Name *

First Name

Last Name

Date Of Birth *

MM

DD

YYYY

Spouse's name

First Name

Last Name

Spouse's Date Of Birth

MM

DD

YYYY

Are you currently living in the USA? *

Yes

No

Legal Address (The address you file your tax return at) *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Preferred Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Will you be moving out of the US or returning to the US soon?

Going Overseas

Coming Home

No Change

Are you currently claiming the Foreign Earned Income exclusion

Yes

No

Does Either spouse work outside of Wycliffe?

Yes

No

Do you own a home?

Yes

No

Would you like FMN to review your home, auto & umbrella insurance?

Yes (If yes please upload your most recent home, auto and umbrella insurance through the document upload link at the bottom of this form.)

No

Are you paying into Social Security?

Yes

No

Are you claiming a housing allowance?

Yes

No

Indicate the best way to communicate

Email

Phone

Virtual Meeting

Preferred Phone Number

(###)

###

####