Tax Preparation Client Intake Form
Client Status?
New
Returning
Taxpayer Information
Name
First Name
Last Name
Social Security Number
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
Identity Protection Pin(If issued by IRS)
Do you have copy of Prior year tax return(2022)?
Yes
No
Can another taxpayer claim you as a dependent on their tax return?
Yes
No
Did you work in 2023?
Yes
No
Have you been disallowed for EITC/AOTC/CTC/ACTC?
Yes
No
I'm not sure
How many dependents will you claim on your 2023 tax return?
0
1
2
3 or more
Dependent 1:
Dependent 2:
Dependent 3:
Dependent 4:
Please upload dependent Social Security Cards:
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Did you pay any child care expenses for dependent(s)?
Yes
No
If yes, upload child care receipts or forms:
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Did you, your spouse or any dependent attend college in 2023?
Yes(Please upload 1098-T below)
No
Did you or your spouse receive unemployment benefits?
Yes(Please upload 1099-G below)
No
Does you, your spouse, or dependents have tuition expenses?
Yes
No
Do you have any medical expenses?
Yes
No
Did you or your spouse receive social security benefits in 2023?
Yes
No
Did you make any charitable contributions in 2023(Church, Salvation Army, Goodwill? If yes, how much?
Are you or your spouse self employed?
Yes
No
Do you or your spouse owe any debt to any Government Agency such as IRS, Student loans, Child Support, etc?
Yes
No
Do you plan on purchasing a home soon?
Yes
No
Are you interested in a credit restoration?
Yes
No
Would you like to see if you qualify for a same day Advance up to $6000?
Yes
No
Additional comments
Please upload W-2, 1099s, and any additional forms and/or receipts:
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Were you referred by anyone? Please provide name if yes:
Ackn & Signature
I confirmed that all information I entered here is accurate and true. I allow ABC Financial to capture my sensitive data like personal id, government id, social security number (SSN), and other information. I have read the terms and conditions and privacy policy of ABC Financial. By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Date Signed
-
Month
-
Day
Year
Date
Taxpayer Signature
Date Signed
-
Month
-
Day
Year
Date
Spouse Signature
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