2025 VIP CLIENT LIST

Hello, Thank you for choosing Campbell Financial to assist you in making your tax season as seamless and as stress free as possible. Please ensure that all Information you submit here is accurate and true.

If we were communicating via Facebook messenger what's your Facebbok Name?

Do you have an IP PIN number?

YES

NO

This number is issued by the IRS as a security measure to protect your identity.

Enter your 2025 Identity Protection Pin

If you have an IP PIN it is needed to process your tax return.

First Name *

Last Name *

Address

Street Address *

City *

State *

Country *

Postal code *

Phone *

Email *

Date of birth *

Job Title *

Referred By:

Do you have offset for a debt owed? Call 1-800-304-3107 to verify if you're unsure. *

Yes

No

Were you considered legally married on the last calendar day of the year? *

Yes

No

Spouse's Name

Spouse's Date of Birth

Spouse's Job Title

Spouse's Telephone Number

Spouse's IP Pin Number

This number is issued by the IRS as a security measure. If an IP PIN was issued we will need it to process the return.

Please check all that apply for you for the tax year: *

Please check all that apply for your spouse for the tax year:

If due a refund, how would you like your refund *

If you have a balance due, how would you like to make your payment *

Bank Name *

Account Type *

Checking

Savings

Account Information *

Routing Number
Account Number

If married, were you married for the entire year?

Yes

No

Did you live with your spouse the last six months of the filing year?

Yes

No

Date of final decree

Date of separate maintenance decree

Would you (spouse,if applicable) like to receive written communications from the IRS in a language other than English *

Yes

No

Year of spouse’s death

Did you have anyone who lived with you last year (except your spouse) OR anyone you supported but did not live with you last year. *

Yes

No

Dependent One Details:

Name
Date of Birth
Dependent Social Security Number
Relationship
Months Lived with You
Marital Status

Dependent One (Yes or No)

U.S. Citizen
Full-time Student
Disabled
Has IP PIN
Enter IP PIN if applicable

Dependent Two Details:

Name
Date of Birth
Dependent Social Security Number
Relationship
Months lived with You
Marital Status

Dependent Two (Yes or No)

U.S. Citizen
Full-time Student
Disabled
Has IP PIN
Enter IP PIN if applicable

Dependent Three Details:

Name
Date of Birth
Dependent Social Security Number
Relationship
Months Live with You
Marital Status

Dependent Three (Yes or No)

U.S. Citizen
Full-time Student
Disabled
Has IP PIN

Dependent Four Details:

Name
Date of Birth
Dependent Social Security Number
Relationship
Months Live with You
Marital Status

Dependent Four (Yes or No)

U.S. Citizen
Full-time Student
Disabled
Has IP PIN
Enter IP PIN if applicable

Do you have more than 4 dependents?

YES

NO

Did you receive a refund last year? *

YES

NO

Were you audited last year? *

YES

NO

Tax Documents (W2,1099, Business P&L, Unemployment,Marketplace Insurance) *

ID/Driver's License *

Social Security Cards for Each Individual on Return *

2025 VIP CLIENT LIST

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Campbell Financial is committed to providing all our clients with accurate tax returns that are audit proof. We find every tax credit and deduction you legally qualify for to help you save money and/or get the max back. We are ready and available all year for all your tax needs.

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