The HCH Firm Tax Intake

The HCH Firm Tax Intake

Complete each section of this form so our team can serve you accurately and efficiently. Your tax return will be prepared based solely on the information you provide, so it is essential that all details are complete and correct. If you have any questions, our tax professionals are available to guide and support you throughout the process.
- Taxpayer Information
  
  First NameLast Name
- Date of Birth
- SSN/ ITIN:
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Email
  example@example.com
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Job Title,
- LAST YEAR WERE YOU...
- A. Full Time Student?
- B. Totally and Permanently Disable?
- C. LEGALLY BLIND
- Name
  
  First NameLast Name
- Date of Birth
- SSN/ ITIN
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Email
  example@example.com
- Job Title
- LAST YEAR WERE YOU...
- A. Full Time Student?
- C. LEGALLY BLIND
- B. Totally and Permanently Disable?
- Marital Status
- MarriedNever MarriedDivorcedLegally SeparatedWidowed
- Please included the date marital status change
- Have you or spouse been a victim of identity theft?
- Have you or spouse a adopted a child
- Number of Dependents
- DEPENDENT INFORMATION
- Income - Did you or your spouse receive:
- Expense- Last year did you or spouse Pay:
- Life Event - Last year did you or your spouse
- Part VI. Health Care Coverage- last year did you, your spouse, and or independent(s)
- Can anyone / claim you or your spouse as a dependent?
- Did you provide more than half the cost for the up keep of your home within the past year?
- Have you or spouse received any letters for IRS?
- Do you owe student loans?
- Do you owe back child support?
- Do you owe the IRS?
- Are you currently been garnished for any debt?
- Who Refer you?
- How would you like to receive your tax refund
- If Direct Deposit is selected, please provide your banking information
- Name of Bank
- Routing number
- Account Number
- Account Type
- Is this account in your name?
- Would you like to see if you qualify for a refund advance of up to $7500?
- Signature
  
  Clear
  Acknowledgment & Authorization I confirm the refund delivery method selected above and understand processing times are determined by the IRS/state and/or issuing bank.
- ⚠️ Refunds deposited into accounts not in the taxpayer’s name may be rejected or delayed.
- Authorization Agreement – The HCH Firm
  By signing below, I authorize The HCH Firm to collect, review, prepare, and file my federal and state 2025 income tax return(s) using the information I have provided. I understand and agree to the following:
  
  • Tax Preparation Fees
  
  I acknowledge that tax preparation fees for the 2025 tax year start at $399.99. If the IRS does not release my refund, or if my refund is reduced or garnished due to any past-due federal, state, or personal debts (including but not limited to child support, student loans, or tax liabilities), I remain fully responsible for payment of my tax preparation fee.
  
  • Acknowledgment of Refund & Fees
  
  I acknowledge that I have been informed of my estimated refund amount (if applicable) and the total tax preparation fees for the 2025 tax year.
  
  • Refund Disbursement Options
  
  I understand that my refund may be issued as a paper check, deposited onto a Green Dot card, or direct deposited into my designated bank account.
  
  • Changes & Adjustments
  
  I understand that any outstanding debts owed to the IRS, changes to IRS or state regulations, or adjustments made by the IRS may impact my final refund amount.
  
  • Accuracy of Information
  
  I declare that all information provided by myself (and/or my spouse) is true, correct, and complete to the best of my knowledge. I authorize The HCH Firm to use this information solely for the preparation and filing of my 2025 tax return(s).
- Signature
  
  Clear
- Date
  
  MonthDayYear
  Date
- Spouse Signature
  
  Clear
- Date
  
  MonthDayYear
  Date
Should be Empty:

The HCH Firm Tax Intake

Marital Status