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Am Tax & Wireless, LLC

13 East State Street,
Trenton NJ 08608
(609) 360-0743/Fax: (609) 526-2337 Cell: (609) 334-9559

Taxpayers’ Declaration, Tax Return Preparation Consent, and Authorization Form

I/We Hereby authorize Am Tax Wireless & Gold, LLC to prepare my/our tax return. The information provided below are true and correct to the best of my/our knowledge. I/we are aware that any misrepresentation including filing status, dependency claims and false W-2,
or SS# (s), or claiming children that are not your dependents or qualify relatives, may results to my/our tax return being delay, Refund
reduced refund, or rejected by the IRS. I also consent that Am Tax Wireless & Gold may use my personal information to solicit from
me, including greeting cards, promotions; other none tax related, wireless services promotions, business consultations, investment opportunities, other financial related products and Services from time to time.

Taxpayer Name:*

*SS#:

Date of Birth:

Spouse Name:*

*SS#:

Date of Birth:

Street address:

Apt.#

City:

State:

Zip:

Home phone:*

Cell:*

Work phone:*

Email:*

*Spouse Email:

Taxpayer occupation:*

Spouse occupation:*

Filing Status: Please check one:

DEPENDENT:*

Name

SS#:

Date of birth:

Name

SS#:

Date of birth:

Name

SS#:

Date of birth:

Name

SS#:

Date of birth:

I/We brought the following Income tax forms including W-2 wages __ W-2 G gambling winnings __,1099-G unemployment
__, 1099-R retirement __ 10999-SS social security __, 1099INT/1099DIV interest & dividend income__/__, Form 1098
home Mortgage interest__, 1098-T/1099-Education/Student loan interest__, 1099-MSC Independent contractor/Selfemployment income __, and tax forms.

I/We are Self-employed and like to file a schedule-C/ business return. I brought our/my business income profit/loss statements and receipts_____, if not, create one by filling the form at the back of this form. Fees starting at: $300, and up.

*I rent , and pay $ monthly.

Am Tax wireless & Gold, LLC preparation Fees: 1040-EZ, $69.99, 1040-A, starting at $175 and up, 1040, starting at $216 and up to $399, Business return starting from $350.00 and up, but less than $599.00, in addition to bank product fees which are beyond our scope of applicable fees. You have the option to avoid bank fees when pay applicable fee upfront.

By signing below, you certified, acknowledged and accept that all information provided are true to the best of your knowledge. And that you accept the terms and conditions for the preparation of your tax return by Am Tax Wireless, & Gold, LLC.

Am Tax Wireless & Gold, LLC

13 East State Street, , Trenton NJ 08608
(609) 360-0743/Fax: (609) 526-2337 Cell: (609) 334-9559

Taxpayers’ Self-Employment Declaration, Consent, and Authorization

Business Returns Form

By signing below, you certified, acknowledged and accept that all information provided are true to the best of your knowledge. And that you authorized and accept the terms and conditions for the preparation of your tax return by am Tax Wireless & Gold, LLC.
Disclaimer: Note that any taxpayer who willfully provide any misrepresentation and fraudulent claims may be liable for committing perjury under the law.

Taxpayer Name:

Signature:

Date:

THIS POTION IS FOR SCHEDULE “C/E” SELFEMPLOYED BUSINESS RETURN INFORMATION
Business Return Fees Starts at $350.00, up to $599.00 if reconstructed during the preparation processing

SOLE PROPARATOR SCHEDULE C,

LLC LIMITED LIABILITY FORM 1065 Number of partner( s):

Partner name:

, 2

Partnership asset: $
Please provide business accounting information

RENTAL REAL ESTATE, SCHEDULE E/:Number of Rental PropertiesPlease provide income

information and properties addresses if more than one rental properties.

I/We are Self-employed and like to file a schedule-C/E business return. I brought our/my business income profit/loss statements and

Gross receipts amount: $/1099 amount: $Cost of goods sold………..$

Advertising…………………………..... $

Car and Truck expense…………….$

Commission and fees…………...…$

Legal Fees/professional fees……$

Office expenses…………………...…..$

Pension plans……………………...…..$

Office rent/other business properties.$

Repairs……………………………….$

Supplies………………………………$

Insurance other than health,……….….$

Depreciation Asset value ….………….$

Taxes and license…….…….$

or business miles driven during the year:

Other expenses not specified elsewhere... $

Travel expense……………..$

Meal & entertainment……...$

Utilities…………………….$

Wages/contract labor………$

Other business expense….…$

Mortgage…………….……..$

Rent/lease of machinery/equipment $

Depletion…………………..$

Year asset place into service;

Cost:

Do you want to depreciate YesNo

I satisfied that I was self-employed and the above reconstructed expenses indicated above, are actual, and legitimate

Signature:[signature* sign class:classtxtfield]

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Am Tax Wireless & Gold, LLC

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