K. Reigns Group

K. Reigns Group

Tax Prep Client Intake Form
Filing Status

SingleHead of HouseholdMarried Filing SeparateMarried Filing JointQualifying Widower
Do you have roommates who could file Head of Household status? (The person who should file as HOH would be the person who covers the majority of the household bills and/or is also the lease holder or homeowner)

YesNo

Taxpayer Information
Name

First NameLast Name
Date of Birth

MonthDayYear
Date
SSN
Wireless Phone Number
Please enter a valid phone number.
Email
example@example.com
The following is needed to process a remote signature on your tax file. Please provide your wireless phone company name here.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you a full-time student?

YesNo
Are you claimed on someone else's taxes?

YesNo
Are all previous tax years filed and up to date?

YesNo

Enter your dependents here

Did you, your spouse, and your dependents have health insurance for all 12 months last year? Please fill in the grid.

General Expenses

	Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses
Adoption Expenses

Spouse Information
Name

First NameLast Name
Date of Birth

MonthDayYear
Date
SSN*
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Wireless Phone Number
Please enter a valid phone number.
The following is needed to process a remote signature on your tax file. Please provide your wireless phone company name here.
Are you a full-time student?

YesNo
Are you claimed on someone else's taxes?

YesNo
Are all previous tax years filed and up to date?

YesNo

Tax Related Questions
Employment Status of Taxpayer

EmployedUnemployedSelf-employedOther
Employment Status of Spouse

EmployedUnemployedSelf-employedOther
What option best describes your business? Taxpayer Section

Single Member LLC, Sole Proprietor, 1099 Independent Contractor, Side HustlesS - CorpC-CorpPartnershipNot Applicable
What option best describes your business? Spouse Section

Single Member LLC, Sole Proprietor, 1099 Independent Contractor, Side HustlesS - CorpC-CorpPartnershipNot Applicable
Business Address or Virtual Address (Taxpayer Section)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Address or Virtual Address (Spouse Section)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Revenue of Taxpayer

Amount

Revenue
Business Revenue of Spouse

Amount

Revenue
Business Information (Taxpayer)

Name of BusinessBusiness EIN (If Applicable)

	Amount
Revenue

	Amount
Revenue

Business Expenses of Taxpayer

	Amount
Tax Preparation Fees
Marketing/Advertising
Business Travel
Office lease/Virtual office rent
Business Attire/ Uniform
Meals
Contract Labor
Supplies
Taxes and Licenses
Equipment (Ex: phone, computer, printer, Tools)
Cost of Goods (for product-based businesses)
Additional supplies and material cost to put product together

Business Expenses of Spouse

	Amount
Tax Preparation Fees
Marketing/Advertising
Business Travel
Office lease/Virtual office rent
Business Attire/ Uniform
Meals
Contract Labor
Supplies
Taxes and Licenses
Equipment (Ex: phone, computer, printer, Tools)
Cost of Goods (for product-based businesses)
Additional supplies and material cost to put product together

Acknowledgment & Signature
I confirmed that all information I entered here is accurate and true. I allow K. Reigns Group 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 K. Reigns Group. By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Taxpayer Signature

Clear
Date Signed

MonthDayYear
Date
Spouse Signature

Clear
Date Signed

MonthDayYear
Date
Should be Empty:

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