An income tax questionnaire, as the name predicts, is widely used by the people, who are willing to file the income tax. Such a questionnaire can be filled online, by visiting any income tax agent and or by contacting the state income tax department.

Sample Income Tax   Questionnaire:

Name of the income tax payee: ____________________

Sex: __________________ Age: ____________________

Tax file no: _____________________________________

Social security number: __________________________

Marital status: __________________________________

Spouse tax file no: ______________________________

Official Address: ________________________________

Phone number: __________________________________

Date: ___/___/____

Q1. Did you fill your income tax last year? If yes, please do mention the slab percentage for the same:


Q2. Please choose a suitable term to proceed further?

  • I want to file my tax
  • I would like to fill it through my agent
  • I would like to complete the procedure online
  • I do not want to file my tax

Q3. Kindly choose the type of income countable for tax clearance:

  • Mutual funds
  • Salary income
  • Interests & dividends
  • Limited partnership income
  • Trust income & other pensions
  • Business or professional income

Q4. Choose the dedications/ credits from the following:

  • Registered saving plans
  • Public pass transit receipts
  • Moving expenses
  • Charitable donations
  • Labour sponsored funds

Q5. Kindly select the slab of your income with respect to tax percentage:

  • $10,000-$50,000 up to10%
  • $51,000-$1, 00, 000 up to 15%
  • $1, 11, 000- $1, 50, 000 up to 25%
  • Above than this, please mention: _________________

Q6. Would you like to have a copy of this income tax questionnaire for further records?

  • Yes
  • No