Tax Client Intake Questionaire

1
Photo IdentificationPlease upload a photo of you holding your identification card. Like a selfie with your identification card.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
2
How did you hear about us ?
Facebook
Instagram
Client Referral
3
If someone referred you ,please type client first and last name below
4
WHICH TAX YEAR(S) ARE YOU FILING? (If you are filing multiple years you must complete a separate form for each year.)
Please Select
Please Select
2016
2017
2018
2019
2020
2021
2022
5
Did you file your 2021 tax return?
YESNO
6
If you completed your 2021 tax return ,please upload the return . * This field is required.You must upload your previous tax return before moving forward . Approved files pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
7
Upload 1098- T Form here Each 1098-T form must be uploaded her fore students that attended college in 2022 and paid with pell grant
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
8
Please enter your first and last name belowTax payer first and last name (must) match SSN and Identification card
First Name
Last Name
9
Date of BirthPlease enter tax payer date of birth below
Date
Year
Month
Day
10
Upload IdentificationPlease upload a copy of your identification card , must be on a flat black surface
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
11
Social Security NumberPlease send tax payer SSN below
12
Social Security Card Upload Please upload tax payer SSN card.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
13
Phone NumberPlease enter best contract number for Tax Payer
Please enter a valid phone number.
14
EmailPlease enter a valid email address for tax payer. All confirmation and returns will be sent to this email
example@example.com
15
WHAT IS YOUR FILING STATUS AS OF DECEMBER 31st?
Please Select
Please Select
Single
Head of house
Married filing separately
Married filing jointly
Qualifying widower
I’m not sure
16
Occupation TypePlease enter your occupation type below
17
Home AddressPlease enter Tax Payer home address below.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
18
Where you previously issued an Identify Protection Pin (IP PIN) by the IRS ?
YESNO
19
Can another taxpayer claim you as a dependent on their tax return ?
YESNO
20
Will you be filling a tax return with your spouse?This question is for married tax payers only
YESNO
21
Did you work in 2022 ?
YESNO
22
Proof of Earned IncomePlease update W2's or 1099 forms here
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
23
Are you self-employed ?
YESNO
24
If self-employed, how much did you make last year ?If you aren't self-employed just enter N/A
25
Proof of Income Self-employed
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
26
Are you claiming Dependents on your 2022 tax return?
YESNO
27
How many dependents are you claiming on your 2022 tax return ?Enter in the number of dependents below
28
Date of birthEnter date of birth for dependent 1
Date
Month
Day
Year
29
Upload each dependent (s) Social Security Card below
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
30
Upload Proof of Residency for DependentsClaiming head of house? Upload a lease agreement, report card, EBT letter for dependents below
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
31
Did anyone in your household attend college in 2022 ?
YESNO
32
Type a question
YESNO
33
Did you or your spouse make payments on your student loans in 2022 ?
YESNO
34
Enter in the amount you or your spouse paid for student loansIf both of you paid student loans enter details below.
35
Did you or your spouse receive unemployment benefits in 2022 ?
YESNO
36
Upload 1099-G formUpload your 1099-G form below , if appliable
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
37
Do anyone in your household receive health insurance through the Healthcare Marketplace in 2022? If so upload your 1095-A forms below
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
38
Did you or your spouse pay any medical or dental expenses in 2022 ?Answer yes only if you had a medical bill you had to personal pay. This doesn't include your monthly premium payments
YESNO
39
Do you rent or own your current residence ?
Rent
Own
40
Do you or your spouse own a rental property ?
YESNO
41
Did you or your spouse have any gambling winnings in 2022 ?
YESNO
42
Did you or your spouse receive social security benefits in 2022 ?
YESNO
43
Did you receive any earnings from interest or dividends in 2022 ?
YESNO
44
Did you make any charitable contributions in 2022 ?Ex: Church, Goodwill,etc
YESNO
45
Do you or your spouse owe debt to a Government Agency?Ex IRS, Child Support. etc
YESNO
46
Are you interested in applying for a same day tax advance up to $6000 ?
