Taxpayer Intake Form
Taxpayer Name
First Name
Last Name
Contact Information
Number
Email
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you a US citizen?
Yes
No
Are you married?
Yes
No
Do you Plan on Filing with a Spouse?
Yes
No
Do you have dependents?
Yes
No
How Many?
What year(s) are you filing
Prior Years
2018
2019
2020
2021
Taxpayer Filing Status
Single
Married Filing Jointly
Married Filing Separate
Head of Hosuehold
Qualifying Widower
Filing Personal or Business return
Personal
Business
Both
Economic Stimulus Simple Tax Form
Did you receive the 2020 stimulus check ($1,200 for Adult and $500 for child)?
Yes
No
How much in total?
Did you receive the 1st 2021 stimulus check including for child ($600 for adults and $600 for child)?
Yes
No
How much in total?
Did you receive the 2nd 2021 stimulus check ($1,400 for adults and $1,400 for child)?
Yes
No
How much in total?
Did you receive any child tax credit payments in 2021 (This payments generally started paying out summer of 2021 and range from $200-$300 per payment)?
Yes
No
How much in total?
Income: Check all that apply
W2
W2G
1099R
1099DIV
1099 INT
1099G
1099MISC
1099NEC
1099SSA
Business Information
If Applicable
Do you have a business?
Yes
No
What entity type is your business ?
Self Employed
Partnership
Sole Proprietor (DBA)
Non - Profit
Limited Liability Corporation (LLC)
C-Corp
S-Corp
Other
None
What type of business is it (ex: production, e-commerce, education, etc.)?
Additional Information
If Applicable
Any additional Information you want to share?
How did you hear about us?
Submit
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