| Online QuestionnairePERSONAL INFORMATION |
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Dependant on
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Are you Married?* |
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| Spouse (if applicable) |
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Dependant on
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| Address |
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Military Address? : |
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| Bank Information (Do you want your return to be Directly Deposited?) |
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Account Type? : |
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| Dependants (Enter the information, starting with the youngest dependant) |
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| Basic Information |
| Do You Own A Home?* |
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Medical Insurance thru Employer?* |
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| Do You Own Rental Property?* |
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Did you or dependants have Medicare?* |
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| Did you or attend College or Trade School?* |
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Medical Insurance with Covered California (Market Place)?* |
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Security
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Type the characters that you
see in the above image:
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