Dale Tax Service - Two Locations in Northeast Philadelphia

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Tax Drop Off Form

Drop off the following documents and we will prepare your return: You will need your 2005 W-2 form(s), last year's return, and a completed questionnaire. You can download the questionnaire (pdf) here and print it out, stop in one of our offices and pick it up, or complete the following online form and drop off required documents:

Phone: 215-342-4200
Fax: 215-342-8601

Name:	Please bring Social Security Number
Spouse Name:	Please bring Social Security Number
Date of Birth:
Spouse Date of Birth:
Phone Number:
Best Time to Call:
Alternate Number:
Latest Time to Call:
Client Occupation
Please check all that apply
Will be bringing a copy of last years return?
Return prepared at this location last year?
Address on last year's return still current? If it is not please provide it below.

Please bring your other documents (W2's, Forms 1098, 1099, etc.) with you.
State of Residence:
Did you live and work the entire year in ths state? If not, list other states below

Dependents (or person living in our household)
Name:	Please bring Social Security Number
Date of Birth:
Relationship to you:
Name:	Please bring Social Security Number
Date of Birth:
Relationship to you:
Name:	Please bring Social Security Number
Date of Birth:
Relationship to you:
Name:	Please bring Social Security Number
Date of Birth:
Relationship to you:

Please check all that apply
Did Tax Service prepare your return last year?
Did you own rental property
Do you own your own business?
Do you have retirement income or Social Security?
Do you have mutual funds or stocks?
Do you have a Partnership, Corporation, or Trust?
Do you own your own home?
Did you pay any student loan interest in 2005?
Did you have education expenses for anyone on your return?
Do you have a coupon?
Are you making tax payments for a prior year?
Do you have any delinquent obligations such as back taxes, alimony, child support, students loans or prior refund anticipation loans?

How would you like to file your return?

Electronic FilingDirect DepositRALPaper Return

Questions or other information for my tax professionals: (Be sure to indicate if you moved or suffered damage or destruction of property from a sotrm, accident, theft, or other unusual occurrence during the year). Please include any other income or deductions not shown on your tax documents. Feel free to write any other additional information and bring this with you.