Tax Appointment Portal

Appointment Preference: *

I would like to file my taxes in-person.
I would like to file my taxes via Zoom.

Name *

First

Middle

Last

Social Security Number *

Date of Birth *

Primary Address *

Address Line 1

Address Line 2

City

State

Zip Code

Monthly Rent

Do you receive help from the government for your rent or live in public housing? *

Yes
No

Home Phone

Mobile Number

Email *

Filing Status *

Single
Married
Legally Separated
Widowed

Dependents Name, D.O.B and Social Security No:

Occupation: *

Do you receive food stamps? *

Yes
No

Type of Health Insurance *

Was this insurance purchased through the market place (Affordable Care Act) yes or no: *

Yes
No

Did you file your taxes in 2021? *

Yes
No

What was your 2021 Adjusted Gross Income (AGI)? *

DIRECT DEPOSIT FORM:

Name of bank/financial institution:

Bank 9-digit routing number:

Type of bank account:

Checking
Savings

Bank account number:

Consent/Signature

I attest that the income and personal information provided in this form are true. I understand that falsification of my income is grounds for termination of Tax Preparation Services rendered by The Campaign Against Hunger. If you have questions or concerns regarding this form, please contact Daniel Wright, Benefits Specialist at dwright@tcahnyc.org.

Applicant Name *

First

Last

Signature Date *

Upload Tax Documentation

Please upload applicable documentation that will be needed for your tax appointment:
- 2022 W-2
- 2022 Bank Interest Statement (1099 INT)
- 2022 Retirement/Pension Statement (1099-R)
- 2022 Unemployment Statement (1098-G)
- 2022 Mortgage Interest Statement
- 2022 Award Letter
- Student Loan Interest Statement
- College expenses (books, supplies ) (1098 T and 1098E)

File Upload

Click or drag files to this area to upload. You can upload up to 15 files.