Tax Preparation Client Intake Form
Enter information for 2022. If you're MARRIED please remember to fill in your spouses information. Also, BUSINESS OWNERS please answer ALL the questions related to your business (if you don't own a business SKIP these).
Filing Status
Single
Head of Household
Married Filing Separate
Married Filing Joint (LEGALLY married)
Qualifying Widower
Taxpayer Information
Name
First Name
Last Name
Age
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
SSN
Are you a full-time student?
Yes
No
Are you totally and permanently disabled?
Yes
No
Are you legally blind?
Yes
No
Can/will you claimed as a dependent on someone else's return?
Yes
No
Spouse Information
Name
First Name
Last Name
Age
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
SSN
Are you a full-time student?
Yes
No
Are you totally and permanently disabled?
Yes
No
Are you legally blind?
Yes
No
Can/will you claimed as a dependent on someone else's return?
Yes
No
Dependents
Enter your dependents here
Name
Relationship (sonn/daughter/etc)
Social Security Number
How many months did this dependent live with you during the year?
Age as of 12/31/2022
Did this person provide more than HALF of their own support for the tax year?
(Y/N)
Birthday
If child is OVER 19: Are they a full time student?
(Y/N)
1
2
3
4
5
6
Does you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it?
Yes/No
Employer
Spouse Ins
Exchange/ Marketplace
Direct with Insurer
Medicare
Medicaid
Taxpayer
Yes
No
Spouse
Yes
No
Dependent 1
Yes
No
Dependent 2
Yes
No
Dependent 3
Yes
No
Dependent 4
Yes
No
Dependent 5
Yes
No
Tax Related Questions
Employment Status
Employed
Unemployed
Self-employed
Are you contributing to 401k or other pre-tax account?
Yes
No
Is this your first time opening a pre-tax account?
Yes
No
Please select what state return are you requesting?
State return
School
Local
RITA
County returns
Did your dependents have tuition expenses?
Yes
No
Did you have any expenses for child care?
Yes
No
Did you have energy star rated improvements to your home?
Windows
Doors
Furnace
Other
Are you currently renting?
Yes
No
What is the monthly rental amount?
How long have you been renting this property?
# of months
Do you own a home?
Yes
No
Do you have documents that show you paid for property taxes?
Yes
No
Did you sell any stock?
Yes
No
Did you take money from your 401K account?
Yes
No
Did you pay for vehicle tax?
Yes
No
Do you have mortgage interest?
Yes
No
Did you pay real estate tax?
Yes
No
Last year, did you itemize INSTEAD of taking the standard deduction? (IMPORTANT!)
Did you receive a state refund last year?
Yes
No
Are you a victim of identity theft?
Yes
No
Expenses
Please fill-up the information within the current year only.
General Expenses
Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses
**BUSINESS OWNERS ONLY**
Business name AND structure (LLC, Partnership etc). If you have multiple businesses (between you & your spouse) enter them ALL. List the EIN if applicable.
Do you have records of expenses/income from your business?
Yes I have financial statements (profit/loss).
No I have no record keeping.
I have the income in the bank statements etc. but no formal compilation of financials.
*ONLY if you use your vehicle for business* Please list the vehicle make, model and year and upload mileage/expense totals to the online portal.
*ONLY if you are taking the home office deduction* Please list total square footage of your home AND the total square footage of your space dedicated solely to work. You can enter like this 300/2500 sq ft.
Do any of these apply to you?
I use a part of my home exclusively for business (room/area).
I use a business cellphone or I use my own cellphone frequently for business communications.
I pay health insurance premiums throughout the year for myself and/or my family.
I traveled last year for my business.
I purchased equipment costing over $1,000 (per item) for my business last year.
I contributed to a charitable organization last year.
Last year was my first year in business and I incurred start up costs of some kind.
Additional comments
LICENSES *REQUIRED FOR E-FILE*
Submit a picture of the license of you and your spouse.
Your License
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Spouse License
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Acknowledgment & Signature
I confirmed that all information I entered here is accurate and true.
I allow Elle & Company Accounting LLC to capture my sensitive data like personal id, government id, social security number (SSN), and other information.
I have read the terms and conditions and privacy policy of Elle & Company Accounting LLC.
By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
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