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Tax Form
Contact Us

(415) 307 - 7563

reachus@moonlighttaxservices.com

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About Us
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Tax Form
Contact Us

We are the Right Experts to Solve Your Tax Challenges

Tax Form

CLIENT INFORMATION

Full Name*

Prefix First Middle Last

Date of Birth*

Month

Day

Year

Gender*

Occupation*

Social Security Number (SSN)*

Email Address*

Phone*

Mailing Address*

Street Address City State / Province / Region ZIP / Postal Code

Preferred Contact Method*

Phone Call

Email

Text/SMS

Filing Type*

New Client

Returning Client

Filing Status*

Single

Married Filing Jointly

Married Filing Separately

Head of Household

Qualifying Widow(er)

DRIVERS LICENSE INFORMATION

Issue Date*

Month

Day

Year

Expiry Date*

Month

Day

Year

Carefully enter the correct Expiry Date

Issuing State*

Upload Drivers Lincense*

Accepted file types: jpg, gif, png, pdf, Max. file size: 5 MB.

SPOUSE INFORMATION

Spouse’s Full Name

Prefix First Middle Last

Spouse’s Gender

Spouse’s Date of Birth

Month

Day

Year

Spouse’s SSN

DEPENDENT INFORMATION

Number of Dependents*

Full Name*

First Middle Last

Dependent’s Gender*

Relationship with Dependent*

Dependent’s Date of Birth*

Month

Day

Year

Number of Months Dependent Lived with You*

Dependents SSN*

2nd Dependent’s Full Name*

First Middle Last

2nd Dependent’s Gender*

Relationship with 2nd Dependent*

2nd Dependent’s Date of Birth*

Month

Day

Year

Number of Months 2nd Dependent Lived with You*

2nd Dependents SSN*

3rd Dependent’s Full Name*

First Middle Last

3rd Dependent’s Gender*

Relationship with 3rd Dependent*

3rd Dependent’s Date of Birth*

Month

Day

Year

Number of Months 3rd Dependent Lived with You*

3rd Dependents SSN*

4th Dependent’s Full Name*

First Middle Last

4th Dependent’s Gender*

Relationship with 4th Dependent*

4th Dependent’s Date of Birth*

Month

Day

Year

Number of Months 4th Dependent Lived with You*

4th Dependents SSN*

5th Dependent’s Full Name*

First Middle Last

5th Dependent’s Gender*

Relationship with 5th Dependent*

5th Dependent’s Date of Birth*

Month

Day

Year

Number of Months 5th Dependent Lived with You*

5th Dependents SSN*

6th Dependent’s Full Name*

First Middle Last

6th Dependent’s Gender*

Relationship with 6th Dependent*

6th Dependent’s Date of Birth*

Month

Day

Year

Number of Months 6th Dependent Lived with You*

6th Dependents SSN*

INCOME INFORMATION

Check all that apply and provide supporting forms*

W-2 (Wages)

1099-NEC (Contractor Income)

1099-MISC

1099-G (Unemployment)

1099-R (Retirement)

1099-DIV / INT (Dividends or Interest)

Social Security Benefits

Business or Self-Employment Income

Rental Property Income

Other

Other, Specify

DEDUCTIONS & CREDITS*

Mortgage Interest (Form 1098)

Property Taxes

Charitable Donations

Education Expenses

Childcare Expenses

Health Insurance (1095-A / Marketplace)

Medical Expenses

Retirement Contributions

Other

Other, Specify

ADDITIONAL SERVICES NEEDED*

LLC Formation

Bookkeeping

Tax Planning

IRS Resolution / Offer in Compromise

Multi-State Filing

Notary Services

Virtual Filing

24-Hour Filing Service

BANK INFORMATION (for Refund Direct Deposit)

Bank Name*

Routing Number*

Account Number*

Account Type*

Checking

Savings

Upload Documents Here*

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 50 MB.

You can upload multiple documents here

Other Notes / Additional Messages

AUTHORIZATION & SIGNATURE*

I hereby certify that the information provided is true and complete to the best of my knowledge. I authorize Moonlight Tax & Financial Services to prepare and electronically file my tax return based on the information I have provided.

Areas of Expertise

Tax and Financial Consultancy

Credit Counselor

Real Estate

Insurance

Home
About Us
Services
Tax Form
Contact Us

Home
About Us
Services
Tax Form
Contact Us

IRS ENROLLED AGENT