Optimum Financial Services CLIENT Intake Form

LETTER OF ENGAGEMENT

OUR RESPONSIBILITIES
- Our work (whether it is a tax consultation, tax return preparation, tax planning or other related services or products) is based on data you provide.
- We are not responsible to auditing or verify the data that you give to us.
- We may ask for clarification of your data or additional information.
- We are not responsible for discovering fraud or other irregularities, should any exist.
- We will work to find all the credits and deductions you are legally entitled to.
YOUR RESPONSIBILITIES
- To provide all the information required for a complete and accurate finished service.
- To provide this information in a timely manner.
- To retain, with the completed work, all the documents, receipts, bank statements and other data that form the basis of the income, credits and deductions claimed since you may later have to provide them to a taxing authority.
- To carefully review all work completed by our office before you sign the final documents. You have the final responsibility for anything submitted on your behalf to a taxing authority to be corrected prior to being transmitted.
- You are responsible not to commit fraud.
- You are responsible to let us know if you received the Child Tax Credit Payments in 2022 or to let us know if you did not receive your stimulus payment 1, 2, and/or 3 payment (if you are filing a 2020 or 2021 tax return). You are also responsible to let us know if you did not receive any other tax forms that may impact your tax return such as but not limited to your 1099K Form, 1099NEC Form or Unemployment Form.
PENALTIES AND/ OR INTEREST, EXAMINATIONS AND NOTICES

The IRS and state taxing authorities (they) impose penalties and/or interest for certain offenses, including understatement of income, filing after the deadline, underpaying estimated taxes, or under withholding taxes If you would like more information, please contact the IRS and state taxing authorities. They can also select any of your tax returns for examination at any time. We also do not guarantee a specific time frame that you can expect to receive your tax refunds.

PRIVACY POLICY

Our tax professionals are bound by professional standards of confidentiality. Therefore, we will always protect your right to privacy. For current and former clients, we do not disclose any nonpublic personal information obtained in the course of our practice except as required or permitted by law, and as is necessary to properly provide our services to you.

CONFIDENTIALITY STATEMENT

In engaging our tax services, you, as the client, acknowledge and agree to maintain strict confidentiality regarding all aspects of our professional relationship. This includes, but is not limited to, information related to products, services, pricing, disputes, details from consultations, and copies of office documents.

CONFIDENTIALITY COMMITMENT Non-Disclosure: You agree not to disclose, share, or disseminate any information provided or discussed during the course of our professional engagement to any third party without our explicit written consent. Documentation: All documents, electronic or otherwise, shared with you during our engagement are confidential and should not be shared or reproduced without our prior authorization. Pricing and Fee Information: Any pricing, fee structures, or financial arrangements discussed or disclosed are considered confidential and should not be disclosed to others.

CONSEQUENCES OF VIOLATION

Any breach of this confidentiality commitment may result in severe consequences, including but not limited to: Termination of Services: We reserve the right to terminate our professional relationship if confidentiality is breached. Legal Action: Violation of confidentiality may lead to legal action seeking damages and injunctive relief. Financial Penalties: You may be subject to financial penalties for any damages incurred due to the unauthorized disclosure of confidential information. By accepting our services, you affirm that you understand and agree to abide by the confidentiality terms outlined above. Your commitment to confidentiality is essential to maintaining the integrity of our professional relationship. We appreciate your cooperation and adherence to these terms.

Types of Nonpublic Personal Information We Collect. We collect nonpublic personal information about you that is provided to us by you or obtained by us with your authorization. You also give us authorization to use your likeness of photos, videos and reviews in our promotional advertisements. Parties to Whom We Disclose Information. We make available information to our employees and to nonaffiliated third parties who need to know that information to assist us in providing services to you. In all such situations, we require a contractual agreement that includes procedural safeguards that protect the confidential nature of the information being shared, such as our Consent & Disclosure Forms. All information given is also shared with Financial Powerhouse LLC, doing business as Optimum Financial Services formerly Quality Tax. Protecting the Confidentiality and Security of Current and Former Client Information. We retain records (based on the IRS and state taxing authorities regulations) relating to professional services that we provide so that we are better able to assist you with your professional needs and, in some cases, to comply with professional guidelines. In order to guard your nonpublic personal information, we maintain physical, electronic, and procedural safeguards that comply with our professional standards.

