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2022 Tax Intake Form
Please Take 5-10 Minutes to Complete this Form
52
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1
To Complete this Form, You will need The Following Documents and information available for Upload to the System:
Picture ID (must be valid; Driver's License, State ID, Passport);
Social Security Card for each person being listed on the return (Proof of Social Security Number)
Must be Registered with the IRS. (visit
irs.gov
and follow the steps to sign in or create an account with ID.me)
Birthdate of each person being listed on the return;
All tax forms for the filing year (W2s, 1099's. 1098s, Retirement
Documents, Stock Documents, etc.);
Stimulus payment information ( if applicable);
Child Advance Tax Credit information(if applicable);
If you have a business, you will need your EIN paperwork, Articles of Corporation
IP PIN Documentation (You can Retrieve this from the IRS Portal)
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2
Name
*
This field is required.
First Name
Middle Name
Last Name
Suffix
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3
Email
example@example.com
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4
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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5
Phone Number
Please enter a valid phone number.
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6
Date of Birth
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7
Social Security Number
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8
Address Used on your Last Tax Return Filed
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9
Filing Status
Single
Head of Household
Married Filing Jointly
Married Filing Separate
Qualified Widower
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10
Spouse Information
If Filing Married, Please Provide Your spouse's Name, Social Security Number, and Birthdate.
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11
Do you have Dependent
YES
NO
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12
Dependents Information
List the full name, birth date, social security number, and relationship of each dependent.
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13
Did you pay Dependent Care Expenses?
YES
NO
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14
Occupation/ Self Employment Type
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15
Was Everyone in your Household Cover by Health Insurance
YES
NO
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16
What Months did you Have Health Insurance?
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17
Do you Own any Foreign Bank Accounts?
YES
NO
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18
If yes, Provide the Information on these Accounts
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19
Do you Own a Business?
YES
NO
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20
Do you have an EIN
YES
NO
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21
Upload Business Documents
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Max. file size
: 10.6MB
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22
Are you (The Tax Payer) Actively Military
YES
NO
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23
If Applicable, Is your Spouse Actively Military
YES
NO
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24
Were you ever Disallowed or Reduced Credits in Previous Years
YES
NO
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25
Have you Ever been a Victim of Identity Fraud?
YES
NO
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26
Do you Have an IP Pin?
YES
NO
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27
Would You like us to assist you in getting a IP Pin?
YES
NO
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28
Did you receive unemployment for this tax year?
YES
NO
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29
Do you own Property
YES
NO
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30
Do You Own a Car(s)?
YES
NO
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31
Did you Pay Student Loans?
YES
NO
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32
Did you Receive payments from Lottery Winnings?
YES
NO
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33
Did you Receive a PPP Loan
YES
NO
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34
Did you Receive Retirement Income?
YES
NO
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35
Are You Interested in any of the Following Products
Credit Restoration
Business Funding
Business Formation
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36
How would you like Your Refund Disbursed?
Direct Deposit
Check Mailed to You
Pick up Check in Office
Refund Applied to the Next Year
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37
Please Provide the Bank Name
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38
In Which Account do you want the funds Disbursed
CHECKINGS
SAVINGS
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39
Provide Routing Number
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40
Provide Checking or Savings Account Number
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41
Upload Voided Check, Bank Statement or Direct Deposit Form
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Select files to upload
Max. file size
: 10.6MB
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42
Picture of Tax Payer Identification
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
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43
Upload the Tax Payer Social Security Card (proof of Social Security Number)
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Max. file size
: 10.6MB
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44
Dependent Information
Please Upload a picture of you dependent social Security card
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Select files to upload
Max. file size
: 10.6MB
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45
If Applicable, Please upload spouse Documents
Identification and social Security Card
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Select files to upload
Max. file size
: 10.6MB
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46
Upload all W2's for the Year
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Max. file size
: 10.6MB
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47
Upload all 1099's for the Year
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Max. file size
: 10.6MB
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48
Upload Any 1098 Forms
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Max. file size
: 10.6MB
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49
Upload Investment and Stocks Documents
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Max. file size
: 10.6MB
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50
Upload any Additional Tax Documentation
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Max. file size
: 10.6MB
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51
Use this space to write any Question you may have
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52
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