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Full Name

Phone *

Email *

Date of birth

Social Security Number

Street Address

City

State

Country

Postal Code

Are you a new client of JTPS?

Yes

No

U.S. Citizen/Resident?

Yes

No

Filing Status

If married

Spouse's Full Name
Spouse’s Date of Birth
Spouse’s Social Security Number

Dependent 1

Full Legal Name

Date of Birth

Social Security Number

Relationship to You

Is Dependent 1 US Citizen/Resident:

Yes

No

Is dependent 1 receiving a Social Security Benefits?

Yes

No

Has the Dependent 1 live with you for more than 6 months?

Yes

No

Do you have another dependent?

Yes

No

Dependent 2

Full Legal Name

Date of Birth

Social Security Number

Relationship to You

Is Dependent 2 a US Citizen/Resident:

Yes

No

Is dependent 2 receiving a Social Security Benefits?

Yes

No

Did the dependent 2 lived with you for more than 6 months

Yes

No

Do you have another dependent?

Yes

No

Dependent 3

Dependent 3 Full Legal Name

Dependent 3 Social Security Number

Dependent 3 Relationship to You

Is Dependent 3 a US Citizen/Resident:

Yes

No

Is dependent 3 receiving a Social Security Benefits?

Yes

No

Did the dependent 3 lived with you for more than 6 months

Yes

No

Earned Income Tax Credit

Is anyone else also claiming this child?

Yes

No

If yes, who?

Did you earn income from work?

Do you or your spouse have investment income over $11,000?

Child Tax Credit (CTC)/Additional Child Tax Credit

Is the child under the age of 17?

Are you claiming the child as a dependent?

American Opportunity Tax Credit (AOTC)

Taxpayer Student Status

Status (optional):

Student

Person with a disability

Do you have form 1098-T?

Yes

No

Is the student enrolled at least half-time in a degree program?

Was the student enrolled in at least one academic period this year?

Has the student completed the first 4 years of postsecondary education?

Has the student been convicted of a felony drug offense?

Were qualified education expenses paid (tuition, books, etc.)?

Health Insurance

Did you or any household member receive health insurance through the Marketplace (Obamacare)?

Yes

No

Do you have form 1095-A?

Yes

No

Business Information (if applicable)

Business Name

EIN (Employer Identification Number)

Are you interested in starting or restructuring a business?

Yes

No

How did you hear about us?

Do you have questions about filing back taxes?

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JTPS Advisory Co — Small Business Tax & Advisory

We specialize in small business tax preparation, business advisory, and credit advisory services. Our approach focuses on proactive tax planning, cash‑flow optimization, and credit-strength strategies tailored to your business.

This page provides general information about our small business tax, business advisory, and credit advisory services and does not constitute personal, business, or credit advice. Formal advice is provided once we understand your specific circumstances and engagement terms are agreed in writing.

Dependent 1

Dependent 2

Dependent 3

If the dependent is not your biological child:

Earned Income Tax Credit

Child Tax Credit (CTC)/Additional Child Tax Credit

American Opportunity Tax Credit (AOTC)

Taxpayer Student Status

Health Insurance

Business Information (if applicable)

Acknowledgment & Signature Please read carefully:

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JTPS Advisory Co — Small Business Tax & Advisory