22 & Older Savvy In Services Tax Client Form

Savvy Taxes by Taneshia Website

Name*

First NameMiddle NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Alternate Phone Number*

Please enter a different phone number.

SSN*

Do you have an IRS Identity pin?*

Please enter you IRS Identity pin:

6-digit number

Birth Date*

MonthDayYear

Occupation*

Are you blind?*

YesNo

Select the best answer:*

I believe I should receive a tax refundI believe I will oweI am not sure

Did you receive, sell, exchange or otherwise disposed of any financial interest in virtual currency?*

YesNo

Virtual Currency. Please upload tax document.

State Driver's License/ID*

Email*

Filing Status*

Type of Income (check all that apply)*

Total Number of Dependents*

Please list the total number of college students included on the tax return*

If you or your dependent attended Post Secondary School (College, University, Technical, etc), how was it funded? (check all that apply)

Financial AidScholarshipsStudent LoansPersonal Finances

Did you have any child care expenses?*

YesNo

Please complete Child Care details:

Spouse Name

First NameLast Name

Spouse Phone Number

Please enter a valid phone number.

Spouse SSN

Spouse: Do you have an IRS Identity pin?

Spouse- Please enter your IRS Identity pin:

6-digit number

Spouse Date of Birth

MonthDayYear

Spouse Occupation

Is your spouse blind?

YesNo

Did your spouse receive, sell, exchange or otherwise disposed of any financial interest in virtual currency?

YesNo

Virtual Currency. Please upload tax document.

Spouse Email

Spouse State Driver's License/ID

Dependent 1

Dependent 2

Dependent 3

Dependent 4

First Stimulus Payment*

Second Stimulus Payment *

Third Stimulus Payment *

Advanced Child Tax Credit*

Did you own or operate a business or work as a contractor?*

YesNo

What is the date that the business was established?

Did you receive a 1099?

YesNo

Did you have business expenses?*

YesNo

Did you have business miles to claim?

YesNo

Vehicle Information

Did you carry inventory for your business?*

YesNo

What was the total amount of your inventory at the beginning of the year?

What was the total amount of your inventory at the end of the year?

Did you use a home office?

YesNo

Home Office Information

Did your spouse own or operate a business or work as a contractor?*

YesNo

What is the date that the business was established?

Did your spouse receive a 1099?

YesNo

Did your spouse have business expenses?

YesNo

Did your spouse have business miles to claim?

YesNo

Vehicle Information

Did your spouse carry inventory for their business?

YesNo

What was the total amount of the inventory at the beginning of the year?

What was the total amount of the inventory at the end of the year?

Did your spouse use a home office?

YesNo

Home Office Information

List your business expenses. If you have a document of your expenses please enter see attachment.

Did you take sick leave for yourself due to Covid-19?

YesNo

How many days were you unable to perform services as a self-employed individual due to Covid-19?

Enter the amount of emergency paid sick leave that you received from an employer:

Did you have to care for a family member due to COVID-19?

YesNo

How many days were you unable to perform services as a self-employed individual because of care that you provided for a family member due to COVID-19?

What is your relationship to the family member that you provided care for?

Enter the amount of emergency family leave wages you received from an employer:

Will your tax return be offset due to any outstanding debt or garnishments?*

YesNo

Would you like to apply for an advance up to $6,000.00?

YesNo

Are you using Direct Deposit for any applicable tax refund?*

Direct Deposit

Please have the following documents available for download (as applicable):

1. A Valid Driver's License/ID card for the taxpayer(s)

2. Proof of Address: Utility Bill, Lease, Mortgage Document, or other mailed document with taxpayer(s) name.

3. Social Security Card for everyone on the return

4. Proof of Income (W-2, 1099, Business Income Statement)

5. 1098-T (if claiming college credit)

6. Proof of Children (Medical Records/School Records/Daycare Records/Other Mail with Child's name present)

W-2 or Income Verification Documents (I.e., 1099, Income Spreadsheets, Bank Records, etc).

