Tax Questionnaire Example

A tax questionnaire is a document that is filled by a tax payer in order to assist governmental authorities in gathering data and formulating appropriate tax measures within a city or state. A test questionnaire example provides glimpse into the layout of a tax questionnaire. A tax questionnaire gives a good understanding of individual earnings and expenses and accordingly the best tax payment option are delved into. Such kinds of surveys are used by authorities in laying down the correct tax payment rules.

Tax Questionnaire Example Sample

Name of the tax payer:    ___________________

SSN number: ___________________________

Address of the taxpayer: ___________________

Date of birth: ___/____/_____

Sex: ____________________

Age: ___________________

Phone number: ________________________

Q1: What is the amount of tax paid by you in 2011?


Q2: What was your total earning in the year 2011?


Q3: How many properties and estates do you own?


Q4: How much tax did you pay on the properties?


Q5: Do you have any dependents in your home, residing with you?

  • Yes
  • No

Q6: If yes, kindly furnish details of the dependent members;

  • Name___________________
  • Age __________________
  • SSN of the dependent: ______________________

Q7: Did you achieve any other income, except from the one earned by your regular job?

  • Yes
  • No

Q8: If yes, kindly fill in details.


Q9: Do you have any property on rent? If so, kindly provide details regarding its location as well as income earned through rent


Income earned: _______________________________

Q10: What was the tax amount payed by you last year? Furnish details




Tax Surveys

Category: Tax Questionnaire

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