info@regencywealthsolutions.com
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Full Name
Email Address
Phone Number
Date of Birth
Residential Address
Social Security Number
Filing Status Select Filing StatusSingleMarried Filing JointlyMarried Filing SeparatelyHead of HouseholdQualifying Widow(er)
Spouse Full Name
Spouse Date of Birth
Spouse SSN
Spouse Email
Spouse Phone
repeater_title1
SSN
Relationship
Lived with you all year? SelectYesNo
Months lived with you
Income Type Select Income TypeW-21099 NEC1099 MISC1099 KSelf EmploymentRental IncomeUnemploymentSocial SecurityRetirement IncomeOther
Upload Documents
Did you have livestock income? YesNo
Did you have crop income? YesNo
Did you receive agricultural 1099s? YesNo
Did you have other farm income? YesNo
Livestock Type Select TypeCattleGoatsSheepPoultryHogsOther
Quantity Sold
Date Sold
Income Received
Upload Sale Receipts
Crop Type Select CropCornSoybeansCottonHayVegetablesOther
Acres
Quantity Sold (bushels/pounds/etc.)
Upload Agricultural 1099s
Describe Other Farm Income
Upload Supporting Documents
Did you pay for childcare? YesNo
Upload Childcare Statements
Did you pay student loan interest? YesNo
Upload 1098-E
Did you attend school? YesNo
Upload 1098-T
Did you have medical expenses over 7.5% of income? YesNo
Did you make charitable donations? YesNo
Upload Receipts
Did you buy a home? YesNo
Upload Closing Documents
Upload 1098 Mortgage Interest
Would you like direct deposit? YesNo
Routing Number
Account Number
Account Type Select Account TypeCheckingSavings
Upload Valid ID (Driver’s License, State ID, Passport)
Upload Any Additional Tax Documents
I confirm all information provided is accurate to the best of my knowledge.
I understand incomplete documentation may delay tax preparation.
I am ready to submit my information.
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