YESNO
47
Would you like your tax refund direct deposited into your bank account ?
YESNO
48
Name of BankBank account must but in tax payer's name
49
I would like to have my tax refund deposited into my ________ account?Enter the type of account you have below. Ex savings or checking. etc ?
50
Upload a Void checkUpload a void check below.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
51
Are you interested in having your credit repaired?
YESNO
52
Would you like your tax preparation fee taken out directly from your tax return? If not payments can be made by cash or money order .All payments are due before tax return is filed and/or submitted to IRS.
YESNO
53
Stop. Please read message below Did you finish uploading your documents? IF YOU DO NOT UPLOAD ALL NECESSARY DOCUMENTS YOUR INTAKE FORM WILL BE VOIDED. I acknowledge that all information provided to Green Magnolia Enterprises is true and accurate to the best of my knowledge. I understand that I am required to have any supporting documentation to validate the information provided. Furthermore, I understand that knowingly providing false information on my tax return and reporting it to the IRS, that I am taking part in a potentially criminal penalty situation and is punishable by law including but not limited to: facing court dates, restitution, and possible imprisonment. I waive Green Magnolia Enterprises , LLC and the preparer of any error due to incorrect information provided by me. By signing below, I authorize Green Magnolia Enterprises to file my taxes. I acknowledge by signing this form if I and/or my spouse owes a federal/governement debt such as IRS, child support, student loans etc., I/we are still responsible for tax preparation fees due to Green Magnolia Enterprises at the time of service. Also, if the federal refund amount is mailed, I/we are still responsible for the tax preparation fees stated on the invoice. If the tax preparation fees are not paid, I understand Green Magnolia Enterprises LLC will take legal action to collect the unpaid tax preparation fees. I am giving Green Magnolia Enterprises and Walker's Tax & Financial Services permission to prepare all forms related to my tax return; to apply for and secure RAC's and RAL's on my behalf; and sign all necessary forms and file my taxes electronically. I take full responsibility for the accuracy of this form and understand that Green Magnolia Enterprises and/or associated affiliates hold no responsibility for any misrepresentation or false claims.
Powered by Jotform SignClear
54
Engagement Letter* This field is required.Dear Taxpayer, Thank you for the opportunity to work with you in preparing your income tax returns. To foster a complete understanding of our relationship, take a moment to review the following information. We will prepare your income tax returns based solely on the information you furnish to us. Upon completion of your tax returns we will return any original tax documents to you. From time to time our office may retain scanned copies of your documents for our records, however you should retain all documents, cancelled checks and other data that form the basis of income and deductions and other tax return forms, schedules, elections and disclosures. Such documents include but are not limited to, proper records to support deductions claimed for meals, entertainment, travel, business gifts, charitable contributions, and vehicle use (if applicable), as well as bank and credit card statements. These records will be necessary to prove the accuracy and completeness of the returns to taxing authorities, should your returns be selected for examination. We recommend keeping all documents and copies of your returns for a minimum of five years after you file your tax returns or after their due date, whichever is later. Our work in connection with the preparation of your income tax returns cannot be relied upon to disclose errors, irregularities or illegal acts, including, without limitation, fraud that may exist within the documents or figures you provide. We will use our professional judgment in resolving questions where the tax law is unclear or where there may be conflicts between the tax authority’s interpretations of the tax law and other supportable positions. Unless instructed by you, we will take a tax position in your favor whenever reasonable. We cannot provide any assurance that tax positions taken will not be challenged or ensure the ultimate outcome of such a challenge. Moreover, we cannot be responsible for issues arising from any income, expenses or other information not provided to us at the time of tax preparation or prior to the filing of your returns. Please note that this engagement, and this firm’s services, include but are not limited to general and annual income tax related services. Unless specifically requested by you, and agreed upon in writing we do not provide any services related to payroll tax, sales tax, excise tax, and personal or real property tax. Nor can we be relied upon to determine or report your compliance, or lack thereof, with any Federal, State, or Local business related laws, health care or human resources regulations, retirement plan compliance or any business, property, or professional permitting/licensing. The charges for our services are on a “per form” basis with references to time spent by our professional staff to perform