Business Expenses Document(s)

Taypayer/Spouse Social Security Card(s), Current State ID

Proof of Address: Mortgage, Lease, Utility Bill, or Other Mailed Document with taxpayer(s) name(s)

Dependent(s) Birth Certicate(s) and Social Security Card(s)

Child Care Expense Document(s)

Post Secondary 1098-T

Referred By

Name/Unique ID

Coupon code

Signature*

Date*

Date

Due Diligence Questionnaire
The United States Congress have, as a reaction to the substantial tax fraud resulting from their original error of choosing to distribute federal social welfare program benefits via the tax return, placed new excessive inappropriate “due diligence” requirements on paid tax return preparers whose clients are claiming certain tax credits. This added to the excessive and inappropriate requirements previously implemented by the Internal Revenue Service, the IRS has forced tax preparers to, in many cases, become Social Workers and verify that their clients qualify to receive certain credits i.e. EIC, CTC, ACTC and now HOH.

We preparers are not compensated by the IRS or the government for doing their job for them but must pass the costs of this required additional work on to our taxpayer clients.

You will be claiming an Earned Income Credit, Child Tax Credit, Additional Child Tax Credit, HOH, and/or an American Opportunity Credit on your 2020 tax return. Because of this you must complete, sign, and return this questionnaire to me. I will keep the original signed copy of this questionnaire with my file copy of your 2020 tax return and will include a photocopy of the completed questionnaire in the package I send you with the finished returns.

1. I/we certify that the child(ren) for whom the tax credit(s) will be requested can be claimed as my/our dependent(s), as per the information provided at the end of this questionnaire.*

YesNoN/A

2. The child(ren) for whom the tax credit(s) will be requested lived with me/us for the year, except for temporary absences.*

YesNoN/A

3. I am the custodial parent of the child(ren) for whom the tax credit(s) will be requested.*

YesNoN/A

4. I have documentation to substantiate the credits being claimed Form 1098-T and receipts for college tuition, material costs (you are responsible for keeping this documentation and providing it to the IRS if you are audited or questioned).*

YesNoN/A

5. Was a Child Tax Credit, Additional Child Tax Credit, or American Opportunity Credit claimed by you disallowed or reduced by the IRS on a past tax return?*

YesNoN/A

6. What year was the Child Tax Credit, Additional Child Tax Credit, or American Opportunity Credit claimed by you disallowed or reduced by the IRS from the past tax return?

7. How long was/is the Child Tax Credit, Additional Child Tax Credit, or American Opportunity Credit claimed by you disallowed or reduced by the IRS from the past tax return?

8. I am unmarried or separated, support a qualifying person as your dependent, and pay more than half the cost of maintaining your household. *

YesNoN/A

Attestation and Disclaimer

Savvy Taxes by Taneshia or Savvy Business Group, LLC is not responsible if the taxpayer provides us with incorrect information (i.e. social security numbers for self, spouse, or dependents, last names, birth dates). This may delay your refund. Savvy Taxes by Taneshia or Savvy Business Group, LLC is not responsible for any IRS audits. All information obtained from the taxpayer and/or spouse must be presentable if the IRS audits your tax return. Savvy Taxes by Taneshia or Savvy Business Group, LLC is not responsible for any incorrect tax figures provided by the taxpayer and/or spouse. If your tax figures change you will need to do an Amendment. Prices Vary. If you have any federal or government debts (i.e. school loans, child support, DPP, DFCS, etc….) there is a chance that your refund will be applied towards your debt. You can call the offset department at 1-800-304-3107 or 1-800-829-7650 to see if your refund will be partially or fully taken. If your refund is fully taken you are responsible for paying the preparation fees. Savvy Taxes by Taneshia provides the taxpayer with ONE complimentary copy of their tax return. Should you need any additional paper copies, there is a $15 fee per copy (federal and state included). Savvy Taxes by Taneshia or Savvy Business Group, LLC is not responsible for any discussions or changes the IRS or bank may make on disbursement dates, filing status or any other required information from the IRS. Savvy Taxes by Taneshia or Savvy Business Group, LLC is not responsible for any IRS glitch problems or IRS problems that may cause a delay in your tax refund. There WILL NOT be any reimbursement of any bank fees in the event of this occurrence. **

