• CLIENT INTAKE FORM

    CLIENT INTAKE FORM

    5 Starr Tax Professionals

  • Thank you for allowing us to prepare your tax return. It is important you provide ALL Information requested in this form to help our qualified staff in completing your return. If you have any questions, please ask, you will need your:

    • Tax information such as Forms W-2, 1099, 1098

    • Social security cards or ITIN letters for you and all persons on your tax return.

    • Proof of identity (government issued photo ID such as driver's license, state ID or other photo ID).

  • Filling status

  • *

  • Part 1: Your Personal Information

  • Date of Birth*
     - -
  • US Citizen*
  • Legally Blind*
  • Permanently Disabled*
  • Are you legally married?*
  • Date of Birth*
     - -
  • US Citizen*
  • Legally Blind*
  • Permanently Disabled*
  • Format: (000) 000-0000.
  • Do you receive government assistance?*

  • Part 2: Dependent Information

  • Do you have dependents?*
  • How many dependents are you claiming?*
  • Date of Birth*
     - -
  • Date of Birth*
     - -
  • Date of Birth*
     - -
  • Did you or anyone on this tax return attend college?*
  • Does anyone attend daycare/aftercare?*

  • Part 3: EITC Questionnaire

    Please answer the following questions accordingly.
  • Rows
  • Rows
  • Do you confirm that all the answers provided above are accurate, correct, and complete to the best of your knowledge?*

  • Part 4: Self Employment

    Sole Proprietor Information Sheet
  • Are you self-employed?*
  • Rows
  • Rows
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  • Do you confirm that the income and expenses listed were received within the current tax year?*

  • Tax preparers are not allowed to give you any totals for your expenses toward your business. By signing this form, you agree that the information that has been provided by you is true.

     

  • Part 5: Bank Information

  • How would you like your IRS refund?*
  • Account Type

  • Part 6: Additional Information

  • Are you a new client?*

  • Part 7: Document Upload

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  • Date*
     - -
  • Date*
     - -

  • TaxPayer Notes

    List any additional information you think your preparer may need
  • Should be Empty: