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LISA TAX SERVICES 3

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Customer Intake Form

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First Name

SSN#

MI

Date of Birth

Street Address

City

State

Last Name

Occupation

State ID (front)

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Other Documents

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State ID (back)

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W2's

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W2's

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Other Documents

PDF

Other Documents

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Email

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Address. 2022 Fairburn Road Douglasville, GA 30135

Tel. 470-260-4221

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