2024 Tax Year- Client Data Intake Form

Welcome to our Virtual Tax Client Data Form
CLIENT PRE-APPLICATION FORM

This form is to collect information to begin your taxes for 2025 Tax Season. Nothing will be submitted to the IRS until YOU have approved your quote amount and signed all documents.
How did you hear about us?

Other
Referred by
Will you be looking for financing for a personal, business or real estate loan this year?

Other
Are you interested in Free Credit Boost Strategy Session?
Would you like to see if you PRE-QUALIFY for a SAME DAY ADVANCE UP TO $7,500 of your tax refund? Based on approval from the bank. Approved within 24 hours (Ends 2/28/2026)
Tax Payers Name

First NameLast Name
Taxpayer's Phone Number
Example: xxx-xxx-xxxx
Taxpayer's Job Title
Taxpayer's Date of Birth
Example: 01/01/2001
Taxpayer's SSN
Example: xxx-xx-xxxx
Taxpayer's Email Address
Spouse's Full Name
First Name
Spouse's SSN
Example: xxx-xx-xxxx
Name

First NameLast Name
Spouse's Date of Birth
Example: 01/01/2001
Spouse's Phone Number
Example: xxx-xxx-xxxx
Spouse's Email Address
Example: example@example.com
Taxpayer's SSN
Example: xxx-xx-xxxx
Spouse's Job Title
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you self employed?
Do you have to file a PIN number?
Did you and your spouse live apart during the year?
What is your filing status as of December 2025?
Did you receive unemployment in 2025?
Did you support a child or family member for more than 6 months out of the year?
If yes, did you live together at any time after June 30, 2025?
How many dependents are you claiming?
Dependent #1

First NameLast Name
Dependent #1 Date of Birth
01/01/2001
Dependent #1 SSN
What is Dependent #1's Relationship to you (son, daughter, etc.)?
How many months did Dependent #1 live with you in 2025? (If all year, enter 12)
Dependent #2

First NameLast Name
Dependent #2 Date of Birth
Example: 01/01/2001
Dependent #2 SSN
How many months did Dependent #2 live with you in 2025? (If all year, enter 12)
What is Dependent #2's Relationship to you (son, daughter, etc.)?
Dependent #3

First NameLast Name
Dependent #3's Date of Birth
01/01/2001
How many months did Dependent #3 live with you in 2025? (If all year, enter 12)
Dependent #3 SSN
Example: xxx-xx-xxxx
Dependent's #3 SSN
What is Dependent #3's Relationship to you (son, daughter, etc.)?
Dependent #4's First Name
First Name
Dependent #4's Last Name
Last Name
Dependent #4's Date of Birth
01/01/2001
Dependent #4's SSN
Example: xxx-xx-xxxx
What is Dependent #4's Relationship to you (son, daughter, etc.)?
How many months did Dependent #4 live with you in 2025? (If all year, enter 12)
Dependent #5's First Name
First Name
Dependent #5's Last Name
Last Name
Dependent #5's Date of Birth
01/01/2001
Dependent #5's SSN
Example: xxx-xx-xxxx
What is Dependent #5's Relationship to you (son, daughter, etc.)?
How many months did Dependent #5 live with you in 2025? (If all year, enter 12)
Are there any dependents in daycare? If yes, please upload the form you received from your daycare provider.
Upload a copy of your daycare form here.

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How would you like to receive your tax refund?
Name of Bank
Which type of account would you like your refund deposited into?

Other
Routing Number
Bank Account Number
Can someone else claim you as a dependent?
Did you have health insurance in 2025?
Did you have health insurance for the entire year?
Who was your insurance cover through in 2025?
Was your insurance through your employer?
Was your insurance through Medicaid?
Was your insurance through the Affordable Care Act (The Marketplace)?
Did your dependents have health insurance for the entire year?
Was YOUR DEPENDENTS' insurance through your employer?
Who was your Dependents insured with in 2025?
Upload Taxpayer & Dependent(s)Insurance Documents

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Was YOUR DEPENDENTS' insurance through Medicaid?
Was YOUR DEPENDENTS' insurance through the Affordable Care Act (The Marketplace)?
Were you or any of your dependents in college in 2025?
Do you have a 1098-T Form for either you or your dependents?
If you have a 1098-T form, upload it here.

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Are you interested in AUDIT PROTECTION?
I acknowlege by signing this form if I and/or my spouse owes a federal / government debt such as IRS, child support, student loans etc., I/we are still responsible for tax preparation fees due to Better Days Tax Service. Also, if the tax preparation fees are not paid, I understand that A Better Day Tax Service will take legal action to collect the unpaid tax preparation fees.
Primary Taxpayer's Signature
I am giving A Better Day Tax Service permission to prepare all forms related to my tax return; to apply for and secure RAC's and RAL's on my behalf; and sign all necessary forms and file my taxes electronically. I take full responsibility for the accuracy of this form and understand that Better Days Tax Services and/or associated affiliates hold no responsibility for any misrepresentation or false claims.
Date

MonthDayYear
Date
Taxpayer's Signature (If no spouse, leave blank)
Spouse's Signature (If no spouse, leave blank)
Date

MonthDayYear
Date
Anything you would like to tell or ask your Tax Preparer?
Date

MonthDayYear
Date
Taxpayer's and Dependent(s ) Social Security Card(s)

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Taxpayer's Driver's License

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Taxpayer's W-2/ 1099'S

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Dependent(s) Birth Certificate(s)

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Dependent(s) Proof of Residency (Lease/Utility Bill)

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Business documents/ Income & expense sheet

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Signature
Should be Empty:

Welcome to our Virtual Tax Client Data Form

CLIENT PRE-APPLICATION FORM