United Tax Services Client Form

Put the name of the person who will prepare your tax return.
Customer Name*
Address*
City, State, Zip*
SSN*
DOB*
Phone Number*

Area CodePhone Number
Email*
example@example.com
Did you pay over half the expenses of maintaining your household for the entire year?
What is your marital status on December 31st? Not married ,married and live with spouse,married but live apart from spouse
IF YOU WILL BE CLAIMING HEAD OF HOUSEHOLD UPLOAD A UTILITY BILL WITH FROM PRIOR YEAR DATE

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Do you receive any Government Assistance? If so how much?
Spouse Name
Occupation(Job Title)
Spouse DOB
Spouse SSN
Cell Number #:
Email
johndoe@gmail.com
Spouse Occupation
Referred by:
Driver Lic #:
Spouse Driver Lic #:
State ID #:
Spouse State ID #:
Issue Date:

MonthDayYear
Date
Spouse Issue Date:

MonthDayYear
Date
Spouse Expiration Date:

MonthDayYear
Date
Expiration Date:

MonthDayYear
Date
Please upload all Social Sec Cards Taxpayer, Spouse and ALL Dependents.

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Please upload your State ID or Drivers License Taxpayer and Spouse.

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Please upload your something that proves your dependent lives with you at your address . It can be a piece of mail with both names and address, Shot record, Health ins form, school paper, Food stamps application ,Medicaid form, Lease agreement, Childcare facilty, Social service agency or Social Security letter.

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******Please upload Birth Certificates for all Dependents you are claiming!!! This is a MUST!!!

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Check Your Source of income?

(Job) W21099 ContractorSelf EmployedSSI/SSAUnemploymentOther
WOULD YOU LIKE TO ADD BUSINESS SERVICE SETUP SERVICES FOR $150

YesNO
WOULD YOU LIKE TO ADD A ROUND OF CREDIT REPAIR FOR $299? IT CAN BE PAID FROM YOUR TAX PREP FEES!!

YesNO
WOULD YOU LIKE TO ADD JUST CREDIT MONITORING SERVICES ?

YesNO
W2 , 1099 ,Unemployment

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W2 , 1099 ,Unemployment

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W2 , 1099 ,Unemployment

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Please upload your most recent 2025 pay stub.This information may be used to assess eligibility for applicable tax credits, including those related to overtime or tipped income.

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Do you have Marketplace Healthcare Insurance (OBAMA CARE 1095 A FORM) You are any of your dependentS?

YesNo
Please upload Marketplace insurance form here. (1095A)

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Do you have any Unfiled tax returns?

YesNo
Were you already claimed as a Dependent?

YesNo
Has the IRS ever issued you an Identity Theft Pin Number?

YesNo
Please upload your Idenity Theft Pin letter here.

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Do you owe the IRS, Delinquent Student Loans, or Back Child Support ?

YesNo
If you would like to apply for a tax advance loan put how much you would like to apply for $500-$6,000
Bank Name:
Check the following:

Checking AccountSaving Account
Blank check for verification

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Bank Routing #:
Bank Account #:
Did you pay child care expenses?
Upload child care form here.

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If you paid childcare to an individual put individual name,address & social security number.
List Dependents that Receive childcare Assistance?
Were you a Fulltime college student in 2025?

YesNo
Did you claim the college credit for 4years?
Upload Documents (COLLEGE FORMS 1098T FORM)

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Please list every w-2 , 1099 or any other tax document that United Tax will be preparing for you for 2023(example: Wendys ,McDonald ,Krystal , 1099NEC. If you leave out any tax forms you will be charged $149.00 per form . United tax service will have to file an admendment on your behalf. Please give us ALL income documents now! OR wait until you have received all of your tax documents to file your taxes .
Please sign stating you agree to the above terms.

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Sworn Statement of Residency
Dates the dependent(s) lived with you in the Calendar Year 2025
Address that your dependent(s) lived at with you in the Calendar Year 2025
List of all dependents that lived with you from your tax return.
I am certifying that the dependents listed above that I am claiming on my 2025 tax return has lived with me at the address above for more than 6 months in 2025 in the United States.
Signature*

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If I was audited by the IRS of EITC, Head of Household or Child Tax Credit I would be able to provide the documents below to prove residency of my dependent:

School RecordsMedical RecordsDaycare RecordsLease AgreementOther Documents
Did you purchase a BRAND new vehicle in 2025 that is financed with an auto loan? If yes, please upload your December auto loan statement (year and end statement) from the lender that financed the vehicle, showing interest paid below

YesNo
Please upload your December auto loan statement here.

