Savvy In Services Tax Client Form

Savvy In Services Tax Client Form
Savvy Taxes by Taneshia Website
PRIMARY TAXPAYER
Name*

First NameMiddle NameLast Name
Are you an existing client?*

YesNo (SKIP the next question: Has any of the following changed?)
Has any of the following changed? Check all that apply and Please complete required sections for any information that has changed. If there are no changes please select no changes and proceed to the next required question.

AddressPhone NumberSocial Security NumberOccupationDrivers License/IDEmailSpouse AddressSpouse PhoneNumberSpouse Social Security NumberSpouse OccupationSpouse Drivers License/IDSpouse EmailFiling Status now SingleFiling Status now Married filing JointlyFiling Status now Married filing SeparateFiling Status now Head of Household with Qualifying DependentFiling Status now Qualifying Surviving Spouse with Dependent ChildNo Changes (please proceed to the next required question)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
SSN
Birth Date

MonthDayYear
Phone Number
Please enter a valid phone number.
Alternate Phone Number
Please enter a different phone number.
State Driver's License/ID*
Email
Occupation
Type of Income (check all that apply)*

Wages or Other CompensationSelf-employment/1099/ContractorUnemployment CompensationCollege StudentSSI/SSA/RetirementTotally or Permanently DisabledActive Military, Reserve, or National GuardFarmerInvestmentRoyalty/PassiveRentalForeign/Crypto CurrencyOther
Do you have an IRS Identity pin?*
Please enter you IRS Identity pin:
6-digit number
New Client Filing Status
Existing Client Filing Status
Are you blind?*

YesNo
Did you purchase health insurance from the marketplace?*

YesNo
Are you an active member of the military?*

YesNo
Did you or your spouse have an unborn child(ren) with a detectable heartbeat from July 20, 2022 - December 31, 2022?*

1 Unborn Child2 Unborn Children3 Unborn Children4 Unborn ChildrenNone
Have you purchased an Electric Vehicle for personal use?*

YesNo
Electric Vehicle Information
Have you made any energy efficiency/clean home improvements?*

YesNo
Home Improvement Information
Did you receive, sell, exchange or otherwise disposed of any financial interest in digital assets?*

YesNo
Digital Assets. Please upload tax document.
Are you requesting to file an extension?

YesNo
Select the best answer:*

I believe I should receive a tax refundI believe I will oweI am not sure
SPOUSE INFORMATION
Spouse Name

First NameLast Name
Spouse Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Spouse SSN
Spouse Date of Birth

MonthDayYear
Spouse Phone Number
Please enter a valid phone number.
Spouse State Driver's License/ID
Spouse Email
Spouse Occupation
Spouse Type of Income (check all that apply)

Wages or Other CompensationSelf-employment/1099/ContractorUnemployment CompensationCollege StudentSSI/SSA/RetirementTotally or Permanently DisabledActive Military, Reserve, or National GuardFarmerInvestmentRoyalty/PassiveRentalForeign/Crypto CurrencyOther
Spouse: Do you have an IRS Identity pin?
Spouse- Please enter your IRS Identity pin:
6-digit number
Is your spouse blind?

YesNo
Did your spouse purchase health insurance from the marketplace?*

YesNo
Did your spouse receive a 1095-A Health Insurance Marketplace Statement?*

Yes (Please provide a copy)No
Is your spouse an active member of the military?*

YesNo
Have you purchased an Electric Vehicle for personal use?*

YesNo
Electric Vehicle Information
Did your spouse receive, sell, exchange or otherwise disposed of any financial interest in digital assets?