Consent To Use

Federal law requires this consent form be provided to you (“you” refers to each taxpayer, if more than one). Unless authorized by law, we cannot use your tax return information for purposes other than the preparation and filing of your tax return without your consent. You are not required to complete this form to engage our tax return preparation services. If we obtain your signature on this form by conditioning our tax return preparation services on your consent, your consent will not be valid. Your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature. For your convenience, we have entered into an arrangement with certain companies to offer an Electronic Refund Disbursement Service and/or Loan product. To determine whether these offerings may be of interest to you, we will need to use your tax return information. If you would like us to use your tax return information to determine whether these offerings are relevant to you while we are preparing your return, please sign and date this consent to the use of your tax return information. By signing below, you authorize us to use the information you provide to us during the preparation of your 2020 tax return to determine whether to offer you an opportunity to apply for the Electronic Refund Disbursement Service and/or Loan product. **

Consent to Disclosure

Consent to Disclosure Of Tax Return Information Federal law requires this consent form be provided to you (“you” refers to each taxpayer, if more than one). Unless authorized by law, we cannot disclose your tax return information to third parties for purposes other than the preparation and filing of your tax return without your consent. If you consent to the disclosure of your tax return information, Federal law may not protect your tax return information from further use or distribution. You are not required to complete this form to engage our tax return preparation services. If we obtain your signature on this form by conditioning our tax return preparation services on your consent, your consent will not be valid. If you agree to the disclosure of your tax return information, your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature. You have indicated that you are interested in utilizing the Electronic Refund Disbursement Service and/or Loan product from Republic Bank or Santa Barbara Trust. To provide you with the opportunity to apply for and/ or receive the Electronic Refund Disbursement Service and/or Loan product, we must disclose all of your 2019 tax return information to Refund Advantage. You may request a more limited disclosure of tax return information, but you will not be eligible to submit an application for the Electronic Refund Disbursement Service and/or Loan product. If you would like us to disclose your 2019 tax return information to Refund Advantage for this purpose, please sign and date your consent to the disclosure of your tax return information. By signing below, you authorize us to disclose to the designated bank all of your 2019 tax return information so that it can evaluate and process your application for the Electronic Refund Disbursement Service and/or Loan product. You understand that if you are not willing to authorize us to share your tax information with Refund Advantage, you will not be able to obtain the Electronic Refund Disbursement Service and/or Loan product, but you can still choose to have your tax return prepared and filed by us for a fee. If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by email at complaints@tigta.treas.gov. *

Disclosure

The information contained in this office or on this website is of a general nature. It should not be construed as legal advice nor should it be acted upon in your specific situation without further details and/or professional assistance. Any use of information contained in this office or on my web site is done so at the risk of the user, and Savvy Taxes by Taneshia is not responsible for the result or outcome of its use. Savvy Taxes by Taneshia does not guarantee and is not liable for the truthfulness, accuracy, effectiveness, or any resulting effects of the use of any information contained in this office or on the web site. It is advised and it is the responsibility of the visitor of this office or web site to seek proper instruction and/or seek professional assistance in all matters regarding taxes and the IRS. Savvy Taxes by Taneshia is thus held harmless, released of, and users of information contained in this office or on this web site assume full responsibility for, any violation of Tax laws and/or IRS procedure, and any other legal liability resulting from use of any information contained in this office or on this web site. I attest that all information contained in this income tax return was obtained from the taxpayer or spouse and is true and correct to the best of his/her knowledge.*

Date*

Date

Savvy in Services Tax Client Form