Individual Information Form Primary Taxpayer Name* First Last Primary Taxpayer Date of Birth* Primary Taxpayer SSNPrimary Taxpayer Mailing Address* Street Address City State / Province / Region ZIP / Postal Code Home PhoneMobile Phone*Work PhonePrimary Taxpayer Email* Spousal Information Check this box if you have a spouse. Spouse's Name* First Last Spouse's Date of Birth* Spouse's SSNSpouse's Email* What brings you to us?*TaxesBookkeepingFinancial AdviceIRS CorrespondencePayrollOtherOther:How did you hear about us?* Word of Mouth Facebook Website Other Who can we thank for your referral?Dependents If you're meeting for tax purposes, check this box if you are claiming dependents. How many dependents are you claiming?Please enter a value between 1 and 3.Dependent's Name* First Last Dependent's Date of Birth* Dependent's SSNSecond Dependent's Name* First Last Second Dependent's Date of Birth* Second Dependent's SSNThird Dependent's Name* First Last Third Dependent's Date of Birth* Third Dependent's SSNFile This iframe contains the logic required to handle Ajax powered Gravity Forms.