Customer Registration Form

Full Name *

First Name Last Name

Social blanks* DOB Date* IPINNumber

Phone Number *

Please enter a valid phone number.

Email *

example@example.com

ID # blanks* Issue Date Date* Exp Date Date*

Spouse Name

First Name Last Name

Social blanks DOB Date IPIN

Spouse Phone Number

Please enter a valid phone number.

Spouse Email

example@example.com

ID # blanks Issue Date Date Exp Date Date

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Filing Status *

Occupation

How did you hear about us? *

Who is your preparer? *

Did you submit a tax return last year?

Did you have marketplace health insurance last year? (Obamacare) *

Do you currently owe the IRS?

Do you currently owe Child Support?

Do you have a copy of a valid ID and social security card? *

Did you receive any early retirement distributions in 2020 or 2021?

Did you receive any unemployment?

Did you receive any advance child tax payments?

Did you receive any Economic Impact Payments (Stimulus)?

Did you or any of your dependents attend higher education last year (college)?

Select documents that you are needing to file

W2 1099 Misc 1099k 1099-R 1098T Childcare Expenses Business Income and Deductions W2G Other

Qualified Dependents:

	Full Name	DOB	Social Security Number	Relationship	Months in home	Can anyone else claim this dependent?
1
2
3
4
5
6

File Upload

Do you have a business return to file?

Do you have a State return to file?

Are you applying for an advance?

How would you like your refund disbursed? *

Bank Name

Account Number

Routing Number

Taxpayer Signature *

Clear

Spouse Signature

Clear

This is an agreement between (the client) and Austin Financial, in which Austin Financial agrees to provide tax preparation and advisory services for the client at a reasonble fee agreed to by the client before submission. Services include compliance check with the IRS, preparation of tax return, reduction of tax liability if applicable , assistance with tax planning and organization if applicable, accounting services if applicable. Any additional work beyond the scope of this engagment can be modified by either party for reasonable cause with reasonable notice. All information provided by the client is certified to be true, any false information provided can result in pentalties and fines by the IRS at which the preparer is not liable.

Customer Details: