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USA Tax Refund Application


How would you like to register?
Chat personally and directly with us by clicking here
or Complete our online registration form below.

Please fill out this simple form with as much information as possible - it will take just 4 minutes! Once you complete this form, our representative will contact you within 1 hour !

CONTACT DETAILS
( * - mandatory fields )

Title
First Name *
Middle Name
Surname *
Postal Address *
Email address  *
 
Phone number *
Line Type *
Country Code *
  Area Code *
   Phone number *
 
Phone number
Line Type
Country Code
  Area Code
   Phone number
 
Please send confirmation via SMS to this number
 
Date of Birth *  
DD/MM/YYYY
Which country are you from? *
State *
City *
How did you hear about our service? *
What is the name of that person/organisation? *
Visaholders who pay for living expenses in their home country while on their US program may be able to deduct them from their taxable income and get a larger refund.
Please tick which living expenses you paid for in your home country, while you were on your US program:
Insurance (medical, home or vehicle, etc):
Mobile phone costs:
Club membership (gym, sports or social, etc):
Transportation (car, bike or scooter, etc):
Housing costs (rent, mortgage or board, etc):
If you had a part/full-time job in your home country before and after your US program, and/or if you maintained a life in your home country while in the US you may be entitled to a larger tax refund.
Did you have a job in your home country?
Do you intend to return to that job when you leave the US?
Do you have a permanent address in your home country?
Do you intend to return to this address when you leave the US?
Did you pay significant contributions to a household in your home country?
Are you entitled to vote in your home country?
Do you have a bank account in your home country?
Did you receive mail to your home address while in the US?
 
EMPLOYMENT INFORMATION
 
Year of Employment *
Have you filed a tax return with the U.S. Tax Authorities for this year of employment?
Approximate first date of arrival in the USA *  
DD/MM/YYYY
Approximate last date of departure from the USA *  
DD/MM/YYYY
Type of Visa *
Program Type *
Which organisation arranged this program for you in your home country?
Who was your Visa Sponsor?
Do you have your Social Security Card?
Social Security Number (if possible) - -
Do you have your DS-2019 Form (formerly known as the IAP66)?
Do you have your J1 Visa in your passport?
Type of employment ?  *
What was the cost of your programme to the US? * $
Travel costs (flight, train, bus tickets and etc): * $
Luggage expenses * $
What part of the expenses above are covered by employer? * $
How many employers did you work for? *
 
EMPLOYER 1
 
Company Name *
Full Business Address
In which US state did you work? *
Telephone Number
Fax Number
E-mail Address / Website
Last date of employment  
DD/MM/YYYY
Do you have your final payslip? *
If yes, please fax, scan and email or post to taxback.com today
Have you received your W2 form? *
If yes, please fax, scan and email or post to taxback.com today
If no, would you like us to source replacements for you?
Any contact information for your employer:
 
EMPLOYER 2
 
Company Name *
Full Business Address
In which US state did you work? *
Telephone Number
Fax Number
E-mail Address / Website
Last date of employment  
DD/MM/YYYY
Do you have your final payslip? *
If yes, please fax, scan and email or post to taxback.com today
Have you received your W2 form? *
If yes, please fax, scan and email or post to taxback.com today
If no, would you like us to source replacements for you?
Any contact information for your employer:
 
EMPLOYER 3
 
Company Name *
Full Business Address
In which US state did you work? *
Telephone Number
Fax Number
E-mail Address / Website
Last date of employment  
DD/MM/YYYY
Do you have your final payslip? *
If yes, please fax, scan and email or post to taxback.com today
Have you received your W2 form? *
If yes, please fax, scan and email or post to taxback.com today
If no, would you like us to source replacements for you?
Any contact information for your employer:
 
EMPLOYER 4
 
Company Name *
Full Business Address
In which US state did you work? *
Telephone Number
Fax Number
E-mail Address / Website
Last date of employment  
DD/MM/YYYY
Do you have your final payslip? *
If yes, please fax, scan and email or post to taxback.com today
Have you received your W2 form? *
If yes, please fax, scan and email or post to taxback.com today
If no, would you like us to source replacements for you?
Any contact information for your employer:
 
EMPLOYER 5
 
Company Name *
Full Business Address
In which US state did you work? *
Telephone Number
Fax Number
E-mail Address / Website
Last date of employment  
DD/MM/YYYY
Do you have your final payslip? *
If yes, please fax, scan and email or post to taxback.com today
Have you received your W2 form? *
If yes, please fax, scan and email or post to taxback.com today
If no, would you like us to source replacements for you?
Any contact information for your employer:
 
Have you also worked in any of the following countries?

to select multiple options, hold down the control key while selecting
Did you receive a tax refund?
 
 
YOUR FEEDBACK AND ADDITIONAL INFORMATION
Please enter any additional comments and information here:
 
Please read our terms and conditions and indicate that you accept them in order for your registration to proceed
Yes, I accept the Terms and Conditions *
DON'T FORGET-IMPORTANT!

Once you hit submit you will need to send us your final pay-slip(s) OR W2(s) from each of your employers (if you have them) - see details on the next page.

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