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Taxes





Tax Application

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    Personal Information

    In case your contact information changes; we can contact you regarding your refund.

    YesNo
    YesNo
    YesNo
    Self-EmploymentW-2
    YesNo
    YesNo
    YesNo
    YesNo
    Dep 1Dep 2Dep 3All Deps
    Dependent Information

    (If you have any dependents, list them in the area below. If you have more than four dependents, list the remainder on the reverse side. If any of your dependents did not live with you in 2019, please notify your preparer.)

    YesNo
    YesNo
    Child Care Provider

    (If you paid for child care for your dependent children, list the child care providers below with the amounts paid.)

    YesNo
    YesNo
    YesNo
    YesNo
    YesNo
    YesNo
    YesNo
    YesNo
    YesNo
    YesNo
    Direct DepositCheckPre Paid Money Card

    I hereby state that the foregoing information is true and correct to the best of my knowledge and recollection and holds no bearings upon the preparer or staff of 901 Cash Express.



    ALTERNATE ELIGIBILTY RECORD (Due Diligence)

    In accordance with Internal Revenue Service (IRS) Bulletin 97-65 and Internal Revenue Code (IRC), this form serves as Alternate Eligibility Checklist, and may be used IN LIEU of other forms of Due Diligence, including form 8867. Maintain this form with your client files.

    HEAD OF HOUSEDHOLD ELIGIBILITY

    You may file Head of Household if you can answer YES to ALL the following questions. (See Publication 17, Chpt 2&3)

    YesNo
    YesNo
    YesNo

    A qualifying person requirements are: (See Table 2-1, Publication 17) 

    1. A qualifying relative such as parent, grandparent, brother, sister, stepbrother, stepsister, stepmother, stepfather, father-in-law, half-brother, half-sister, brother-in-law, sister-in-law, daughter-in-law, uncle, aunt, nephew, or niece who is related to you by blood and lived with you for the entire year.
    2. Child, grandchild, stepchild, or adopted child.
    3. Consult our clients during normal business hours of 10 a.m. to 6 p.m. (E.S.T) Monday - Friday.  
    4. Eligible foster child. (Note: For eligibility for dependent only a foster child is a child who is in your care, that you care for as your own child, and who lived with you the entire year. It does not matter how the child became a member of the household).
    EARNED INCOME CREDIT (EIC) ELIGIBILTY

    You may claim the EIC if you can answer YES to ALL 4 tests below. (See publication 17, Chapter 36)

    Relationship Test
    YesNo
    Age Test
    YesNo
    Residency Test
    YesNo
    YesNo
    Qualifying Child of another Test
    YesNo



    UPLOAD DOCUMENTS

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    Need to upload additional documents? Submit the application and on the next screen you will have to option to upload additional documents.



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