TWS Financial Services, LLC-Tax Client Intake Form
Your Name
*
First
Middle
Last
Suffix
Your Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Email
*
example@example.com
Your Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Who Referred you?
First/Last Name
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Filing Status
*
Single
Head of Household (HOH)
Married Filing Joint (MFJ)
Married Filing Separate (MFS)
Not Sure
Number of Dependents
*
0
1
2
3+
Dependent #1 Date of Birth
-
Month
-
Day
Year
Date
Dependent #2 Date of Birth
-
Month
-
Day
Year
Date
Dependent #3 Date of Birth
-
Month
-
Day
Year
Date
Dependent #4 Date of Birth
-
Month
-
Day
Year
Date
Did you and your dependents have Health Care Coverage during 2024?
Yes - Entire year
Yes - Part of the year
None
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Total Income (W-2, 1099NEC, 1099G, SSA1099, 1099R)
*
ex. $26,567.23
Total Federal Withholding
*
ex. $49.57
Total Business Income
ex. $34,567.12
Total Business Expenses
ex. $12,345.67
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