Tax Preparation Client Intake Form
Are you a new client or returning client?
New Client
Returning Client
What tax year are you filing for? (check all that apply)
2025
2024
2023
2022
Taxpayer Information
SSN
*
Filing Status
*
Single (no dependents)
Head of Household (dependents)
Married Filing Separate
Married Filing Joint
Qualifying Widower
Name
*
First Name
Last Name
Age
*
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation/Job Title
Did you live in the United States the entire filing year?
*
Yes
No
Is anyone on this returned considered and recieving disability?
NO
YES
Are you legally blind?
Yes
No
Are you going to be claimed as a dependent on someone else's return?
*
Yes
No
Did you file and recieve your tax refund last year?
*
I filed and recieved my refund
I filed but have NOT recieved my refund
I did not file
I was claimed on someone elses return
Who Referred You?
name of business or person
Spouse Information (leave blank if unmarried)
Name
First Name
Last Name
Age
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
SSN
Are you totally and permanently disabled?
Yes
No
Are you legally blind?
Yes
No
Dependents
Enter your dependents here
Rows
Name
SSN
Date of Birth
Relationship
1
2
3
4
5
6
7
8
Does you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it? IF YOU HAVE MARKETPLACE INSURANCE UPLOAD YOUR 1095 A FORM.
Rows
Yes/No
Employer
Spouse Ins
Exchange/ Marketplace
Direct with Insurer
Medicare
Medicaid
Taxpayer
Yes
No
Spouse
Yes
No
Dependent 1
Yes
No
Dependent 2
Yes
No
Dependent 3
Yes
No
Dependent 4
Yes
No
Dependent 5
Yes
No
College Student Information
Did You Go To College For At Least 1 Semester In 2025? IF YES UPLOAD YOUR 1098-T FORM GIVEN BY THE INSITUTION.
Yes
No
Did You Make Any College Tuition Payments In 2025?
YES
NO
NOT SURE
PLEASE LIST ANY OUT OF POCKET EXPENSES (books, attire, supplies, travel expenses, etc) include an estimate of the amounts.
Tax Related Questions
Employment Status
*
Employed
Unemployed
Self-employed
Are you contributing to 401k or other pre-tax account?
Yes
No
Check If You Recieve Any Of The Following:
SNAP
TANF
SECTION 8
HOUSING ASSISTANCE
CHILD SUPPORT
Do you have energy star rated improvements to your home?
Windows
Doors
Furnace
Other
Do you have any expenses for child care? If yes please upload the yearly summary given by the daycare provider.
Yes
No
Do you have your own home?
*
Yes
No
Do you have documents that shows you paid for property taxes?
Yes
No
Do you live in a county that was affected by a natural disaster?
*
Yes
No
Did you collect any income this past year from FEMA?
*
Yes
No
Do you have mortgage interest?
Yes
No
Did you collect any unemployment wages in the year 2024? If so please upload the form given to you from unemployment.
Yes
No
SELF EMPLOYED ONLY
WHAT TYPE OF BUSINESS DO YOU HAVE?
(CLEANING,BARBER,FOOD CATERING, ETC.)
EIN Number (optional)
Business Name (optional)
BUSINESS ADDRESS (OPTIONAL)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
AVERAGE ANNUAL INCOME
WHAT YOU MADE ALL YEAR
WHICH OF THE FOLLOWING RELATES BEST TO YOU?
I RUN MY BUSINESS FROM HOME
I PAY RENT AT A LOCATION FOR MY BUSINESS
I HAVE TO TRAVEL TO MY CLIENTS
I GET PAID ON A COMMISSION SPLIT
WHAT IS THE RENT AMOUNT YOU SPEND ON YOUR BUISNESS? HOME RENT OR LOCATION RENT.
Are you interested in business formation services?
YES!
NO!
PLEASE LIST YOUR EXPENSES FOR THE YEAR.
PHONE BILL, SUPPLIES, WORK ATTIRE, UTILITIES
Acknowledgment & Signature
I confirmed that all information I entered here is accurate and true.
I allow Reyna Financial Group to capture my sensitive data like personal id, government id, social security number (SSN), and other information.
I have read the terms and conditions and privacy policy of Reyna Financial.
By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Date Signed
*
-
Month
-
Day
Year
Date
Taxpayer Signature
Date Signed
-
Month
-
Day
Year
Date
Spouse Signature
File Upload: Valid ID, Proof of address, social security card(s), W-2 or 1099
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Back
Next
How would you like your refund paid out to you?
*
Prepaid Money Card
Check
Direct Deposit
If you chose direct deposit please list the Bank Name. Please double check the numbers you imput.
You must be the account holder for the bank to accept your return.
What Type Of Account?
Checking Account
Savings Account
Routing Number
Account Number
Would You Like To Apply For A Cash Advance Loan?
*
Up to $1,000 No Interest
Up to $7,000 With a 36% Interest Rate
No
Would You Be Intrested In Credit Repair?
Yes, Please Contact Me!
No, My Credit Is Over 650!
Privacy Policy
Reyna Financial Group and its preparers are bound by professional standards of confidentiality. Therefore, we have implemented policies and procedures to protect your right to privacy. For all clients and potential clients, we do not disclose any nonpublic personal information obtained in the course of our practice except as required or permitted by law, and as necessary to propery provide our services to you.
Arbitration
If a dispute arises out of or relates to this contract or engagement letter, or the obligations of the parties therein, and if the dispute cannot be settled through negotiation, the parties agree first to try in good faith to settle the dispute by mediation administered by the American Arbitration Association under its commercial Mediation Rules before resorting to arbitration, litigation, or some other dispute resolution procedure.
I understand the policies listed above and agree to any terms listed.
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