CLIENT INTAKE FORM

CLIENT INTAKE FORM

Thank you for allowing us to serve you. We value your business and are committed to protecting your privacy.
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 (such as drivers license or other picture ID).
Full Name*

First NameLast Name
Date of Birth

MonthDayYear
Occupation:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Filing Status*

SingleMarried Filing JointMarried Filing SeparateHead of HouseholdQualifying Widower
What Type of income do you have*

W-2 Income1099 Independent ContractorSelf EmployedEntrepreneur Small Business Owner
Number of Dependents*
If claiming son/daughter. Is the other parent providing any financial support?
If claiming niece, nephew. Where are the parents to the dependent/dependents?
If claiming brother or sister. Why are the parents not claiming the dependent/dependents?
Head of household filers must present one of the following to file this status.

LeaseUtility BillMortgage StatementBank Statement
Did you pay someone to watch your child/children?

YesNo
How did you hear about us?*
Select Your Agent*
UPLOAD VALID PICTURE IDENTIFICATION

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UPLOAD TAXPAYER SOCIAL SECURITY CARD

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UPLOAD DEPENDENT SOCIAL SECURITY CARD

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UPLOAD DEPENDENT BIRTH CERTIFICATE

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UPLOAD 2024 W2 FORM

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UPLOAD 2024 1099 FORM

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UPLOAD ADDITIONAL TAX DOCUMENTS

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I hereby state that all the information above is true to the best of my knowledge and that I am allowing LEGACY FAITH to prepare my taxes based on the information I provided. I understand that I am financially responsible for any outstanding balance due to any false information given. If there is a balance due, I must pay the tax preparation fee upfront. If for any reason I owe an entity and they take the entire refund, I am STILL responsible to pay the tax preparation fee for services rendered. If for any reason an amendment must be filed with no fault of the tax preparer, an upfront fee of $150 is required! LEGACY FAITH is not responsible if you provide false information or do not provide all of the 2024 income documents. Please view your tax return, which is emailed to you. (it is sent AFTER submission). (bank and service fees) are found in the return and are neither refundable nonnegotiable! NO EXCEPTIONS TO THIS!! By signing this form, you give LEGACY FAITH permission to transmit your 2024 tax return. Please utilize www.irs.gov for all federal refund tracking. Please utilize your state Department of Revenue site for any State Refund tracking. Please allow 8 weeks to surpass from the date of submission before calling the IRS, if you have any tracking questions. For any direct assistance please email info@legacyfaith.net or call the IRS for all updates at 800-829-1040. IF YOU AGREE TO ALL STATED ABOVE, SIGN BELOW.

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