the work, and costs incurred for related supplies and expenses, including copy charges, long distance phone charges and computer processing charges. Our fee for the preparation of your tax returns will be due and payable upon presentation of your completed income tax filing. It is company policy not to release tax returns or any tax related reports, schedules, information, advice, or notes without payment in full. Should a situation arise where services have been rendered but payment is not received and our firm is forced to or elects to seek legal assistance to collect fees due to us, please note that you may be asked to reimburse our firm for the legal costs to collect any outstanding balance due. Because we understand that cost is an important issue for many clients, we will do our best to provide you with an estimate of our fees prior to completing your returns but please understand that circumstances arise which may raise or lower the estimated fee. We will contact you if such a situation arises after you receive an estimate. Upon completion of your returns and after you have paid your tax preparation fees we will provide you with a copy of your returns as well as the e-file signature authorizations and any applicable payment vouchers to complete your tax filing. You should review the completed returns carefully. If you see anything that requires changing please bring it to our attention immediately and we will either explain the matter to you or correct it without delay and provide you with new, corrected copies. If you are satisfied with the returns and see no issues, please sign and date the e-file signature authorizations and return them to this office immediately. Please note that all taxing authorities prohibit us from transmitting your tax returns without signed authorization from you. Please also note that if your returns can not be e-filed we will provide you with paper copies to sign and mail to the taxing authorities. By signing this engagement you are agreeing to compensate Green Magnolia Enterprises LLC for services you have requested. In the event you terminate the engagement prior to the completion of your tax accounting work, Green Magnolia Enterprises LLC reserves the right to invoice you for any out of pocket expenses, time at our hourly rate, or other expenses that were incurred during this engagement. If you sought in person consultation services, received advisory services by phone or email, sought representation work or received any tax accounting services, by signing this engagement letter you are agreeing to compensate Green Magnolia Enterprises LLC for these services, even if you terminated the engagement prior to our firm completing the work requested or required. Please be advised that if you receive any correspondence from a taxing authority that pertains to a tax return prepared by this firm we will be happy to address this matter on your behalf. Included in the cost of your tax preparation is 120 minutes of correspondence work per tax year at no additional charge. During that 120 minutes we will assess your situation and apprise you of the course of action we believe is best to take. If we can also compose and send off a reply to the appropriate taxing authority then we will certainly do so. If the matter or issue will involve more than 120 minutes of work, each additional hour (or fraction thereof) will be billed at a standard hourly rate of ninety nine dollars ($99) per 60 minute hour. When possible, we will do our best to inform you if we believe your issue will require more than 120 minutes to handle, however there may be a situation when we are unable to inform you in advance. Even if we are unable to inform you, the standard hourly rate listed above will apply and is payable upon completion of this work. At any time in the process you may choose to have us cease our work in connection with your correspondence but we will require said request in writing with your name ,address,date and signature included. If, during the course of this work, it becomes apparent the correspondence received was due to an error or omission by this office there will be no charge for handling the correspondence regardless of the time involved. Please note that except in cases where our office is deemed at fault, a flat $50 dollar handling charge will be assessed for all matters where our assistance is requested in handling any such correspondence from any taxing authority. This charge is not included in your annual tax preparation fees and is payable upon completion of our work in connection with said correspondence. Please also note that audit/examination representation work is not included in the tax preparation fee and is considered a different engagement with a separate fee structure. If you have any questions regarding the specifics of audit/examination representation please feel free to ask any time before, during or after your appointment. Again if your returns are audited or examined by any taxing authority, for any reason, the fee you paid for their preparation does not include the costs to represent you with regard to any audit or examination unless you opt in for the Audit Maintenance Protection for personal tax returns at $89 and or business tax returns at $109 which will be added in with your tax preparation fees. Green Magnolia Enterprises LLC and affiliated companies