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Birthday
Last name
Phone
Email
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Job Title / Job Position
What Is Your Filing Status?
Do You Own A Home Or Pay Mortgage?
Did You Pay For Child Care?
Did You Receive A 1095-A Medical Statement?
Do You Have Dependents?
Did You Or One Of Your Dependents Attend College This Tax Year?
Name Of Your Dependents
Bank Name (For Direct Depost Of Federal And Or State Refund)
Bank Routing Number
Bank Acct. Number
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