YesNo
Digital Asset. Please upload tax document.
DEPENDENT(S)
Total Number of Dependents*
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5
Additional Dependents Information
CHILD CARE
Did you have any child care expenses?*

YesNo
Total Number of Dependents with Child Care Expenses
Please complete child care details for dependent #1:
Please complete child care details for dependent #2:
Please complete child care details for dependent #3:
Please complete child care details for dependent #4:
Please complete child care details for dependent #5:
Additional Dependents Child Care Information
POST SECONDARY SCHOOL
Please list the total number of Post Secondary School (College, University, Technical, etc) students included on the tax return*
If you or your dependent attended Post Secondary School (College, University, Technical, etc), how was it funded? (check all that apply)

Financial AidScholarshipsStudent LoansPersonal Finances
Student #1
Did Student #1 attend more than one postsecondary institution last year?

YesNo
Student #1 Additional Postsecondary Institution Information:
Student #2
Did Student #2 attend more than one postsecondary institution last year?

YesNo
Student #2 Additional Postsecondary Institution Information:
Student #3
Did Student #3 attend more than one postsecondary institution last year?

YesNo
Student #3 Additional Postsecondary Institution Information:
BUSINESS OWNER/SELF-EMPLOYMENT
Did you own or operate a business or work as a contractor?*

YesNo
What is the date that the business was established?
What is the name of the business?
What is the six digit NAICS Code for the business? If unknown please copy and paste the website below into your web browser to search.
https://www.naics.com/search/
Does the business have an EIN?

YesNo
What is the EIN for the business?
Did you receive a 1099?

YesNo
Did you have business expenses?*

YesNo
Did you have business miles to claim?

YesNo
Vehicle Information
Did you carry inventory for your business?*

YesNo
What was the total amount of your inventory at the beginning of the year?
What was the total amount of your inventory at the end of the year?
Did you use a home office?

YesNo
Home Office Information
Did your spouse own or operate a business or work as a contractor?*

YesNo
What is the date that the business was established?
What is the name of the business?
What is the six digit NAICS Code for the business? If unknown please copy and paste the website below into your web browser to search.
https://www.naics.com/search/
Does the business have an EIN?

YesNo
What is the EIN for the business?
Did your spouse receive a 1099?

YesNo
Did your spouse have business expenses?

YesNo
Did your spouse have business miles to claim?

YesNo
Vehicle Information
Did your spouse carry inventory for their business?

YesNo
What was the total amount of the inventory at the beginning of the year?
What was the total amount of the inventory at the end of the year?
Did your spouse use a home office?

YesNo
Home Office Information
List your business expenses. If you have a document of your expenses please enter see attachment.
TAX RETURN INFORMATION
Will your tax return be offset due to any outstanding debt or garnishments?*

YesNo
Would you like to apply for a none interest-bearing advance of $250, $500, or $1,000?*

YesNo
Would you like to apply for an interest-bearing advance of $1,250.00 up to $6,000.00?*

YesNo
How would you like your refund to be disbursed?*
Direct Deposit
DOCUMENTATION
Please have the following documents available for download (as applicable):

1. A Valid Driver's License/ID card for the taxpayer(s)

2. Proof of Address: Utility Bill, Lease, Mortgage Document, or other mailed document with taxpayer(s) name.

3. Social Security Card for everyone on the return

4. Proof of Income (W-2, 1099, Business Income Statement, Interest, Retirement, etc)

5. 1098-T (if claiming college credit)

6. Proof of Children (Medical Records/School Records/Daycare Records/Other Mail with Child's name present)
Income Verification Documents (I.e., W-2, 1099, Income Spreadsheets, Bank Records, Retirement, SSA, Unemployment, Interest, etc).

