3275 Snapfinger Rd Lithonia, GA 30038
MTS INFORMATION SHEET
DATE OF BIRTH
HEALTH INSURANCE COVERAGE
SPOUSE SOCIAL SECURITY
(choose which applies):
Married Filing Separately
Married Filing Jointly
Head of Household
Qualifying window(er) with dependent
Can you or your dependents be claimed as a depender on another return?
Do you have any outstanding debts (child support, IRS, Banks, Santa Barbara):
I attest that all the above information is correct and was provided voluntary. In additional, none of the above information was by any fashion, shape, or form aided by of Magic Tax Solution (MTS) prepares. Therefore, I agree to release Magic Tax Solution (MTS) of any liability that may incur from the above information.
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