Tax Preparation Client Intake Form: Full Version

Tax Preparation Client Intake Form

www.caressenco.com
Engagement Letter

Welcome and Thank You for choosing our firm, Caresse & Co Financial Services to assist you with your tax returns. This letter confirms the terms of my engagement with you and outlines the nature and extent of the services I will provide.
OUR RESPONSIBILITIES
Our work (whether consultation, tax return, tax plan, or related products) is based on the data you provide.
- We may ask for clarification of your data or additional information.
- We are not responsible to discover fraud or other irregularities, should any exist.
- We will work to find all the credits and deductions you are legally entitled to.
YOUR RESPONSIBILITIES
- To provide all the information required for a complete and accurate finished product.
- To provide all of your information needed in a timely manner.
- To retain, with the completed work, all the documents, canceled checks, and other data that form the basis of income and deductions since you may later have to provide them to a taxing authority.
- To carefully review all work completed by our office before you sign. You have the final responsibility for anything submitted to a taxing authority.
- You are responsible for not committing fraud.
PENALTIES, EXAMINATIONS, AND NOTICES

The IRS and state taxing authorities impose penalties for certain offenses, including understatement of income, filing after the deadline, underpaying estimated taxes, or under withholding taxes (if you would like more information, please contact us). They can also select any return for examination.

PRIVACY POLICY

Tax preparers are bound by professional standards of confidentiality. Therefore, we have always protected your right to privacy. For current and former clients, we do not disclose any nonpublic personal information obtained in the course of our practice except as required or permitted by law, and as is necessary to properly provide our services to you.

Types of Nonpublic Personal Information We Collect. We collect nonpublic personal information about you that is provided to us by you or obtained by us with your authorization.

Parties to Whom We Disclose Information. We make available information to our employees and to nonaffiliated third parties who need to know that information to assist us in providing services to you. In all such situations, we require a contractual agreement that includes procedural safeguards that protect the confidential nature of the information being shared.

Protecting the Confidentiality and Security of Former Client Information. We retain records relating to professional services that we provide so that we are better able to assist you with your professional needs and, in some cases, comply with professional guidelines. In order to guard your nonpublic personal information, we maintain physical, electronic, and procedural safeguards that comply with our professional standards.

OUR FEES

Our fee for services will be based upon the extent of the tax forms required for us to properly file your tax return. However, if complications are discovered in the process of preparing your tax return, I will inform you and fees may be adjusted. Before proceeding with the preparation of the return, I will generally contact you in advance if my original quote requires significant revision due to the amount of work involved. Invoices are due and payable upon presentation. To the extent permitted by state law, an interest charge may be added to all accounts not paid within thirty (30) days. We may invoice for partially completed work that is placed on extension or remains undone. All invoices are due and payable upon completion of the tax returns under this engagement. Tax returns will not be filed with the IRS without payment in full for our services.

TAX DOCUMENTS

All clients are provided a copy of their tax documents at the conclusion of their tax preparation if the return is e-filed to the IRS. Tax documents are issued via email or in the office only. In order to provide you with a copy of your tax documents, your tax return must be e-filed and submitted to the IRS. Any additional copies of your e-filed tax documents are $25 per year.

ARBITRATION

If a dispute arises out of or relates to this contract or engagement letter, or the obligations of the parties therein, and if the dispute cannot be settled through negotiation, the parties agree first to try in good faith to settle the dispute by mediation administered by the American Arbitration Association under its Commercial Mediation Rules before resorting to arbitration, litigation, or some other dispute resolution procedure.

AGREEMENT

The foregoing is in accordance with my (our) understanding of your engagement to provide tax and financial services and you are hereby advised that each item of revenue or expense can be substantiated by receipts, canceled checks, or other documents. This information is true, correct, and complete to the best of my (our) knowledge. Further, it is my understanding that these terms will continue to be enforced for the succeeding years of our engagement.

