Client Intake Form 2021

  • AAA Tax Prep TN

    PLEASE FILL OUT ALL APPLICABLE INFORMATION
  • Are You a Returning Client?*
  • If A New Client, Were You Referred By Anyone?
  • Filing Status:*
  • Taxpayer Date of Birth*
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  • Format: (000) 000-0000.
  • Date of Birth
     - -
  • Format: (000) 000-0000.
  • Which Of The Following Applies to You?
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  • If You Are Claiming Dependents, Did You Receive a 6419 Letter From The IRS?
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  • How Many Dependents Are You Claiming?
  • Date of Birth
     - -
  • Date of Birth
     - -
  • Date of Birth
     - -
  • Date of Birth
     - -
  • Date of Birth
     - -
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  • IF YOU ARE CLAIMING A DEPENDENT, PLEASE ANSWER THE QUESTIONS BELOW THAT PERTAINS TO YOUR DEPENDENT RELATIONSHIP.
  • Did you pay someone to watch your child/children?
  • Did you collect social security or retirement income?
  • Did you purchase health insurance through healthcare.gov marketplace (Obama Care)?*
  • If yes, did you receive a 1095-A Form from the marketplace?
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  • Were you ever disallowed the Earned Income Tax Credit prior to this year?*
  • Did you receive unemployment compensation (1099-G) regular or PUA last year?*
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  • Did you make college tuition payments and received a 1098-T Form last year?*
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  • Do you owe any delinquent:*
  • Would you like your refund to be direct deposited to your bank account?*
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  • How would you like to pay for tax preparation services?*

  • An invoice will be issued following the completion of your tax return. Payment must be received in order for your return to be submitted to the IRS.

     

    Please sign below to agree.

  • The total fees for your tax preparation service plus a fee of $50 will be deducted from your refund if applicable. This fee is directly from the bank used to provide this service and does not increase the fees AAA Tax Prep TN receives from you. If you do not receive a refund, or are obligated to pay additional taxes, an invoice will be issued that must be paid in full before your tax return is submitted to the IRS via Credit/Debit card payment. In this case the $50 fee would not be applicable.

     

    Please sign below to agree.

  • I, hereby, state that all the information above is true to the best of my knowledge and that I am allowing On Journey Financial to prepare my taxes based on that fact.
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