2025 Prosperity Tax Service Intake Form!

Intake Form

Please take a few moments to upload forms !
Thank you for taking the time to complete our intake package. For our New Clients,

this information is critical to ensure an accurate filing of your tax returns. For Our

existing clients, while we may have some of this information from past engagements,

we kindly request you provide it again so we can make sure our records are 100%

accurate and up to date.

IMPORTANT: UPON COMPLETION OF ALL APPLICABLE PARTS OF THIS FORM YOU MUST CLICK THE "SUBMIT" BUTTON AT THE BOTTOM OF THE FORM TO SEND THIS INFO TO OUR OFFICE. CLOSING YOUR BROWSER BEFORE CLICKING THE "SUBMIT" BUTTON WILL DELETE ALL INFO WITHOUT SENDING TO US. IT SHOULD BE NOTED THAT UPON CLICKING THE SUBMIT BUTTON YOU WILL GET A CONFIRMATION EMAIL THAT WE RECEIVED YOUR INFO.

Please also note that to comply with federal and state identity theft protection efforts our firm will ask for a valid state issued photo identification card during your engagement.

*** This page is highly secure. We use Industry-leading technology Secured Socket Layer (SSL) to keep your information safe. All sensitive information are securely transmitted and can not be compromised.

Main Office: 140 West Washington st. Suite G, Newnan Ga 30263

Corporate (Main) phone: 678-499-1129

E-Mail: mariamoore1982@yahoo.com
Name

First NameLast Name
Spouse Name (if any)

First NameLast Name
Current Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
File Upload - Social Security card, ID (All Taxpayers), previous 1040 if you didn't file with us last year , if HH (Head of Household) utility Bill.

This is for filing purposes (IRS MANDATED)
Cancelof
Single (No dependents, not married, legally separated)Head of Household (not married, legally separated, paid 50% + upkeep of home)Married Filing Joint (Mutual Agreement)Married Filing Separate (Legal separation, live apart the last 6 months)Qualifying Surviving Spouse (60+, 50-59 Disabled, married at least 9 months)
Filing status will be determined by due dilligence*
W2Self Employment (1099NEC/1099K/1099MISC)1098T (College Form)1099G (Unemployment Income)Intrest Income1098 (Mortgage Interest form)IP Pin number1095A Market Place InsuranceOther
Please Upload ANY IRS form you have below:

All Forms, Id, Social security card (Taxpayers and dependents) Birth Certificates, Lease, Utility Bill
Cancelof
Are you claiming any of the following deductions?
yesno
If yes, please provide the details below. Put N/A on Dependent's details if you have less dependents than the provided slots

First NameLast Name
Date of Birth

MonthDayYear
Date
Relationship Status:
Dependent #2

First NameLast Name
Date of Birth

MonthDayYear
Date
Relationship Status:
Dependent #3

First NameLast Name
Date of Birth

MonthDayYear
Date
Relationship Status:
Dependent #4

First NameLast Name
Date of Birth

MonthDayYear
Date
Relationship Status:
Please upload dependents Social Security Card below:

Cancelof
yesno
yesno
yesno
IP PIN NUMBER
Identity Protection Pin
yesno
Do you want an Advance (up to $7000, Bank choose the amount)
Please give it at least 24 hours
Which payment method do you choose?
The way your Advance comes will be the same way the remainder of your refund will come !!!
Direct Deposit Information (Bank Name)
The Banking Account Must be in the taxpayer(s) name
Bank Routing Number
nine digit number
Bank Account Number
checkingsavings
Less than 1 year1–2 years3–4 years5+ years
Onsite Filing (pick up)Fax, Email, and making copiesOffsite Virtual FilingQuoteConsult/ MentorNotaryTax Training (Prosperity Tax Academy)DIY Options: Credit Repair, Home buyer Guide, Business Credit, Kids Credit ebook, etc
Select Tax Agent*
Choose Agent
Your Phone Number *
Please enter a valid phone number.Format: (000) 000-0000.
Your Email *
example@example.com
I confirm that I have reviewed and understand the IRS regulations applicable to my situation.
If I was audited by irs can I provide document(s) Sworn Statement of Residency*
If filing Head of Household or (and) a dependent

Price List Base Line: Starting at $250

EZ forms: Base line start at $250

1040: Base Line start $450

Sch C/ Itemize : Base Line Start ( additional ) $150

Book keeping ( If i create your profit and loss sheet) (additional $150)

S corp: Base Line Start $600

Non Profrofits, sch k (To be discussed)
CONSENT FOR PAYMENT

We here at Prosperity Tax Service, value the relationship we have with all of our clients. We are in the business to provide you with the absolute best service possible. With that being said, we will like to remind you that we are providing you a service NOT a refund. You as a taxpayer have the choice to pay your tax preparation fees by one of the following: cash, check, money order, credit card, or directly from your refund. (Cash app, Zelle, Paypal is 678-499-1129.

If you choose to have the tax preparation fees taken from your refund and for whatever reason your taxes are intercepted, YOU ARE STILL RESPONSIBLE FOR THE TAX PREPARATION FEES! Please contact us immediately via email(mariamoore1982@yahoo.com) or at 678-499-1129 (main office) for payment or payment arrangements. By signing your return you're agreeing to pay the preparation fees, regardless if your refund was received or not. After 3 months from the date the refund was scheduled to arrive, if no payment arrangements was made, we will be forced to put your account in collections. We hope we never have to go this route so please keep open communication with us so we can work with you!

Thank You!!

Warms Regards,

Maria Whatley (Owner)
Signature:
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