Tax Client Intake Form

Please complete the following questionnaire as it relates to your tax return. Complete every question. If you submit this form without income statements, social security cards, State issued ID, your submission will be removed from the system.

***All the fields below are required***

If you are a returning client and are not claiming ANY ADDITIONAL dependents, we do not need your social security cards because they are on file.

What tax year is this submission for?(Please do not attach documents that are for ALL the years you selected. If you need multiple years filed, submit a new form for each year.)*

Is this an amendment?*

Do you need to schedule a tax consultation?*

Are you a new or returning client?*

Name*

First NameMiddle NameLast NameSuffix

DOB*

Tax Payer Social Security #*

WITHOUT DASHES

Tax Payer Job Title*

Phone Number*

Confirm Phone Number*

Cell Phone Carrier*

Email*

Filing Address*

Is this a new address with the IRS?*

Can another taxpayer claim you as a dependent?*

Are you LEGALLY married?*

Spouses Name(if applicable)

First NameMiddle NameLast NameSuffix

Spouses Social Security #

WITHOUT DASHES

Did you pay any child care expenses for any dependent?

Did you, your spouse, or any dependent attend college in 2023?

Did you receive health insurance through Market Place?*

If you own a home, have you received Form 1098 from your mortgage lender?

Did you or your spouse receive unemployment benefits in 2023?*

Did you or your spouse make payments on your student loans in 2023?*

Do you owe debt to any Government Agency, such as the IRS, Student Loans, Child Support, etc.?*

Are you self-employed or a business owner?

Do you have an IRS IP PIN?

Do you have a copy of your tax return from last year?

Are you interested in Audit Protection?*

Are you interested in an Advanced Loan up to $6000?

REFUND DISBURSEMENT*

Tax Forms(W2, 1099, 1098-t, etc.) Please attach ALL documents. Make sure we can see the entire page. Make sure all documents are visibly clear.

State ID/Driver's License (taxpayer)

Social Security Card (taxpayer and spouse)

Social Security Card(dependents)

Is there anything you would like for us to know when preparing your return?

I acknowledge that all information provided to BOOM FINANCE LOANS AND SERVICES LLC. 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 submitting false information on my tax return and reporting it to the IRS, that I am potentially taking part in a criminal activity. I wave BOOM FINANCE LOANS AND SERVICES LLC. and the preparer of any error due to incorrect information provided by me. By signing below, I authorize BOOM FINANCE LOANS AND SERVICES, LLC. to file my tax return.

Signature

Thank you for trusting us to prepare your income tax return. To gain a better understanding of our process, please take a moment to review the following information.

We will prepare your income tax returns based solely on the information you provided to us. Upon completion of your tax return, we will return all original tax documents to you. Our office will keep a copy of your tax return and supporting documents for a minimum of 3 years. These documents are solely for our records. It is also important that you keep a record of your ducuments for 3 years.

As we work on your tax return, your income documents will not be relied upon to disclose errors irregularities or illegal acts, including fraud.

TAX CLIENT INTAKE FORM

DEPENDENTS