***Please note that you have fully read and understand everything listed above by signing this form. You are in full agreeance with Caresse & Co Financial Services completing your tax return, and making sure that your return is filed with all of the available deductions given your filing circumstances. Since your tax return is unique to your circumstances, we CANNOT GUARANTEE the outcome of what happens after your return is sent to the IRS. If your return is used to fulfill an offset, this DOES NOT RELIEVE YOU OF YOUR OBLIGATION TO PAY for services provided***
Taxpayer Full Name
Taxpayer Signature

Clear
Today's Date

MonthDayYear
Spouse's Full Name (if applicable)
Spouse's Signature (if applicable)

Clear
Today's Date

MonthDayYear
Date
Be sure to upload ALL SUPPORTING DOCUMENTS at the end of the form, ie:
- Last year's tax return (New Clients Only)
- All statements (W2s, 1098s, 1099s, Business Income Statements, and Receipts)
- Supporting documents for Child Tax Credit
Please upload each document SEPARATELY. If for some reason you cannot upload documents, contact you preparer.
Taxpayer Information

First NameM.I.Last Name
Taxpayer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Taxpayer Address Verification (Must Have)

Utility BillLeaseRental LedgerBank Statement
Email
example@example.com
Taxpayer Phone Number
Please enter a valid phone number.
Cell Phone Provider/Carrier
Taxpayer Social Security Number
*000-00-0000
Taxpayer Date of Birth

MonthDayYear
Date
Tax Payer Verification for Filing Status (Must Have)

State ID (unexpired)Driver's License (unexpired)Marriage LicensePassportOther (please see preparer for this option)
Taxpayer Driver's License or State ID Number
-License or ID Issue Date
-License or ID Expiration Date
**If you have an Identity Protection Pin (IPPIN) list it here**
Taxpayer Occupation
***What filing status was used on your 2021 tax return?
(If unknown, select unknown)
Are you a U.S. citizen?
Last year were you a full-time student?
Last year were you totally & permanently disabled?
Last year were you legally blind?
Can anyone claim you (or your spouse) as a dependent?
Did you or your spouse purchase health insurance through marketplace (Obama Care)?
If yes, upload 1095-A
SPOUSE INFORMATION

*Leave Blank is Not Applicable
SPOUSE INFORMATION

First NameLast Name
Spouse Email
example@example.com
Spouse Address (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Spouse Phone Number
Please enter a valid phone number.
Spouse Social Security Number
*000-00-0000
Spouse's Date of Birth

MonthDayYear
Date
Spouse's Verification

State ID (unexpired)Driver's License (unexpired)Passport
Spouse Driver's License or State ID Numer
-License or ID Issue Date
-License or ID Expiration Date
**Spouse Identity Protection Pin (IPPIN)**
As of December 31, 2022, what was your marital status?

Dependent Information

	Name	SSN	Date of Birth	Relationship	# Of months lived in your home	U.S. Citizen	Full-time student last year	Totally and permanently disabled
1
2
3
4
5
6

Dependent Relationship Verification

Birth Certificate (Must Have)Social Security Card (Must Have)
* Dependents Identity Protection Pin (Include: Full Name, IPPIN Number - EX. Child / #102030)
Did the dependent live in your home for more than 6 months in the past year?
If no, which months did they live with you? Also explain why and who the dependents did lived with and who the other party was for the missing months.
Dependent Residency Verification

School RecordsMedical RecordsShot RecordsGoverment Statements (ie. SNAP or Housing)Other (see preparer for this option)
Are all of the dependents being claimed on your 2022 tax return your biological children?
If no, explain why.
If you are filing SINGLE, did you receive any support from the other biological parent?
If yes, provide the other biological parents first and last name, the city and state that they live in.
How many months did you receive support from the other biological parent?
Why is the other biological parent not claiming the dependent(s) for 2022? Explain.
Did you receive any additional income support for your dependent(s) in 2022? (Gifts, loans, family assistance, credit cards, etc.) If yes, how much did you receive?
Are any of the dependents adopted?
(If yes, provide PROPER Documentation)
Did you claim the dependents last year?
If no, explain why.
Can the taxpayer, spouse, or any dependents be claimed by anyone else?
Were any credits disallowed or reduced in a previous tax year?
If yes, explain.
In the event of an audit, can you prove residency and responsibility for the dependents being claim?
(Be sure to upload documents)
Do you have supporting documents to prove your relationship to the child
(Be sure to upload documents)
Are any of the dependents disabled?
If yes, what is the nature of the disability? (Permanently and totally disabled or temporarily)
(Be sure to upload documents)
Would you like to apply for a Refund Advance Loan
***Refund Advance options are discussed in office, and are subject to bank approval...
How much would you like to apply for up to $1000 with no advance loan fee or up to $6000 with an advance loan fee?
***Refund Advance options are discussed in office, and are subject to bank approval. Loan amount not guaranteed it is subject to bank approval***
How would you like to receive your refund?
(debit cards available while supplies last)
Bank Name
Routing Number
Account Number
Type of Account
***Taxpayer agrees that if he/she owes any taxes, prior obligations, or back taxes (offsets), all fees will have to be paid upfront before the return is filed
**Failure to pay any balances in full will result in the company taking legal action against the taxpayer
Did you or your spouse receive unemployment?
* If yes, you must Upload 1099-G)
EITC Government Assistance Verification
Did you receive any government assistance in 2022? If yes, what?
(If you answer no, go to the next section)
Did you receive Food Stamps (SNAP) in 2022? If yes, how much and for what months?
Did you, your spouse, or your children receive medicaid in 2022? If yes, who received benefits and what months?
Did you receive housing assistance in 2022? If yes, what was the amount received, and for what months? Also list the address(es) where housing was used?
Did you receive dependent care assistance in 2022? If yes, what was the amount and for which months?
Student Acknowledgement
Did you, your spouse, or any dependent receive any post-secondary education?
(If yes, upload form 1098-T)
Did you pay for dependent care to work or look for work?
Please discuss what supporting documents are needed with your preparer
Please answer the following questions to determine the maximum deductions.
Are you self employed or do you receive hobby income?
Did you receive income from farming income and crops?
Did you receive rent from real estate or other property?
Did you receive any income from gravel, timber, minerals, oil, gas, copyrights, or patents?
Did you withdraw or write checks from a mutual fund?
Did you have a foreign account, trust, or business?
Did you provide a home or help someone not listed in Section 2 above?
**If yes, please see your preparer.
Did you receive any correspondence from the IRS or State Department of Taxation?
**If yes, provide documentation to preparer.
Did you have healthcare coverage (health insurance) for you, your spouse and dependents during this tax season?
**If yes, be sure to upload forms 1095a, 1095b, or 1095c
Did you apply for an exemption through the Marketplace/Exchange?
If yes, provide the exemption certificate number?
How did you hear about us (Please answer below...)
Supporting Documents
Driver's License/State ID, Social Security Card(s), Passport, Birth Ceritificates

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Lease, School Records, Vaccination Cards, Award Letters from Gov Assistance (Proof of Residency, HOH, and Dependent Care)

Cancelof
W2, 1099(s), Income and Expenses for Self Employed (Proof of Income)

**Discuss Self Employment verification with your tax preparer
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Provide 1098-T, Child Care Forms, any other Government Documents, Alimony, Proof of Charitable Contributions, Taxes Paid, Medical/Dental Expenses

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By signing below, I hereby certify the information provided above is true and accurate to the best of my knowledge. As the taxpayer, I have been informed that claiming a dependent for EITC/CTC/AOTC/HOH can result in audits, fines, and other consequences if the information provided is incorrect.
Signature

Clear
Date

MonthDayYear
Name of Tax Preparer
*Be sure to ask your preparer for their name
***Call, text or email your preparer once the form is completed, and all documents are loaded, so that you will be in the queue to have your return completed. All services will be provided in the order in which your intake form is received.

Thank you for choosing Caresse & Co Financial Services!
Should be Empty:

Tax Preparation Client Intake Form

Engagement Letter

SPOUSE INFORMATION

EITC Government Assistance Verification

Student Acknowledgement

Supporting Documents