RB Financial Services and Tax Prep Client Intake Form (2025)

Tax Preparer Name
How did you hear about us:
Taxpayer Name

First NameMiddle NameLast Name
Birthdate

MonthDayYear
Date
Social Security Number
Email Address
example@example.com
Occupation
Job Title
Work Phone Number
Upload Supporting Documentation (Identification / Social Security Card)

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Spouse Information
Spouse Name

First NameMiddle NameLast Name
Spouse Birthdate

MonthDayYear
Date
Social Security Number
Email Address
example@example.com
Occupation
Job Title
Work Phone Number
Spouse Work Number
Spouse Supporting Documentation (Identification / Social Security Card)

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Current Address

Street Address

Street Address Line 2

CityState

Zip Code
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Other Phone
Please enter a valid phone number.Format: (000) 000-0000.
Did you, and/or your spouse earn income? Employment or Contract Labor
Upload your documents (W2 / 1099s)

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Are the Taxpayer and Spouse legally married?
Filing Status
Dependents
Dependent #1

First NameMiddle NameLast NameSuffix
DOB

MonthDayYear
Date
SSN
Relationship
Months in home
Dependent #2

First NameMiddle NameLast NameSuffix
DOB

MonthDayYear
Date
SSN
Relationship
Months in home
Dependent #3

First NameMiddle NameLast NameSuffix
DOB

MonthDayYear
Date
SSN
Relationship
Months in home
Do you have any expenses for Child Care?
Upload Supporting Documentation (Social Security Cards/ Day Care Form)

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Do you have an IRS PIN #? If so, please enter below
RB Financial Services and Tax Prep will prepare your current year's individual tax return from the information you have provided. We will not audit or verify the information you furnished to us. You, the taxpayer, are ultimately responsible for the preparation and filing of your tax return. I, the taxpayer named above, have provided to RB Finanical Services and Tax Prep the attached tax information and to the best of my knowledge this information is true, correct and complete.
Tax Payer Signature
Spouse Signature
Tax Declaration

(Please upload all supporting documentation at the end of the section)
Have you provided correct identification numbers (photocopies if possible)?
Can someone else claim you/spouse as a dependent?
Do the names on the return match your social security records, children included?
Did you attend school or continued Education?
Do you have assets such as home, retirement accounts, etc?
Did you pay any medical and dental expenses?
Did you make any gifts to charity?
Did you take any casualty or theft loss?
Did you pay any mortgage interest?
Did you pay any state or local taxes on real estate or personal property?
Did you have any Gambling Winnings or Losses?
Did you/spouse receive any kind of military pay earnings?
Did you/spouse receive SSA, SSI, or Unemployment?
Do you buy or sell any stocks or bonds?
Do You/spouse Have A Business In Which You Made A Profit Or Took A Loss?
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DEPENDENTS AND/OR QUALIFYING CHILDREN

(Please provide all supporting documentation at the end of the section)
Have you verified your dependent’s birthday information as entered in the return?
Did you/spouse provide over 50% of total support for each dependent?
Did you pay any medical and dental expenses?
Do your EIC qualifying children meet any one of these requirements?
Under age 19 and lived in the taxpayer’s home more than one half of a year?
Under age 19 and foster child of a taxpayer and lived in the taxpayer's home full year?
Full time student age 19 to 23?
Totally disabled and can provide proof?
Did your EIC qualifying children live with you in the same main home in the US?
Did you receive a 1095-A, Health Insurance Marketplace Statement? If so, please upload below.
Upload Supporting Documents

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CONSENT TO USE OF TAX RETURN INFORMATION

For the purposes of this consent form, “we,” “us,” and “our” mean RBF Tax Prep Federal law requires this consent form be provided to you. 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 in our tax return preparation services. If we obtain your signature on this form by conditioning our tax 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. If you do not consent, you may still have your tax return prepared and electronically filed by us for a fee. For your convenience, we have entered into an arrangement with third parties to provide qualifying taxpayers with the opportunity to apply for an Electronic Refund Disbursement Service and/or Loan product. To determine whether these products may be available to you, we will need to use your tax return information in order to calculate the amount of your anticipated refund. If you would like us to use your tax return information to determine whether these products may be available 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 2024 tax return to determine whether to present you with the opportunity to apply for these products and services.
Printed Name of Taxpayer
Taxpayer Signature
Printed name of Joint Taxpayer Signature(if applicable)
Joint Taxpayer Signature (if applicable)
Date

MonthDayYear
Date
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

I DECLARE THAT I UNDERSTAND THE ABOVE QUESTIONS AND HAVE ANSWERED THEM TRUTHFULLY TO THE BEST OF MY ABILITY.
Taxpayer Signature
Have you already submitted your information but forgot to submit other documents? Upload them here!

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