2025 Tax Client Intake Form

Please choose your tax professional

Tax Pro 1

Tax Pro 2

Tax Pro 3

Tax Pro 4

How did you hear about us?

Facebook

Instagram

Referral

Returning Client

If someone referred, you please list the name.

What is the best time to reach you?

Did you file a tax return?

Yes

No

Taxpayer Information

Filing Status

Single

Head Of Household

Married Filling Separate

Married Filling Joint

Taxpayer Name

First Name

Taxpayer SSN

example:000-00-0000

Taxpayer Date OF Birth

example:12/31/2000

Taxpayer Phone Number

Example: 222/326/4444

Address

Taxpayer Address

Street Address

City

State / Province

Country

Postal / Zip Code

Taxpayer Occupation

Example: job title

Taxpayer Email

Example: [email protected]

Spouse Name

Spouse SSN

Spouse Date of Birth

Spouse Email

Spouse Occupation

Income Information

Business income received

Example:$15,000.00

Please list all your business expenses here.

Example: Advertisement $25.00

Due Diligence Questionnaire

Did you and your spouse live apart this year?

Yes

No

Did you pay over half the expenses to maintain your home for the entire year?

Yes

No

Did you support a child(ren)or family member at least 6 months out the year?

Yes

No

If yes, did y'all live together at any time after June 30,2024?

Yes

No

Have you ever been denied the Earn Income Tax Credit or Child Tax Credit?

Yes

No

Did you receive any government assistance?

Section 8

Rental Assistance

Can someone else claim you as a dependent?

Yes

No

Dependent Information

Dependent #1 Date of Birth

Dependent #1 SSN#

Relationship to the dependent

Dependent #2 SSN#

Dependent #2 Date of Birth

Relationship to the dependent

Dependent #3 SSN#

Relationship to the dependent

Dependent #4 SSN#

Dependent #4 Date of Birth

Relationship to the dependent

If you have additional dependents, please list them here. Name, Date of Birth, Social Security Numbers and Relationship.

How many months did the dependent(s) live in the same home as you?

Are any dependent(s) in daycare? If yes, please upload the form that was provided to you from the daycare provider.

Yes

No

Please upload a copy of your daycare form here.

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Drag and drop files here

Health Insurance Questionnaire

Did you have health insurance in 2024?

Yes

No

Did you or your dependent receive Medicaid?

Yes

No

Did you or your dependent receive health insurance through the Affordable Care Act (Marketplace)?

Yes

No

Please upload your marketplace insurance 1095-A form.

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College Questionnaire

Were you or any of your dependents enrolled in college in 2024?

Yes

No

Do you have the 1098-T form for either you or your dependent(s)?

Yes

No

If you have your 1098-T form, please upload here.

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Banking Information

How would you like to receive your refund?

Direct Deposit

Check

Prepaid Card

Which type of account would you like to your refund deposited into?*

Checking

Savings

Name Of Bank?

Routing Number

Account Number

Other Services Offered

Are you interested in Audit Protection for $93.00?

Yes

No

Are you interested in Identity Theft Protection $39.95?

Yes

No

Are you interested in Bookkeeping Services? prepares invoices, expense reports, 1099s, receipts etc. for all small business owner for $350.00.

Yes

No

Tell me more about the service

Are you interested in the cash advance loan up to $7000.00 upon bank approval?

Yes

No

IRS Identity Pin Information

Were you issued an Identity Pin from the IRS

Yes

No

Please list your pin here.

Taxpayer’s Signature

Date *

Taxpayers Spouse Signature if applicable

Clear

Date *

Need to ask a question?

Do you have any questions? If so type here.

Documents to be uploaded. Please upload all the documents.

Taxpayer’s Drivers License

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Taxpayer and dependent(s) Social Security card(s)

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Taxpayer’s W-2 /1099’s

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Drop and drop files here

Self-Employment only! Expenses log,Summary of income etc

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Dependent(s) Birth Certificate

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Drop and drop files here

Proof of Residency

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Drop and drop files here