Clone of Individual Client Questionnaire

Individual Client Extension Request
Filing Status*

SingleHead of HouseholdMarried Filing SeparateMarried Filing Joint
Primary Taxpayer Information
Name*

First NameMiddle NameLast NameSuffix
Social Security Number*
Please enter a valid SSN.
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Occupation*
Spouse Information (If Married Filing Jointly)
Spouse's Name

First NameMiddle NameLast NameSuffix
Spouse's SSN*
Please enter a valid SSN.
Spouse's Date of Birth*

MonthDayYear
Date
Spouse's Phone Number*
Please enter a valid phone number.
Spouse's Email*
example@example.com
Spouse's Occupation*
Submission acknowledges that all information herein is correct and that you are requesting Collins Financial Services to prepare and submit an "Individual Extension Request". Submission also consents to creation of a free document sharing account in SmartVault where you may view a copy of your Extension.
Please verify that you are human*
Fee for Individual Extension Request*

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USD$40 fee applicable towards related tax prep

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Individual Client Extension Request