Tax Preparation Client Intake Form (Personal)

TAX PREPARATION CLIENT INTAKE FORM (PERSONAL)

Thank you for taking the time to complete this Deduction Discovery Tool. This will help us prepare a more accurate return and reduce missed deductions.

This tool is intended to help you gather and submit your documents There are several ways for you to give us your documentation
Submit documentation by:*

Our Secure LinkIn-Person (drop-off)EmailPortal
Click to send to attach your documents to the email: receptionist@casacastilloinc.com
Click to submit to attach your documents in our secure link: SECURITY LINK
Log in to our portal to see the status of your processes and attach your documents to the notes: PORTAL

If you do not yet have an account on our portal you can request an invitation that you will receive through your email to the phone number (801) 612 9522)
What was your civil status at the end of the tax year?*

SingleWidowedMarriedSingle with a dependentDivorced

Taxpayer Information
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation*
Last 4 of SSN*
Are you a full-time student?*

YesNo
Are you totally and permanently disabled?*

YesNo
Are you legally blind?*

YesNo
Are you dependent of another?*

YesNo

Dependents

Enter your dependents here

	Name	SSN	Date of Birth	Relationship	Months lived with you
1
2
3
4
5
6

Did you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it?

	Yes/No	Employer	Spouse Ins	Exchange/ Marketplace	Direct with Insurer	Medicare	Medicaid
Taxpayer
Spouse
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5

Tax Related Questions
Employment Status*

EmployedUnemployedSelf-employed
Are you contributing to 401k or other pre-tax account?*

YesNo
Is this your first time opening a pre-tax account?*

YesNo
Do your dependents have tuition expenses?*

YesNo
Do you have any expenses for childcare?*

YesNo

Do you have energy star rated improvements to your home?*

WindowsDoorsFurnaceSolar PanelRoof (non metal roof)Other
Do you have your own home?*

YesNo
Do you have mortgage interest?*

YesNo
Do you have real estate tax?*

YesNo
Do you have documents that shows you paid for property taxes?*

YesNo
Did you sale any stock?*

YesNo
Did you take money from your 401K?*

YesNo
Did you pay for vehicle tax?*

YesNo
Did you receive a federal tax refund last year?*

YesNo
Are you a victim of identity theft?*

YesNo

Expenses
Please fill-up the information within the current year only.

General Expenses

	Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions

Total Expenses
Additional comments

Acknowledgment & Signature
- I confirmed that all information I entered here is accurate and true.
- I allow ABC Financial 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 Casa Castillo Inc.
- By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Date Signed

MonthDayYear
Date
Taxpayer Signature

Clear
Date Signed

MonthDayYear
Date
Spouse Signature

Clear
Document Requirement for Personal Tax Return

° W-2 Forms for you and your spouse.

° 1099-C forms for cancellation of debt.

° 1099-G forms for unemployment income, or state or local tax refunds.

° 1099-MISC forms for you and your spouse (for any independent contractor work).

° 1099-R, forms 8606 for payments/distributions fron IRAs or retirement plans.

° 1099-S forms for income from sale of a property.

° 1099-INT, - DIV, - B, or K-1s for investment or interest income.

SSA-1099 for Social Security benefits received.

°Business or farming income - profit/loss. stateement, capital equipment information.

°Rental property income and expenses: profit/loss statement, suspended loss information,

°Pior year installment sale information - forms 6252, principal and interest collected during the year, SSN and address for payer.

°Miscellaneous income: jury duty, gambling, winnings, medical savings account, scholarship, etc.
Upload the document that applies to your application

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Document Requirement for Personal Tax Return