Tax Application

APPLICATION

Tax Application

PRIMARY APPLICANT

Today's Date

First Name

Middle Name

Last Name

Primary Phone

Secondary Phone

Date of Birth

Address Line 1

Address Line 2

City

State

Zip Code

Country

Birth State

Gender

Immigration Status

Social Security #

Filing Status

Individual Tax Credits

Deductions

NUMBER OF DEPENDENTS

Dependant One

First Name

Last Name

Social Security #

Immigration Status

Date of Birth

Dependant Two

First Name

Last Name

Social Security #

Immigration Status

Date of Birth

Dependant Three

First Name

Last Name

Social Security #

Immigration Status

Date of Birth

Dependant Four

First Name

Last Name

Social Security #

Immigration Status

Date of Birth

Dependant Five

First Name

Last Name

Social Security #

Immigration Status

Date of Birth

If filing jointly, spouse information:

First Name

Middle Name

Last Name

Birth State

Spouse Phone Number

Social Security #

Network Agreement

I understand that this is not a government agency. I authorize Eltine Multiservices to file my taxes. I hereby certify that, to the best of my knowledge, the provided information is true and accurate. *

Confirmation

About Us

ELTINE MULTI SERVICES is primarily a financial service company helping you and your family with planning and choosing proper plans that can keep their lives sustainable.

Our services include Life Insurance, Health Insurance, [we mainly specialized in Obamacare], Car Insurance, Will and Testimony, Investment, and College Planning.

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TAX APPLICATION

APPLICATION

PRIMARY APPLICANT

NUMBER OF DEPENDENTS

Dependant One

Dependant Two

Dependant Three

Dependant Four

Dependant Five

If filing jointly, spouse information:

Network Agreement

About Us

Services

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