Client Information Form
Name
*
First Name
Last Name
SSN
*
XXX-XX-XXXX
Date of Birth
*
-
Month
-
Day
Year
Occupation or job title
*
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What state did you live in as of 12/31/2024
*
Resident State
Best Phone Number
*
Best Email
*
example@example.com
What was your marital status on December 31, 2024?
Single
Married
Married BUT separated
Married BUT not living together
Divorced
Widowed
Which filing status do you generally use?
*
Please Select
Head of Household
Single
Married filing Jointly
Married filing Separate
Qualified Widower
Unsure
Did you file a tax return last year? (2023)
*
YES
NO
This is my first time filing
I haven't filed taxes in over a year
Did you serve in the U.S. Armed Forces in 2024? (Active, Reserve, National Guard)
*
YES
NO
Did you pay more than half the cost for keeping up the home where you lived during the year?
*
YES
NO
Someone else did
I split costs with someone else
Did you receive income from multiple states?
*
YES
NO
Can someone claim you as a dependent on their tax return?
*
YES
NO
I DON'T KNOW
Did you have children or dependents last year?
*
YES
NO
Did you pay for child or dependent care?
YES
NO
Dependent Information
First Name
Last Name
Birthdate
Social Security #
Relationship to you
Did dependent live with you all year? (Y/N) How many months?
1-Dependent
2-Dependent
3-Dependent
4-Dependent
5-Dependent
6-Dependent
Did you have a job last year? (W-2)
YES
NO
How many W-2's did you receive?
*
Please Select
1
2
3
4
5 OR MORE
DIFFERENT EMPLOYERS
Did you own your own business or do any gig work/independent contractor last year? (1099-NEC, 1099-MISC, 1099-K or other Records)
YES
NO
Did you receive unemployment benefits?(1099-G)
*
YES
NO
Did you receive interest from a bank account? (1099-INT)
*
YES
NO
Did you receive any dividends? (1099-DIV)
*
YES
NO
Did you sell any stocks or investments? (1099 B)
*
YES
NO
Did you sell or trade cryptocurrency or digital assets? (1099-B or other statements)
*
YES
NO
Did you have gambling or other lottery winnings? (W-2G, 1099 MISC)
*
YES
NO
Did you withdraw money from or receive income from a retirement account (1099-R, 401k, pension)
*
YES
NO
Did you receive Social security benefits? (1099 SSA or RRB - 1099)
*
YES
NO
Did you receive rental property income? (1099-MISC, 1099-k or other records)
*
YES
NO
Did you receive income from an S-Corp, Partnership, or trust? (Schedule K-1)
*
YES
NO
Did you sell a home? (1099-S or escrow statement)
*
YES
NO
Did you have cancelled debt? (1099-C)
*
YES
NO
Do you have an Identity Protection Pin Number? Input current IP PIN#
https://www.irs.gov/identity-theft-fraud-scams/retrieve-your-ip-pin
Did you enroll in or have health insurance from the Marketplace / Healthcare.gov / ObamaCare / Affordable Care Act? (1095-A)
*
Yes
No
Unsure
Did you pay any mortgage interest? (1098)
*
Yes
No
Did you pay any tuition or college expenses? (1098-T)
*
YES
NO
Did you pay student loan interest? (1098-E)
*
YES
NO
Did you use money from a Health Savings Account (HSA) or Medical Savings Account (MSA)? (1099-SA)
*
YES
NO
Did you purchase an electric vehicle? (Form 8936)
*
YES
NO
Attach Valid Photo Identification for everyone 18 yrs. & older listed on tax return
*
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Driver's License or State ID card
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Attach Income Documents: (W-2, 1099'S, ETC...)
*
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Attach Self employment / independent contractor documentation (1099's, expense sheet, business card, flyer, brochure, IRS tax ID number, etc)
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Attach any other documentation you may use to file taxes (School Forms 1098T, Mortgage Form, Contribution Statement, Itemized Expenses, Investment Forms, etc.)
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of
Attach dependents birth certificate, social security card, or report cards (1 or more)
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of
Attach your prior year tax return (New Clients Only)
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New Clients Only
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of
Preferred Refund Method
Check
Direct Deposit
Prepaid Card
Upload Direct Deposit Information -if direct deposit was selected
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Choose a file
Voided Check, Direct Deposit Form, must list-bank name, routing and account number
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of
What type of appointment would you prefer?
*
Phone Call
Virtual Zoom Meeting
Other
Who referred you
*
List any people you may have referred
Signature
*
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