Cancelof
Business Expenses Document(s)

Cancelof
Taypayer/Spouse Social Security Card(s), Current State ID

Cancelof
Proof of Address: Mortgage, Lease, Utility Bill, or Other Mailed Document with taxpayer(s) name(s)

Cancelof
Dependent(s) Birth Certicate(s) and Social Security Card(s)

Cancelof
Child Care Expense Document(s)

Cancelof
Post Secondary 1098-T(s)

Cancelof
Healthcare Marketplace Statement 1095-A

Cancelof
Virtual Currency

Cancelof
Referred By
Name/Unique ID
Coupon code
ATTESTATIONS AND CONSENT
Signature*

Clear
Date*

MonthDayYear
Date
Due Diligence Questionnaire
The United States Congress have, as a reaction to the substantial tax fraud resulting from their original error of choosing to distribute federal social welfare program benefits via the tax return, placed new excessive inappropriate “due diligence” requirements on paid tax return preparers whose clients are claiming certain tax credits. This added to the excessive and inappropriate requirements previously implemented by the Internal Revenue Service, the IRS has forced tax preparers to, in many cases, become Social Workers and verify that their clients qualify to receive certain credits i.e. EIC, CTC, ACTC and now HOH.

We preparers are not compensated by the IRS or the government for doing their job for them but must pass the costs of this required additional work on to our taxpayer clients.

You will be claiming an Earned Income Credit, Child Tax Credit, Additional Child Tax Credit, HOH, and/or an American Opportunity Credit on your 2020 tax return. Because of this you must complete, sign, and return this questionnaire to me. I will keep the original signed copy of this questionnaire with my file copy of your 2020 tax return and will include a photocopy of the completed questionnaire in the package I send you with the finished returns.
1. I/we certify that the child(ren) for whom the tax credit(s) will be requested can be claimed as my/our dependent(s), as per the information provided at the end of this questionnaire.*

YesNoN/A
2. The child(ren) for whom the tax credit(s) will be requested lived with me/us for the year, except for temporary absences.*

YesNoN/A
3. I am the custodial parent of the child(ren) for whom the tax credit(s) will be requested.*

YesNoN/A
4. I have documentation to substantiate the credits being claimed Form 1098-T and receipts for college tuition, material costs (you are responsible for keeping this documentation and providing it to the IRS if you are audited or questioned).*

YesNoN/A
5. Was a Child Tax Credit, Additional Child Tax Credit, or American Opportunity Credit claimed by you disallowed or reduced by the IRS on a past tax return?*

YesNoN/A
6. What year was the Child Tax Credit, Additional Child Tax Credit, or American Opportunity Credit claimed by you disallowed or reduced by the IRS from the past tax return?
7. How long was/is the Child Tax Credit, Additional Child Tax Credit, or American Opportunity Credit claimed by you disallowed or reduced by the IRS from the past tax return?
8. I am unmarried or separated, support a qualifying person as your dependent, and pay more than half the cost of maintaining your household. *

YesNoN/A
Attestation and Disclaimer
Savvy Taxes by Taneshia or Savvy Business Group, LLC is not responsible if the taxpayer provides us with incorrect information (i.e. social security numbers for self, spouse, or dependents, last names, birth dates). This may delay your refund. Savvy Taxes by Taneshia or Savvy Business Group, LLC is not responsible for any IRS audits. All information obtained from the taxpayer and/or spouse must be presentable if the IRS audits your tax return. Savvy Taxes by Taneshia or Savvy Business Group, LLC is not responsible for any incorrect tax figures provided by the taxpayer and/or spouse. If your tax figures change you will need to do an Amendment. Prices Vary. If you have any federal or government debts (i.e. school loans, child support, DPP, DFCS, etc….) there is a chance that your refund will be applied towards your debt. You can call the offset department at 1-800-304-3107 or 1-800-829-7650 to see if your refund will be partially or fully taken. If your refund is fully taken you are responsible for paying the preparation fees. Savvy Taxes by Taneshia provides the taxpayer with ONE complimentary copy of their tax return. Should you need any additional paper copies, there is a $15 fee per copy (federal and state included). Savvy Taxes by Taneshia or Savvy Business Group, LLC is not responsible for any discussions or changes the IRS or bank may make on disbursement dates, filing status or any other required information from the IRS. Savvy Taxes by Taneshia or Savvy Business Group, LLC is not responsible for any IRS glitch problems or IRS problems that may cause a delay in your tax refund. There WILL NOT be any reimbursement of any bank fees in the event of this occurrence. **