OUR FEES

We invoice for our tax professionals time spent assisting you and based on the difficulty of the tax returns or services, depending on schedules and forms completed and out-of-pocket expenses incurred by the company, our rates vary depending. For our new clients we do not offer free estimates, we invoice an nonrefundable upfront deposit to start the process of completing your return(s), itemizing your documents, consultations and also for partially completed work that is placed on extension or remains undone. The total of the deposit is applied to your tax preparation fee or service fee. The amount of your deposit depends on the difficulty of your tax return(s) or service(s). For a *basic tax return we require a $25 nonrefundable deposit and for **complex tax returns require a $75 nonrefundable deposit prior to service being performed. We do have several of our services that the entire nonrefundable cost of the service or product must be paid in full up front. If for any reason your tax return is offset for collection obligations and all or a portion of your tax preparation fees are not paid due to the offset. In the event that your tax return is offset or rejected due to outstanding obligations or any other reasons, you, as the client, are still fully responsible for all unpaid tax preparation fees. By engaging our services, you agree to fulfill your financial obligations promptly. Payment Obligation: If your tax return is offset or rejected, you are obligated to pay any outstanding tax preparation fees within 30 days of the offset or rejection date. Acknowledgment of Liability: Regardless of the status of your tax return, the responsibility for unpaid tax preparation fees remains with you.

CONSEQUENCES OF NON-COMPLIANCE:

Failure to adhere to these terms may result in the following consequences: Late Payment Fees: A late payment fee may be applied for any unpaid tax preparation fees not settled within the specified 30-day period. Interest Charges: Interest charges may accrue on the unpaid balance if not paid within the stipulated time frame. Restriction of Services: Non-compliance may result in the restriction of future services until all outstanding fees are settled. Legal Action: Persistent failure to fulfill payment obligations may lead to legal action or involvement of a collection agency that will help in seeking the recovery of unpaid fees, including associated costs and attorney fees.This debt may also be reported to all 3 credit bureaus.

TAX DOCUMENTS

All clients are provided a copy of their tax documents at the conclusion of their tax preparation, if return is e-filed to the IRS and all up front fees have been paid in full. Tax documents are issued via your customer portal, email and/or in office as a paper copy. In order to provide you with an additional copy of your tax documents, your tax return must be e-filed and APPROVED by the IRS and/or state. Any additional copies of your e-filed tax documents are $5-$25 per year tax year and per additional tax or identity document requested (price depends on if you are or are note a loyal customer).

ARBITRATION

If a customer dispute arises out of or relates to this contract or engagement letter, or the obligations of the parties therein, and if the customer dispute cannot be settled through negotiation, the parties agree first to try in good faith to settle the dispute by mediation administered by the American Arbitration Association under its commercial Mediation Rules before resorting to arbitration, litigation, or some other dispute resolution procedure. We do not provide monetary refunds but will offer to amend your tax return(s) or fix your incorrect service(s) or product(s) at no cost to you if the mistake is of our tax professionals doing; or we will offer a credit on future services based on our management value of the damage to the customer for the incorrect service or product redored. In order to maintain a positive and productive working relationship, it is essential for both parties to adhere to certain guidelines. Please take a moment to review the following terms of engagement and disengagement: Respectful Communication: Optimum Financial Services values open and respectful communication. In the event of disrespectful behavior or non-responsiveness from the client, we reserve the right to disengage from our services. Response Time: Clients are expected to respond to our communications in a timely manner. Failure to respond within 30 days may result in the termination of our services. Negative Reviews: If a client leaves a negative review without first attempting to resolve the issue directly with Optimum Financial Services, we reserve the right to suspend services until the review is removed. We encourage clients to reach out to us for resolution before resorting to public feedback.

Financial Obligations: In the event of service disengagement, all remaining balances for services become immediately due. Please note that all deposits are nonrefundable. Cancellation Policy:If a client cancels on the same day as the scheduled appointment or is a no-call, no-show, a $30 cancellation fee will be charged.

