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ACCOUNTANT, TAX & REALTOR SOURCE INC.

Subtitle

RETURNING CLIENT Information Form

Please complete so that we have your most current information on file


First Name / Last Name_________________________________________________________________________________________________


         SS# / Date of Birth_____________________________________________ (DOD)_________________________


Spouse First Name / Last 

Name ________________________________________________________________________________________________


         SS# / Date of Birth_____________________________________________ (DOD)_________________________


Current mailing address_______________________________________________________________________________________________

Apt # _____

City /State / Zip Code ___________________________________________________________________________________________________


Cell Phone# for calls/texts_______________________________________________________


Email address_______________________________________________________________________________________


Did you receive letter from IRS regarding Advance Child Tax Payment and/or Recovery Rebate? Y____ N____


Did you pay for health insurance? Yes_ (1095A) No_ / Internet Virtual Currency during tax year? Yes ___No___


Did you donate money to charity this year? Yes _ (how much) $____or No___


Students! Scholarship amount was used for fees, books or supplies $__________________


Scholarship amount included in your W2 income $__________________

             ------------------------------------------------------------------------------------------------------------------------------------------------------


Claiming Dependents? Yes ___ or No ___ If yes, are they SAME dependents as last year? Yes ___ No___ (if no, make add or delete below)


Dependents name                                                                                  DOB & SS#                                  Relationship     #of Months   Student or

      First/Last                                                                                                                                                                            in Home       Disabled


_________________________________________        ___________________________________    ____________       _____            _____


_________________________________________        ___________________________________    ____________       _____            _____


_________________________________________        ___________________________________    ____________       _____            _____


_________________________________________        ___________________________________    ____________       _____            _____


_________________________________________        ___________________________________    ____________       _____            _____


                             *******************************************************************************************************

P.S. Don't trust one of your biggest financial decisions to a stranger, contact us for all of your real estate needs at 803.265.2771. Let the 'Team Bryant' put our trusted accounting and real estate expertise and experience to work for you.

Are you or anyone you know of going to purchasing a home or

other real estate this year?

Yes ___ or No ___


Name of referral ________________________________________________________________


Email/Phone # _________________________________________________________________