takes your privacy and personal information very seriously. We will take whatever steps are necessary to safe guard that information and will never sell or disclose said information to anyone outside the firm for any reason. Please note that while we will protect your confidential information, our firm, from time to time, will need to utilize some of your information for internal purposes not related directly to your current year tax preparation. An example of this usage would be mailing you a newsletter or holiday card to your confidential home address or perhaps a personal phone call to wish you or a member of your family greetings or a happy birthday. By signing this letter you agree to allow our staff limited access to your information for such informal, non-tax preparation related situations. Please also note that in an effort to help combat the increasing threat of identity theft and to ensure the returns filed by our firm are accurate, true, and pertain to the proper client or taxpayer, Green Magnolia Enterprises LLC reserves the right to request, as condition of our providing services, certain documents to verify your identity and the identity of others you may be listing on your tax returns. This is for your protection and for the protection of your spouse and/or dependents and these documents will be safeguarded to the best of our ability and in accordance with our document protection procedures. Such documents requested by our firm may include but are not limited to; government issued photo identification, Social Security Cards, birth certificates, or visa and immigration related documents. If you agree with the terms of our engagement as described in this letter please sign below. Please be aware that by signing below and giving us your income tax information, you expressly agree to the terms of this engagement letter. We want to thank you for putting your trust in Green Magnolia Enterprises LLC and look forward to a long and mutually satisfying relationship. Thank you for your business, Green Magnolia Enterprises , LLC (225) 238-7340 ask@greenmagnoliaenterprises.com
Powered by Jotform SignClear
55
I HAVE READ AND UNDERSTOOD THE ABOVE ENGAGEMENT LETTER. * This field is required.
I agree
56
Signature form 7216 CONSENT TO DISCLOSURE OF TAX RETURN INFORMATION * This field is required.For the purpose of completing this consent form, Green Magnolia Enterprises shall be referred to as “we,” “us,” and “our”.Federal law requires this consent form to be provided to you ("you" refers to each taxpayer, if more than one). Unless authorized by law, we cannot use your tax return information for purposes other than the preparation and filing of your tax return without your consent. You are not required to complete this form to engage our tax preparation services. If we obtain your signature on this form by conditioning our tax preparation services on your consent, your consent will not be valid. Your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature.. For your convenience, we have entered into an agreement with certain companies to offer Electronic Refund Products. To determine whether this service may be of interest to you, we will need to use your tax return information. If you would like us to use your tax return information to determine whether this service is relevant to you while we are preparing your return, please sign and date this consent to the use of your tax return information by signing below, you (including each of you if there is more than one tax payer) authorize us to use the information you provide to us during the preparation of your 2020 or 2021 tax return to determine whether to offer you an opportunity to offer you an opportunity to apply for an Electronic Refund Product . If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by e-mail at complaints@tigta.treas.gov.
Powered by Jotform SignClear
57
I GIVE CONSENT TO GREEN MAGNOLIA ENTERPRISES TO PREPARE MY TAXES BASED UPON THE INFORMATION I PROVIDED AND SUBMIT MY TAX RETURN TO THE IRS AND/OR STATE ON MY BEHALF* This field is required.
I agree
58
Signature for 6713 Form CONSENT FOR PAYMENT* This field is required.We here at Green Magnolia Enterpiese,LLC we value the relationship we have with all of our clients. We are in the business to provide you with the absolute best service you can have. With saying that, we would like to remind you that we are providing you a service NOT a refund. You as a taxpayer have the choice to pay your tax preparation fees by one of the following: cash, check, money order, credit card, or directly from your refund*. *If you choose to have the tax preparation fees taken from your refund and for whatever reason your taxes are intercepted, due to child support, garnishment of wages. You are still responsible for tax preparations fees. Please contact us immediately at our office for payment or payment arrangements. By signing your return, you are agreeing to pay the preparation fees regardless if your refund was received or not. After 3 months from the date the refund was scheduled to arrive if no payment or arrangement is made, we will be forced to put your account into collections. We hope we never have to go this route so please keep open communication with us so we can work with you, thank you.
Powered by Jotform SignClear
59
Taxpayer Signature
60
Today’s Date
Date
Year
Month
Day
Should be Empty: