Lopez & Associates

If you have already submitted your return you can click here to submit additional documentation.

Taxpayer

Taxpayer First Name

Driver License/ID Number

Taxpayer Middle Name

Issue State

Taxpayer Last Name

Issue Date

Date of Birth

Expiration Date

Social Security Number

Occupation

Filing Status

Filing Status

Number of Dependents

Spouse

Spouse Name

Driver License/ID Number

Spouse Middle Name

Issue State

Spouse Last Name

Issue Date

Date of Birth

Expiration Date

Social Security Number

Occupation

Cell Phone

Spouse Email

Dependents

Dependent 1

First Name

Social Security Number

Middle Name

Type of Relationship

Last Name

Is Dependent a Student?

Date of Birth

Is Dependent Disable?

Dependent 2

First Name

Social Security Number

Middle Name

Type of Relationship

Last Name

Is Dependent a Student?

Date of Birth

Is Dependent Disable?

Dependent 3

First Name

Social Security Number

Middle Name

Type of Relationship

Last Name

Is Dependent a Student?

Date of Birth

Is Dependent Disable?

Dependent 4

First Name

Social Security Number

Middle Name

Type of Relationship

Last Name

Is Dependent a Student?

Date of Birth

Is Dependent Disable?

Dependent 5

First Name

Social Security Number

Middle Name

Type of Relationship

Last Name

Is Dependent a Student?

Date of Birth

Is Dependent Disable?

W2 Return

Number of W2 Return

W2 Return 1

22222

VOID

Employee SSN

For Fofficial Only
OMB No. 1545-0008

Employer'S (EIN)	1 Wages, Tips, Other Compensation	Federal Income Tax Withheld
Employer's Name Employer's Address Employer's City Employer's State Employer's ZIP Code	Social Security Wages	Social Security Tax Withheld
	Medicare Wages and Tips	Medicare Tax WIthheld
	Social Security Tips	Allocated Tips
Verification Code		Dependent Care Benefits
	Nonqualified Pians	12a Amount 12a Letter
	Statutory Employee Retirement Plan Third-party Sick Pay 12c Amount 14 Other	12b Amount 12b Letter 12c Amount 12c Letter 12d Amount 12d Letter

Employer's State ID Number	State Wages, Tips, Etc	Local Wages, Tips, Etc	State Income Tax	Select State	Local Income Tax	Locality Name
Employer's State ID Number	State Wages, Tips, Etc	Local Wages, Tips, Etc	State Income Tax	Select State	Local Income Tax	Locality Name

Address / Misc.

Address

Cell Phone

Apartment

Cellular Provider

Zip

How did you hear about us?

City

Name of Referral

State

Contact Information

Email Address

Company

Office

Preferred Location

Payment Options

Payment Options

Upload Additional Documents

Social Security Number

Please upload one or more files into the areas below. Uploads will accept JPG, PNG and PDF files only. You can select multiple files to upload for each section by Shift or Cmd/Ctrl clicking files in the prompt.

Upload W2 Forms