Global Financial Service Southside Intake Form

Global Financial Services Tax & Credit

Client Intake Form
Filing Status*

SingleMarried-Filing JointQualifying WidowerHead of HouseholdMarried - Filling Separate
Taxpayer / Spouse Information
Taxpayer's Name *

First NameMiddle NameLast Name
Spouse's Name (if applicable):

First NameMiddle NameLast Name
Taxpayer's Birth Date

MonthDayYear
Spouse's Birth Date (if applicable):

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Spouse E-mail (if applicable):
example@example.com
Tax Payer E-mail
example@example.com
Taxpayer's Occupation
Spouse's Occupation (if applicable):
Taxpayer's SSN*
Spouse's SSN (if applicable):
Taxpayer's Phone Number
Please enter a valid phone number.
Spouse's Phone Number (if applicable):
Please enter a valid phone number.
Dependent Information
Please provide Dependent Name , Birthdate, SSN, & Dependent Relationship
Please provide Dependent Name , Birthdate, SSN, & Dependent Relationship
Please provide Dependent Name , Birthdate, SSN, & Dependent Relationship
Please provide Dependent Name , Birthdate, SSN, & Dependent Relationship
Bank Account Information
Bank Name
Bank Account Number
Bank Routing Number
Additional Information
Referred by
Did you receive one or both stimulus checks or deposits?*
Do you wish to apply for refund advance? *
Did you receive the Advance Child Tax Credit ? If yes, please upload your IRS form. *
Do you own a business?*
Do you own a home? *
Do you rent? *
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Global Financial Services Tax & Credit