Taxpayer Last Name:

First:

Email Address:

Preferred Method of Contact:

Home PhoneCell PhoneEmailText

If your address changed in 2025, complete this section.

Street Address:

Apt.#:

City:

State:

Zip Code:

Did you buy/sell a home in 2025?

YesNo

(If yes, include copy of Closing Disclosure Form)

If you had any marital or family changes in 2025, complete this Section. If not, go to Section 4.

Select the option that best describes your marital status in 2025:

SingleMarriedDivorcedWidow

Were there any births, deaths, or adoptions in your immediate family in 2025?

YesNo

Name:

Date of Birth:

Date of Death:

Social Security Number:

Please check off the items of income that you received in 2025

Wages (include W-2)

Unemployment Compensation (include 1099-G)

Interest Income (include 1099-INT)

Gambling Winnings (include W2-G)

Dividends (include 1099-DIV)

Independent Contractor (include 1099-NEC/MISC)

Investment Sales (include 1099-B)

Rental Income (include 1099-MISC or support)

Social Security (include SSA-1099)

Receipt or Sales of Digital Assets/ Cryptocurrency

Other:

Did you or your spouse receive payments/distributions from a retirement plan such as a pension, 401K, or IRA in 2025 or plan to in 2025? (If yes, attach Form 1099-R)

YesNo

Did you receive an early distribution from a retirement plan to pay medical bills, for college or to purchase a home?

YesNo

Did you purchase Health Insurance from the Marketplace? (Attach Form 1095-A)

YesNo

Did you participate in a Health Savings Account (HSA) in 2025? (If yes, attach Form 1099-SA and 5498-SA)

YesNo

Did you rent during 2025? If yes and total household income is less than $69,700 answer the following:

YesNo

Name and Address of Landlord:

Monthly Rent Paid in 2025:

Number of Months Rented:

Did you pay any child/dependent care expenses in 2025 for a child under 13 years old or costs to care for a handicapped individual? If yes, complete the following:

YesNo

Name of Child Care Provider:

Provider EIN/Social Security#:

Provider Address:

Amount Paid to Provider:

College Tuition (include 1098-T)

Mortgage Interest (include 1098)

Student Loan Interest (include 1098-E)

Property Tax Statements

Contributions to 529 Education Plan

Charitable Contribution Receipts

Vehicle Registration Fees

Gambling Losses (if you had winnings)

Energy Efficient Home Improvements

Purchase of Electric Vehicle

Unreimbursed Medical Expenses (if total amount paid is over 7.5% of your income)

Contributions to Michigan First-Time Home Buyer Savings Program in 2025

Did you receive a 6-digit IRS Identity Protection PIN Number? You can check to see if you were issued a PIN by visiting your IRS Online Account.

YesNo

The IRS is able to deposit refunds directly into up to (3) taxpayer’s accounts. If you receive a refund, would you prefer to have your funds direct deposited?

YesNo

If yes, please confirm that the bank account used on your 2024 Tax Return is still valid. If not, please enter updated account information below:

Bank Name:

Routing Number:

Account Number:

Type of Account:

Select OneCheckingSavingsMoney MarketOther