Tax Preparation Client Intake Form
Are you a New or Returning Client
Please Select
New
Returning
Do you want to see if you qualify for a cash advance?
Yes
No
Do you have an IP PIN?
Yes
No
If you have an IP PIN what is it?
Filing Status
Single
Head of Household
Married Filing Separate
Married Filing Joint
Qualifying Widower
Taxpayer Information
Name
First Name
Last Name
SSN
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Current Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
Are you a full-time student?
Yes
No
Do you Receive SSI or SSA?
Yes
No
Are you legally blind?
Yes
No
Can someone else clam you as a dependent on their tax return?
Yes
No
Dependents
Enter your dependents here
Rows
Name
SSN
Date of Birth
Relationship
1
2
3
4
5
6
Does you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it?
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
Tax Related Questions
Employment Status/Check all that apply
W2
Unemployment Benefits
Self-employed
1099 MISC
1099 NEC
1099K
1099R
Are you contributing to 401k or other pre-tax accounts such as Mortgage Interest, 403B, IRA, HSA (health savings account), Insurance?
Yes
No
If yes to previous question do you have your 1099/1098 INT forms yet?
Yes
No
Please select what state return are you requesting?
State return
Property Tax Credit/Circuit Breaker
Lived in Another state
Worked in another state
Lived in 2 states in tax year
Does your dependents have tuition expenses?
Yes
No
Did the tuition expense dependent receive a 1098T form?
Yes
No
Do you have any child care expenses?
Yes
No
What is your monthly childcare expenses?
Are you currently renting and use your home as a home office?
Yes
No
What is the monthly rental amount?
Do you have mortgage interest?
Yes
No
Do you have documents that shows you paid for property taxes?
Yes
No
Did you sell any stock/cryptocurrency/Gains or Losses/Form 1099-B?
Yes
No
Did you pay for vehicle tax, or do you have a vehicle that you use to conduct business?
Yes
No
If you answer yes to the above question- What is the Year/Make/Model and total miles used for business purposes?
Do you have real estate tax?
Yes
No
Did you receive a federal tax last year?
Yes
No
Do you have to complete ID Verification for the release of your prior year's taxes?
Yes
No
Expenses
Please fill out the information within the current year only.
General Expenses
Rows
Amount
Medical Expenses
Dental Expenses
Supplies
Cell Phone
Home Office Square Footage
Cash Contributions
Non-Cash Contributions/ item donations
Unreimbursed Business Expenses
Cost of NEW Car/Computer/ Equipment
Tax Preparation Fees
Investment Expenses
Total Expenses
Please Upload Current (unexpired) ID Driver's License or State ID/SSN cards OR Birth Certificates for all dependents/ Proof of Residences/ 1098T/ 1099s/ Banking Information
Browse Files
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Additional comments
Acknowledgment & Signature
I confirmed that all information I entered here is accurate and true.
I allow Serene Angels Business Services LLC to capture my sensitive data like personal id, government id, social security number (SSN), and other information to use to file my tax return/s.
I have read the terms and conditions and privacy policy of Serene Angels Business Services LLC.
By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing your tax return/s.
Date Signed
-
Month
-
Day
Year
Date
Taxpayer Signature
Banking Information: Bank Name. 9-digit Routing Number and Full Account Number:
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