AGREEMENT

The foregoing is in accordance with my (our) understanding of your engagement to provide tax and financial services and you are hereby advised that each item of revenue or expense can be substantiated by receipts, canceled checks, or other documents. This information is true, correct, and complete to the best of my (our) knowledge. Further, it is my (our) understanding that these terms will continue to be enforced for the succeeding years of our engagement. If there are multiple tax year returns completed or a prior year tax return completed all the same terms and conditions apply in this engagement letter.

*Basic Tax Return = Dependents, W2s, 1098T, EIC, CTC, ACTC, Day Care Credit, Social Security, Unemployment, Student Loans, IPPIN Letter just to name a few forms

** Complex Tax Return = Schedule C (small business),1099NEC, 1099K, 1099MISC, Schedule A (itemizing), Real Estate, Investments & Income, Retirement 1099R, Gambling Wins & Losses, HSA, 1099C, 1095A Health Insurance, 1099C, 1st Home Buyers Credit, 1099INT, 1099DIV, SCorp, Partnership, Nonprofit, Estimated Taxes, Daycare Credit, Educator Expense, IRA Distributions or Contribution, Capital Gains & Losses, Farming, Adoption Credit, K1, Household Help just to name a few forms
Print Taxpayer Name*
Taxpayer Signature*

Clear
Date*

MonthDayYear
Date
Print Spouse’s Name (if applicable)
Spouse Signature

Clear
Date

MonthDayYear
Date

CLIENT PROFILE SHEET

EVERY QUESTION REQUIRES AN ANSWER.
I. Personal Information:
What tax year(s) are you filing with the information in these packets (you can select multiple years):*

202420232022202120202019Other
DO NOT complete the questions for your spouse if your filing status is single or head of household.
Taxpayer’s Name: *

First NameMiddle NameLast Name
Taxpayer’s Social Security Number / ITIN: *
Taxpayer’s Date of Birth: *

MonthDayYear
Date
Taxpayer’s Occupation:*
Upload the Tax Payers ID*

Cancelof
Upload the Tax Payers Social Security Card*

Cancelof
Spouse’s Name:

First NameMiddle NameLast Name
Spouse Social Security Number / ITIN:
Spouse Date of Birth:

MonthDayYear
Date
Spouse Occupation:
Upload the Spouse ID

Cancelof
Upload the Spouse Social Security Card

Cancelof

MARRIED FILING

Head of Household OR Single Form
I certify that I have been separated/ divorced from my spouse,
Spouse Full Name during the tax year, and that my spouse and I did not cohabitate during the last six months of the tax year. I resided at the address shown on this tax return the last six months of the tax year and my spouse resided at (Address Spouse lived at the last six months of the tax year MUST be different from your address) .

(Check The One That Applies)
I further certify that I have one or more qualified dependents living in my home more than 6 months of the year and for whom I also provided more than half of the financial support for during the tax year. The address on this return was the main address for the dependents and I all year. Therefore, qualify me to file as “Head of Household” and I desire to file my tax return using that filling status for tax year 2023 instead of Married Filing Separate. My tax preparer has explained to me the penalties that could be imposed if I file as “Head of Household”, and it is determined at a later date that I was not authorized to file with this status. more than 6 months of the year and for whom I also provided more than half of the financial support for during the tax year. The address on this return was the main address for the dependents and I all year. Therefore, qualify me to file as “Head of Household” and I desire to file my tax return using that filling status for during the tax year instead of Married Filing Separate. My tax preparer has explained to me the penalties that could be imposed if I file as “Head of Household”, and it is determined at a later date that I was not authorized to file with this status.
I further certify that I have NO qualified dependents living in my home.I therefore qualify to file as “Single” and desire to file my tax return using that status for during the tax year instead of Married Filing Separate. My tax preparer has explained to me the penalties that could be imposed if I file as “Single”, and it is determined at a later date that I was not authorized to file with this status.
Additional Notes in regards to why you and your spouse are separated:
I can provide proof that my spouse and I did not live together the last 6 months of the tax year.
Taxpayer Signature

Clear
Date

MonthDayYear
Date
Taxpayer First and Last Name (Printed)

First NameLast Name

	Amount ($)
1. Gross receipts or sales
2. Returns and allowances:
3. Other income, including Federal and state gasoline or fuel tax credit or refund:

	Answer
4. Purchases less cost of items withdrawn for personal use:
5. Cost of labor. Do not include any amounts paid to yourself:
6. Materials and supplies:
7. Other Cost:
8. Inventory at the end of the year:

