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Dependent Infomation (Fill out entire form)

	FULL NAME	SSN/ITIN	RELATIONSHIP	MONTHS IN HOME	DATE OF BIRTH
Dependent #1
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Dependent #5

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Bank Name (For Direct Deposit of Federal and State Refunds)

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Referred By:*

File Upload (W2's, 1099, CTC Form 6419, EIP Letter 6475, Mortgage Statements, All Forms)

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File Upload (A U.S Social Security Card)

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File Upload (Please Upload 2021's Tax Return)

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State I.D (Front/Back)

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