Tax Client Intake Form

How did you hear about us?

Are you interested in a Cash Advance up to $7,000?

If you are interested in a Cash Advance, how much?

Are you interested in the Business in the Box (LLC Formation)?

Are you interested in Life Insurance?

Tax Payers Name

First NameLast Name

Taxpayer's Date of Birth

Example: 01/01/2001

Taxpayer's SSN

Example: xxx-xx-xxxx

Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Taxpayer's Phone Number

Example: xxx-xxx-xxxx

Taxpayer's Email Address

Taxpayer's Occupation

Taxpayer’s Type of Identification

Taxpayer's Identification Number

Taxpayer's Identification Issued Date

Taxpayer's Identification Expiration Date

Do you have IP PIN from the IRS?

Taxpayer’s IP Pin

Identification Protection Pin issued by the IRS

Spouse’s Name

First NameLast Name

Spouse's Date of Birth

Example: 01/01/2001

Spouse's SSN

Example: xxx-xx-xxxx

Spouse's Phone Number

Example: xxx-xxx-xxxx

Spouse's Email Address

Example: example@example.com

Spouse's Occupation

Spouse’s Type of Identification

Spouse’s Identification Number

Spouse’s Identification Issued Date

Spouse’s Identification Expiration Date

Spouse’s IP PIn

Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

What is your Filing Status?

What is your marital status as of December

Did you and your spouse live apart during the year?

If yes, did you live together at any time after June 30, 2022?

Did you pay over half the expenses of maintaining your residence for the entire year?

Did you support a child or family member for more than 6 months out of the year?

Are you self employed?

Are you on any Government Assistance

How many dependents are you claiming?

Dependent #1

First NameLast Name

Dependent #1 Date of Birth

01/01/2001

Dependent #1 SSN

What is Dependent #1's Relationship to you (son, daughter, etc.)?

How many months did Dependent #1 live with you in 2022? (If all year, enter 12)

Dependent #2

First NameLast Name

Dependent #2 Date of Birth

Example: 01/01/2001

Dependent #2 SSN

How many months did Dependent #2 live with you in 2022? (If all year, enter 12)

What is Dependent #2's Relationship to you (son, daughter, etc.)?

Dependent #3

First NameLast Name

Dependent #3's Date of Birth

01/01/2001

How many months did Dependent #3 live with you in 2022? (If all year, enter 12)

Dependent #3s SSN

Example: xxx-xx-xxxx

Dependent's #3 SSN

What is Dependent #3's Relationship to you (son, daughter, etc.)?

Dependent #4's First Name

First Name

Dependent #4's Last Name

Last Name

Dependent #4's Date of Birth

01/01/2001

Dependent #4's SSN

Example: xxx-xx-xxxx

What is Dependent #4's Relationship to you (son, daughter, etc.)?

How many months did Dependent #4 live with you in 2022? (If all year, enter 12)

Dependent #5's First Name

First Name

Dependent #5's Last Name

Last Name

Dependent #5's Date of Birth

01/01/2001

Dependent #5's SSN

Example: xxx-xx-xxxx

What is Dependent #5's Relationship to you (son, daughter, etc.)?

How many months did Dependent #5 live with you in 2022? (If all year, enter 12)

Are there any dependents in daycare? If yes, please upload the form you received from your daycare provider.

Upload a copy of your daycare form here.

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How would you like to receive your tax refund?

Which type of account would you like your refund deposited into?

Other

Name of Bank

Routing Number

Bank Account Number

Can someone else claim you as a dependent?

Did you have health insurance in 2022?

Did you have health insurance for the entire year?

Who was your insurance cover through in 2022?

Did your dependent(s) have health insurance in 2022?

Did your dependents have health insurance for the entire year?

Who was your Dependents insured with in 2022?

Upload Taxpayer & Dependent(s)Insurance Documents

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Did you trade any Virtual Currency

Have you ever been denied the Earned Tax Credit (EITC)?

Were you or any of your dependents in college in 2022?

Do you have a 1098-T Form (College Students) for either you or your dependents?

If you have a 1098-T form, upload it here.

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Primary Taxpayer's Signature

Spouse's Signature (If no spouse, leave blank)

Date

ADDITIONAL SERVICES

At One Stop Taxes, we do more than just taxes. Please check below if you would be interested in any of the additional services we provide. We will schedule a time to speak with you ar a later time.

I am giving One Stop Taxes permission to prepare all forms related to my tax return; to apply for and secure RAC's and RAL's on my behalf; and sign all necessary forms and file my taxes electronically. I take full responsibility for the accuracy of this form and understand that All Things Financial LLC and/or associated affiliates hold no responsibility for any misrepresentation or false claims.

Taxpayer's Signature (If no spouse, leave blank)

Spouse's Signature (If no spouse, leave blank)

Date

Type a question

Taxpayer's/ Spouse’s Valid Identification

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Taxpayer's/ Spouse and Dependent(s ) Social Security Card(s)

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Taxpayer's W-2/ 1099'S/Tax Documents

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Spouse's W-2/ 1099'S/Tax Documents

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Dependent(s) Birth Certificate(s)

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Dependent(s) School or Medical Records

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Taxpayer’s Proof of Residency (Lease/Utility Bill)

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TAX CLIENT INTAKE FORM