Address

Street Address

City

State

Country

Postal Code

Phone *

Email *

Date of birth *

Filing Status *

Preferred Method Of Contact *

Phone

Text

Full Social Security Number *

Verification - Upload State ID (Front & Back) *

Verification - Upload State ID (Front & Back)

Verification - Upload SELFIE HOLDING ID *

Verification - Upload SELFIE HOLDING ID

Are You Claiming Dependents?

Yes

Add Dependents Details

Dependent 1

D1 - Full Name

D1 - Date of Birth

D1 - Relationship

D1 - Social Security Number

Dependent 2

D2 - Full Name

D2 - Date of Birth

D2 - Relationship

D2 - Social Security Number

Dependent 3

D3 - Full Name

D3 - Date of Birth

D3 - Relationship

D3 - Social Security Number

Months Dependent Lived With You In 2025?

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Notes (Please Add Any Information We May Have Missed)

Direct Deposit Preference?

Yes

Bank Name

Routing Number

Account Number

Account Type

Checking

Savings

Prior Year Tax Return (Optional)

Consent & Agreements

Must Agree To All In Order To Proceed

I certify the Information provided is true and accurate.

I authorize Exact Tax Academy to prepare and file my return(s).

I understand that preparer fees will be deducted from my refund after the IRS has approved.

I consent to receive text/email/phone updates.

I agree to Private Policy & Engagement Terms.

Taxpayer Signature

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Date