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Letter of Engagement

Thank you for choosing United Tax Service to prepare your federal and applicable state income tax returns for the requested tax year. This letter outlines the scope of our services and the terms of our engagement.

Scope of Services

United Tax Service will prepare your tax return based solely on the information and documentation you provide. You are responsible for ensuring all information is complete, accurate, and supported by proper documentation. We do not audit, verify, or independently confirm the information submitted. Our services are limited to tax preparation and should not be relied upon to detect errors, fraud, or other illegal acts. However, any material issues identified during preparation will be brought to your attention.

Responsibilities and Authorization

By signing this agreement, you confirm that all information provided is true and accurate to the best of your knowledge. You understand that providing false or misleading information may result in penalties or criminal consequences under federal or state law. You agree to hold United Tax Service harmless for errors resulting from incorrect or incomplete information you provide and authorize United Tax Service to electronically file your tax return on your behalf.

Fees and Payment Terms

Tax preparation fees are due at the time services are rendered. If your refund is delayed, reduced, intercepted, mailed, or withheld for any reason, you remain fully responsible for all fees owed. You authorize United Tax Service to collect outstanding fees via ACH debit from the bank account you provide or through another agreed-upon payment method. Failure to pay fees may result in collection actions. Tax preparation fees are not subject to dispute due to IRS or government processing delays.

Record Retention

Original documents will be returned to you upon completion of services. You are responsible for maintaining your tax records. United Tax Service will retain copies of your records and work papers for up to three years, after which they will be securely destroyed. Paper copies of tax returns may be provided for an additional fee.

E-Filing and Document Authorization

Our engagement concludes upon delivery of your completed return or successful electronic filing with your authorization. If you choose not to e-file through our office, you assume full responsibility for timely filing. Your signature authorizes the use of electronic signatures on IRS Forms 1040, 8879, 7216, and any other required tax documents.

Treasury Offset Program Authorization

By signing this engagement letter, you authorize United Tax Service to contact the U.S. Treasury Offset Program (TOP) at 1-800-304-3107 for the sole purpose of verifying whether your federal tax refund is subject to offset. Possible offsets may include past-due taxes, child support, student loans, or other government obligations. This authorization is for verification only and does not permit United Tax Service to resolve or negotiate any outstanding debts on your behalf.

Final Acknowledgment

By checking the box below, you confirm that you understand and agree to the terms of this engagement and authorize United Tax Service to prepare and file your tax return.
Signature*

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I have read and understand the Letter of Engagement and agree to the terms, including authorization for United Tax Service to prepare and electronically file my tax return, verify Treasury Offset status, and collect applicable tax preparation fees
I hereby affirm under penalty of perjury that the facts set forth in this statement are true:

Taxpayer Signature
Signature Date

Taxpayer Print Name
First Name Last Name
Please sign stating you agree to the terms above,

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NOTICE: (1) By signing form below, I certify that all information is true, Complete, and accurate. I understand that false information may be grounds for the federal government to seek criminal charges against myself. I also release United Tax Services from any liability related to the information provided. My signature also authorized United Tax Services to electronically file my tax year 2024 income tax return. I am aware my refund can take typically between 9 to 21 business days to deposit in my account.

NOTICE: (2) It is important that you present all your income and expense statements i.e. W-2, unemployment, retirement, P&L, etc. Failure to report such documents could result in the delay of your refund and or you will receive an IRS audit notice via mail. If you have read and understand this notice, please sign and date below.
Tax Payer Signature*

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Date*

MonthDayYear
Date
Spouse Signature

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Date

MonthDayYear
Date
United Tax Services
Should be Empty:

Sworn Statement of Residency

Letter of Engagement

Responsibilities and Authorization

Fees and Payment Terms

Record Retention

E-Filing and Document Authorization

Treasury Offset Program Authorization

Final Acknowledgment

United Tax Services