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Consent To Use
Federal law requires this consent form be provided to you (“you” refers to each taxpayer, if more than one). Unless authorized by law, we cannot use your tax return information for purposes other than the preparation and filing of your tax return without your consent. You are not required to complete this form to engage our tax return preparation services. If we obtain your signature on this form by conditioning our tax return preparation services on your consent, your consent will not be valid. Your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature. For your convenience, we have entered into an arrangement with certain companies to offer an Electronic Refund Disbursement Service and/or Loan product. To determine whether these offerings may be of interest to you, we will need to use your tax return information. If you would like us to use your tax return information to determine whether these offerings are relevant to you while we are preparing your return, please sign and date this consent to the use of your tax return information. By signing below, you authorize us to use the information you provide to us during the preparation of your 2020 tax return to determine whether to offer you an opportunity to apply for the Electronic Refund Disbursement Service and/or Loan product. **

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Consent to Disclosure
Consent to Disclosure Of Tax Return Information Federal law requires this consent form be provided to you (“you” refers to each taxpayer, if more than one). Unless authorized by law, we cannot disclose your tax return information to third parties for purposes other than the preparation and filing of your tax return without your consent. If you consent to the disclosure of your tax return information, Federal law may not protect your tax return information from further use or distribution. You are not required to complete this form to engage our tax return preparation services. If we obtain your signature on this form by conditioning our tax return preparation services on your consent, your consent will not be valid. If you agree to the disclosure of your tax return information, your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature. You have indicated that you are interested in utilizing the Electronic Refund Disbursement Service and/or Loan product from Republic Bank or Santa Barbara Trust. To provide you with the opportunity to apply for and/ or receive the Electronic Refund Disbursement Service and/or Loan product, we must disclose all of your 2019 tax return information to Refund Advantage. You may request a more limited disclosure of tax return information, but you will not be eligible to submit an application for the Electronic Refund Disbursement Service and/or Loan product. If you would like us to disclose your 2019 tax return information to Refund Advantage for this purpose, please sign and date your consent to the disclosure of your tax return information. By signing below, you authorize us to disclose to the designated bank all of your 2019 tax return information so that it can evaluate and process your application for the Electronic Refund Disbursement Service and/or Loan product. You understand that if you are not willing to authorize us to share your tax information with Refund Advantage, you will not be able to obtain the Electronic Refund Disbursement Service and/or Loan product, but you can still choose to have your tax return prepared and filed by us for a fee. If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by email at complaints@tigta.treas.gov. *

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Disclosure
The information contained in this office or on this website is of a general nature. It should not be construed as legal advice nor should it be acted upon in your specific situation without further details and/or professional assistance. Any use of information contained in this office or on my web site is done so at the risk of the user, and Savvy Taxes by Taneshia is not responsible for the result or outcome of its use. Savvy Taxes by Taneshia does not guarantee and is not liable for the truthfulness, accuracy, effectiveness, or any resulting effects of the use of any information contained in this office or on the web site. It is advised and it is the responsibility of the visitor of this office or web site to seek proper instruction and/or seek professional assistance in all matters regarding taxes and the IRS. Savvy Taxes by Taneshia is thus held harmless, released of, and users of information contained in this office or on this web site assume full responsibility for, any violation of Tax laws and/or IRS procedure, and any other legal liability resulting from use of any information contained in this office or on this web site. I attest that all information contained in this income tax return was obtained from the taxpayer or spouse and is true and correct to the best of his/her knowledge.*

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Date*

MonthDayYear
Date
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Savvy In Services Tax Client Form

PRIMARY TAXPAYER

SPOUSE INFORMATION

DEPENDENT(S)

CHILD CARE

POST SECONDARY SCHOOL

BUSINESS OWNER/SELF-EMPLOYMENT

TAX RETURN INFORMATION

DOCUMENTATION

ATTESTATIONS AND CONSENT