Tax Preparation Virtual Client Intake Form

Virtual Client Tax Info

Completely fill out the form below to submit your tax information to me. Upload all documents before final submission. If you are claiming any dependents, be sure to upload their SS CARDS, BIRTH CERTIFICATES AND ALL ITEMS THAT SHOW THEIR ADDRESS IS THE SAME AS YOURS. (e.g. school records, medical records, doctor bills, medicaid statement, social service records or anything that shows your child's name and current address). IF YOU ARE FILING MULTIPLE YEARS YOU MUST COMPLETE A SEPARATE FORM FOR EACH YEAR. If you have any questions prior to completing this form, do not hesitate to contact me by email at virtualtaxlady@gmail.com or by phone at (910) 975-6761. Thank you!
How did you hear about us or who referred you?
First Name*
Middle Name
Last Name*
Suffix
Jr, Sr, II, III
Social Security Number*
Date of Birth*

MonthDayYear
Date
Occupation*
What do you do for a living?
Can someone file you as a dependent?*

YesNo
Address*

Street Address

Street Address Line 2

CityState

Zip Code
What County Do You Live in?*
Phone Number*

Area CodePhone Number
Email*
example@example.com
Driver's License #*
State Driver's License Was Issued*
Date Driver's License Was Issued *
MM/DD/YYYY
Driver's License Expiration Date*
MM/DD/YYYY
Photo of Social Sec. Card & Driver's License *

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Identification Cancelof
What is your filing status?*
Are you filing an eligible spouse on your tax return?*

YesNo

Spouse Name

First NameMiddle NameLast NameSuffix
Social Security Number*
Occupation*
Date of Birth*

MonthDayYear
Date
Phone Number*

Area CodePhone Number
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Driver's License #*
State Driver's License Was Issued*
Date Driver's License Was Issued *
MM/DD/YYYY
Driver's License Expiration Date*
MM/DD/YYYY
Photo of Driver's License *

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Identification Cancelof

Dependents

Should only be listed if you take care of the dependent over half of the year
Please provide proof that your dependents live with you (school records, medical records, doctor bills, medicaid statement, social service records, or anything that shows your dependents name and current address).*

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This is required in case of an audit Cancelof
Image of Dependent's S.S.Card*

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1. Dependent Information

GenderFirst NameMiddle NameLast NameSuffix
How are you related to Dependent?*
Date Of Birth*

MonthDayYear
Date
Social Security Number*
Do you want to enter another dependent?*

YesNo, all dependents are entered
2. Dependent Information

GenderFirst NameMiddle NameLast NameSuffix
How are you related to Dependent?*
Date Of Birth*

MonthDayYear
Date
Social Security Number*
Do you want to enter another dependent?*

YesNo, all dependents are entered
3. Dependent Information

GenderFirst NameMiddle NameLast NameSuffix
How are you related to Dependent?*
Date Of Birth*

MonthDayYear
Date
Social Security Number*
Do you want to enter another dependent?*

YesNo, all dependents are entered
4. Dependent Information

GenderFirst NameMiddle NameLast NameSuffix
How are you related to Dependent?*
Date Of Birth*

MonthDayYear
Date
Social Security Number*
Did you pay any child care expenses throughout the year ?

YesNo

Child and Dependent Daycare Expenses

If the provider is a person, enter the care provider's SSN
Child Name Amount Paid*

First NameAmount Paid
Provider Phone Number*

Area CodePhone Number
Provider*

NameTax ID #/ SSN
Provider Address*

Street Address

Street Address Line 2

CityState

Zip Code
Do you want to enter another child care provider?*

YesNo
Child Name Amount Paid*

First NameAmount Paid
Provider*

NameTax ID #/ SSN
Provider Phone Number*

Area CodePhone Number
Provider Address*

Street Address

Street Address Line 2

CityState

Zip Code

Business Owners Data Sheet

Schedule C
Name of Business*
Employer ID Number
EIN
What is the legal structure of your business?*
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Amount of business taxes paid throughout the year?
$
Business Income

All income receive during the fiscal year
Total Income
$
Business Expenses

Complete to the best of your ability. In each field enter the approximate amount you spent in each category.
Advertising
Social media, Flyers, Business Cards, etc
Contract Labor
An person or company paid to assist you
Insurance
(Other than health)
Interest
Mortgage, Loans, Credit Cards, etc.
Legal & Professional Services
Training, Conferences, Mentors, Lawyers, etc
Office Expenses
Software, postage, email, internet, and any operating expenses
Rent and Lease
Vehicles, Machinery, Equipment, Electronics, Accessories, etc.
Repairs and Maintenance
Supplies
Objects used to operate your business
Taxes and Licenses
Travel, Meals, and Entertainment
Airfare, Uber, Taxi, Lyft, Business Dining, Business Entertainment, and etc.
Utilities
Other Expenses
Is there any other information, questions, or concerns that you want to include to your tax preparer pertaining to your business?
Attach any photos or documents that you want us to have on file.

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STOP!

DID YOU FINISH UPLOADING YOUR DOCUMENTS?

IF YOU DID NOT UPLOAD ALL NECESSARY DOCUMENTS YOUR INTAKE FORM WILL BE VOIDED.

Client non-payment/offset clause

At FTB TAX, we strive to assist all of our clients in their tax needs, however, we understand that situations arise. If your refund is offset by the IRS, student loans, child support or your check is mailed, you are still obligated to pay our company the fees associated with filing your tax return. By signing this agreement you acknowledge that if payment is not made in full within 30 days legal actions will be sought to resolve payment.

VERY IMPORTANT (Upload a selfie with you holding your ID beside your face) The IRS wants us to verify that it is you.*

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E- Signature Below*

Clear
By filling out this form, you are giving us permission to prepare your tax return and you are confirming that ALL information entered is accurate. If you have any questions do not hesitate to call our office at (910)975-6761 or email virtualtaxlady@gmail.com
Should be Empty:

Virtual Client Tax Info

Payment/Refund

Dependents

Child and Dependent Daycare Expenses

Upload photos of your W-2,1099,and ALL documents

Business Owners Data Sheet

Business Income

Business Expenses