Client Intake Form

Welcome and thank you for choosing Sims Tax Associates. We appreciate your services. Our Client Intake Form is located below. Please take a moment to fill out the form so we can better assist you with filing your taxes. Thank You!
Are you a new or returning client? Please select the option below that apply.*

New ClientReturning Client
Full Name*

First NameLast Name
Date of Birth*
mm/dd/yyyy
Social Security Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com
Occupation*
What school district did you live in as of December 31st, of the tax year your filing?
What tax year are you requesting to file?*
Did you file your 2024 tax return?*

YesNo
Was your 2024 tax refund offset (taken to pay off a debt) last year?*

YesNo
What was your previous year filing status?*
If your filing status is HEAD OF HOUSEHOLD you will need to provide proof of residency such as lease and or utility bill. Can you provide the required documents?

YesNo
What was your marital status as of December 31st, of the tax year your filing?*

Single (Not Married)MarriedSeparatedDivorcedQualifying widow with dependent child
If your marital status is SEPARATED can you provide a separation decree/agreement?

YesNo
Have you or your spouse been a victim of identity theft and been given an identity theft protection pin (IPPIN)number by the IRS?*

YesNo
If you answered yes to the previous question, please enter your 6-digit IPPIN number.
Taxpayer IPPIN Number
Spouse Full Name: (If Applicable)

First NameLast Name
Spouse Date of Birth
mm/dd/yyyy
Spouse Social Security Number
Spouse Phone Number
Format: (000) 000-0000.
Spouse Email
Spouse Occupation
Spouse IPPIN Number (If Applicable)
IPPIN Number
Did you or your spouse receive form W-2 from your employer or form 1099-NEC?*

YesNo
Did you or your spouse receive Unemployment Compensation? (Form 1099-G)*

YesNo
Did you or your spouse collect Social Security or Retirement Income?*

YesNo
Did you or your spouse take an early withdrawal from your retirement account? (Form 1099-R)*

YesNo
Did you receive any of the forms listed below regarding your Health Insurance (If Applicable)

1095A (Market Place or Obama Care)1095C (Employer)
Do you have a HSA (Health Savings Account) account through your employer?

YesNo
Have you ever had EARNED INCOME CREDIT disallowed by the IRS?*

YesNo
Do you rent your home? If so, list the amount you pay monthly for rent?
Do you or your spouse own your home?*

YesNo
Did you pay more than half of the expenses at your residence for the entire year?*

YesNo
Did you make any ENERGY IMPROVEMENTS on your home for the tax year you are filing? If so list the amount you paid?
Did you purchase or own an electric vehicle for the tax year your filing?

YesNo
Did you sell or exchange any stock in the tax year your filing?

YesNo
Did you pay a significant amount in medical/dental expenses that was not covered by medical/dental insurance in the tax year your filing?
Did you pay any cash-noncash contributions to charity or non-profit organizations in the tax year you filing? (please list type of organization and amount paid)
Did you receive any State or Government assistance for the tax year your filing? For Example:

Section 8/ Subsidized HousingSNAP (Food/Cash)Social Security BenefitsOther
DEPENDENT INFORMATION
Are you claiming any dependents that you provided more than half the support for? If yes please fill out the required information for each dependent.*

YesNo
Dependent # 1 Full Name

First NameLast Name
Date of Birth
mm/dd/yyyy
Social Security Number
Relationship (son, daughter etc.)
How long did the child live with you?
Months
IPPIN (Identity Protection Pin Number) if applicable
6 digit pin
Dependent # 2 Full Name

First NameLast Name
Date of Birth
mm/dd/yyyy
Social Security Number
Relationship (son, daughter etc.)
How long did the child live with you?
Months
IPPIN (Identity Protection Pin Number) if applicable
6 digit pin
Dependent # 3 Full Name

First NameLast Name
Date of Birth
mm/dd/yyyy
Social Security Number
Relationship (son, daughter etc.)
How long did the child live with you?
Months
IPPIN (Identity Protection Pin Number) if applicable
6 digit pin
Dependent #4 Full Name

First NameLast Name
Date of Birth
mm/dd/yyyy
Social Security Number
Relation to you (son, daughter etc.)
How long did the child live with you?
Months
IPPIN (Identity Protection Pin Number) if applicable
6 digit pin
Can you or any dependents be claimed by anyone else?*

YesNo
If yes, which dependent can be claimed by someone else?
Name
Do you have joint custody of any dependents listed above? If so, please list them below.
Names
Did you pay any daycare expenses for any dependents this year?

YesNo
Which dependents did you pay daycare for? (If Applicable)
Name
Total dollar amount of daycare paid for the entire year.
Number
Name, address and phone number of daycare provider. (If Applicable)
Name, Address, Number
COLLEGE STUDENTS
Were you, your spouse or dependents enrolled at least part time in an accredited college, trade school or university in the year you are filing?*

YesNo
Who attended college? And how many years?(If Applicable)
Name and years attended.
Name of the accredited college, trade school or university.
Name
Was this person issued form 1098T or 1098E? (student statement from the college, trade school or university they attended).

YesNo
If you paid for any college supplies such as book, electronics etc. Please list below the total amount you paid below. (Note you will need to provide proof of the expenses)
Do you or your spouse owe any of the following?*

Back TaxesChild SupportStudent LoansAlimonyNone
How would you like to pay for your Tax Services?*

$0 up front cost (Payment deducted from my tax refund. Bank fees will apply)Pay upfront for my tax services (Cash, Debit, Credit, Zelle)
Are you interested in Tax Advance Loan option? This loan is not credit based. Approval decisions are determined by the bank. Advances range from $250-$7000.*

YesNo
How will you like to receive your refund?*
Bank Information

(If receiving refund by direct deposit)
Name of Bank: (If Applicable)
Type of Bank Account

CheckingSavings
Bank Routing Number
Bank Routing Number
Re-Enter for accuracy
Bank Account Number
Bank Account Number
Re-Enter for accuracy
BUSINESS OWNER/SELF-EMPLOYMENT

NOTE: If this section does not apply to you, please skip this section of questions.
Did you own a business or was self-employed including (uber/lyft/doordash) in 2025?

YesNo
Do you have an IRS federal EIN number (Tax ID Number) for your business. If so please enter below.
Is your business registered with the Secretary of the State? If so what type of entity is your business registered under? (LLC, Corporation, Partnership etc.)
How many years have been in business?
What is the name of your business?
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you have a business bank account?

YesNo
How do you advertise your business?

WebsiteSocial MediaBusiness Cards/FlyersOther
Did you receive form 1099 MISC or 1099 NEC for any contracted work?

YesNo
Did you incur expenses for your business or self-employment?

YesNo
Do you have proof of all income and expenses for your business or self-employment? (Ex: Profit and loss, receipts, bank account statements, invoices, electronic payment records, mileage records, rental contracts etc.)

YesNo
What forms of payments did your business accept from customers, clients etc.?

Cash/ZelleElectronic Payments(credit/debit)Merchant Account(Paypal, Square etc)Cash AppOther
The IRS may ask you to provide receipts so please keep supporting business documents on file for at least 5 years.
How did you hear about us?*
If referred please list the first and last name of the person who referred you
Name
Please take a few moments to look over all requested information to make sure your information is complete and accurate.
I certify that all statements are true on this client intake form to the best of my knowledge. I understand that Sims Tax Associates will not hold any responsibility for any misrepresented data or false claims. I certify that i am not being coerced in any way or form to report income falsely.*

YesNo
Please type your full name below:*
Spouse full name
Signature*
Spouse Signature
Please upload proof of all documents: ID/driver license, proof of residency (utility bill, lease etc), social security cards, for self and dependents, proof of all income (W-2s, 1099s etc), business info (expense report and profit documents if applicable). Another option to send documents are emailing them to Contact@simstaxassociates.com

Cancelof
If you have any questions, please contact Sims Tax Associates via phone or text at (678) 433-9551 or you can email us at Contact@Simstaxassociates.com
Thank you for choosing Sims Tax Associates.
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Welcome and thank you for choosing Sims Tax Associates. We appreciate your services. Our Client Intake Form is located below. Please take a moment to fill out the form so we can better assist you with filing your taxes. Thank You!

DEPENDENT INFORMATION

COLLEGE STUDENTS

Bank Information

BUSINESS OWNER/SELF-EMPLOYMENT

The IRS may ask you to provide receipts so please keep supporting business documents on file for at least 5 years.

Please take a few moments to look over all requested information to make sure your information is complete and accurate.

If you have any questions, please contact Sims Tax Associates via phone or text at (678) 433-9551 or you can email us at Contact@Simstaxassociates.com

Thank you for choosing Sims Tax Associates.