	Answer
11. Commissions and fees:
12. Depletion:
13. Employee benefit programs (other than pension and profit-sharing plans):
14. Self Employed Health Insurance:
15. Insurance, other than health:
16. Long Term Care Insurance to be carried to adjustment:

	Answer
18. Legal and professional services:
19. Name Badges:
20. Office expense:
21. Self Employed Pension, Retirement, 401K, and profit-sharing plans:
22. Personal property (i.e. business car tags):
23. Real Estate Taxes:

	Answer
Vehicles, machinery, and equipment:
Rent or lease of property:
Other business property:

	Answer
Business Travel:
Business Meals and entertainment:

	Amount
Gas Bill:
Water Bill:
Electric:
Alarm System/ Security:

	Answer
30. Wages Paid To Employees:
31. Payroll Taxes:
32. Uniforms/ Wardrobe:
33. Work Shoes/Boots:
34. Bad Debts:
35. Business Use of Cell Phone/ Pager:
36. Machinery:
37. Equipment:
38. Training & Certifications:
39. Memberships:

	Total number of miles
Business:
Commuting:
Other:

	DIRECT EXPENSE ONLY RELATED TO THE BUSINESS:
Casualty losses:
Deductible mortgage interest:
Real estate taxes:
Excess mortgage interest:
Insurance:
Rent:
Repairs and Maintenance:
Office Furniture:
Office Supplies:
Home Phone:
Utilities:
Other expenses:
Carryover of operating expenses from last year’s return:
Excess casualty losses:
Carryover of excess casualty losses and depreciation from last year’s return:

	INDIRECT EXPENSE RELATED TO BUSINESS & PERSONAL USE:
Casualty losses:
Deductible mortgage interest:
Real estate taxes:
Excess mortgage interest:
Insurance:
Rent:
Repairs and Maintenance:
Office Furniture:
Office Supplies:
Home Phone:
Utilities:
Other expenses:
Carryover of operating expenses from last year’s return:
Excess casualty losses:
Carryover of excess casualty losses and depreciation from last year’s return:

ITEMIZED EXPENSES
STOP!

NO PROOF, NO FILING

Under penalty and perjury of law I understand that by signing this form and by completing the pages in the attached Schedule A packet that I am claiming expenses and/or deductions on my Type a label (year) tax return in order to be able to itemize my return (if I qualify) and have provided/reviewed all of the information on the Schedule A with my tax preparer.

If any information in the Tax Pro Software is different from the packet attached, it is because I gave my tax accountant verbal information (as allowed under circular 230). I agree with all information on my transmitted tax return. I understand that if I am audited for any information it is my responsibility to meet the federal and/or state proof requirements.
Taxpayer Name Printed
Date

MonthDayYear
Date
Taxpayer Signature

Clear
ITEMIZED EXPENSES PACKET
What is your filing status?
Standard deduction by filing status:
- (2023) Single $13,850; Married Filing Jointly or Qualifying Widow(er): $27,700; Head of household: $20,800
- (2022) Single $12,950; Married Filing Jointly or Qualifying Widow(er): $25,900; Head of household: $19,400
- (2021) Single $12,550; Married Filing Jointly or Qualifying Widow(er): $25,100; Head of household: $18,800
In order for the Schedule A to take effect your total itemized expenses on this form must be equal to or more than your standard deduction for your federal and/ or state return.
I certify that I incurred the following itemize expenses for this tax year:

Casualty Losses

Amount

Natural Disasters
I. Unreimbursed Employee Business Expenses:

III. Other Expenses

Optimum Financial Services (OFS) holds no liability for information reported on my Schedule A. In the event of an audit, I acknowledge the obligation to furnish supporting evidence for all claims made on this schedule. I am aware that the particulars disclosed in this packet can influence applications for social security, car loans, or home mortgage loans.

Any discrepancies between the Cloud Tax Office Pro software and the information provided on this form shall be governed by verbal communication. In accordance with Circular 230, I am permitted to rely on verbal communication for guidance.
Taxpayer Signature:

Clear
Date

MonthDayYear
Date
Spouse Signature:

Clear
Date

MonthDayYear
Date

	Yes	No
Taxpayer:
Spouse:

	Yes	No
Taxpayer:
Spouse:

	Yes	No
Taxpayer:
Spouse:

	Yes	No
Taxpayer:
Spouse:

	Yes	No
Taxpayer:
Spouse:

CLIENT PROFILE SHEET

I. Personal Information:

II. Filing Status:

MARRIED FILING

III. General Questions:

THE SMALL BUSINESS

SMALL BUSINESS/ SELF CONTRACTOR/ RIDE SHARE PACKET

Part I: Income

Part II: Cost of Goods Sold

Part III: General Expenses

Part IV: Information on Your Business Vehicle or Business Use

Part V: Depreciation of Business Property

Part VI: Other Expenses

Part VII: Business Use of Home

Part of Your Home Used for Business

Expenses

Depreciation of Your Home

EDUCATION CREDITS/DEDUCTIONS PACKET

ITEMIZED EXPENSES

ITEMIZED EXPENSES PACKET

I. Unreimbursed Employee Business Expenses:

III. Other Expenses

IV. Earned Income Credit Qualifications

DEPENDENT PACKET

I. Dependent Detail

IP PIN

II. Qualifying Child Rules for EIC

III. Earned Income Credit With Qualifying Child

IV. Additional Questions (Only answer these questions if you have qualifying children)

V. Dependency Exemption for Qualifying Relative

For DIRECT DEPOSIT/ Payment Plan use the following banking information below:

	Amount
Medical and dental insurance
Prescription Medicines
Legally Obtained Drugs
Insulin
Doctors/Dentists/Nurses Fees Paid Out of Pocket
Eyeglasses & Contact Lenses
Eye Exam
Transportation for Medical Treatment/ Miles
Nonprescription medical supplies
Canes/ Crutches/ Braces
Co-Pays
Ultrasounds
Fees for Operations Out of Pocket
Long-Term Care Insurance
Hospital & Emergency Room Fees
Hospital Care (including meals & lodging)
Lab & X-Ray
Visiting Nurse/ In-Home Care
Dentures & Braces
Medical Aids (Hearing Aids, Crutches, Wheelchair & Batteries)
Orthopedic Shoes
Therapy Treatments
Wheelchairs
Air Conditioning (with Doctor’s Advice)
Vaporizers (with Doctor’s Advice)
Thermometers & Bandage (with Doctor’s Advice)
Birth Control, Braces, chiropractor, dancing lessons, abortion, vitamins, beast pump and supplies
Alcohol/ Drug Rehabilitation
Medical Miles Driven
Long Term Care Insurance Premiums
Other Medical Expenses

	Amount
Churches (tithes & offering)
College Donations
Cash Donation
United Way/ March of Dimes
Cash Donations to Salvation Army/ Goodwill
Value of Furniture Donated to Salvation Army/ Goodwill
Other Donations to Salvation Army/ Goodwill
Auto Miles Driven for Charity

	Amount
Real Estate Tax
Personal Property Tax (i.e car tags)
State Income Tax
State & Local Sales Tax (owed)
Prior Year 4th Quarter State Estimates paid after 12/31

	Amount
Home Mortgage Interest (1098)
2nd Mortgage/ Home Equity
Home Mortgage to Individual
Points Paid Closing
Investment Interest
Mortgage Insurance Premiums

	Answer
Parking Fees:
Tolls:
Transportation (including train, bus, etc.):
Travel expense (lodging, airplane, car rental, etc.):
Meals and Entertainment Expenses:
Other Expenses:
Tax Preparation Fees:
Safe Deposit Box:
Union Dues:
Job Search Expenses:
Job Supplies:
Uniforms:
Job Education Expense:
Uniform Cleaning:
Miles Driven to 2nd Job:
Employment/ Job Seeking Fee:
Business Cell Phone:
Safety Shoes, Gloves, and Equipment:
Work Tools:

	Answer
Occupation:
Parking fees, tolls and transportation:
Travel Expense while away overnight (lodging, airplane, car rental) no meals:
Business expenses not included above?
Amount paid by employer (not on W2 box 1):
Enter your meal expense

	Type	Amount
1
2
3
4
5
6
7

	Yes	No
Taxpayer
Spouse ⚪ Dependents

	Yes	No
Taxpayer
Spouse

	Yes	No
Taxpayer
Spouse