5) Do you have a qualified Health
6) Would you prefer to NOT
compute Health Insurance Shared Responsibility Payment? *
7) Did any of
the DEPENDENTS claimed on your tax return WORK during the year?
undersigned guarantees that all information provided to Gregory's Tax and
Bookkeeping Service for the purpose of preparing income tax returns is true
and accurate. This also constitutes a contract with Gregory's Tax and
Bookkeeping Service for the purpose of preparing income tax returns and the
undersigned agrees to be responsible for all charges incurred in that process.
Please Print this Page, Sign and Bring with you to your appointment!!