Personal Information

Please complete this questionnaire to provide details about the 2019 tax year. In addition, please provide your supporting source documents. A ‘Tax Form Reference Guide’ is included at the end of this questionnaire to assist you in gathering applicable forms.

If you prefer to complete this questionnaire on paper, please visit valleynationalgroup.com/tax for a printable PDF, or you may e-mail tax@valleynationalgroup.com to request a paper tax questionnaire.

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* Taxpayer's Full Name

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* Spouse's Full Name (if filing a joint return)

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* Did your marital status change during the year?

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* Did your address change during the year?

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* If you moved, please provide your new address.

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* Did you or your spouse retire or change jobs?

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* Have you or your spouse been a victim of identity theft and have you or your spouse contacted the IRS?

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* Anything else you want your tax prep team to know about your Personal Information?
*SECURITY NOTE: Please do not include any account numbers, social security or other detailed personal information on this form.

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