Client Information Form

  • Client Information Form

  • READ AND SIGN BEFORE PROCEEDING

    Dear client:

    We are looking forward to working with you this year and appreciate your business!

    This letter confirms our agreement for Integrity Tax to prepare your federal and applicable state income tax returns based on the information you provide. 

    You are responsible for providing complete and accurate income, deduction, credit, and dependent information, along with supporting documentation. We do not audit or independently verify the information submitted. You are also responsible for reviewing your completed tax return before signing and authorizing filing.

    We will comply with IRS due diligence requirements and may request additional documentation. Failure to provide requested information may delay or prevent filing.

    Fees are based on the complexity of the return and are due prior to filing unless otherwise agreed. Fees are not contingent upon refund amounts.

    Any refund advance or financial product is offered by a third-party lender and is subject to their terms and approval.

    Our liability is limited to the fees paid for tax preparation services. We are not responsible for penalties, interest, or additional taxes resulting from incomplete or inaccurate information provided by you.

    By signing below, you acknowledge that you have read, understand, and agree to these terms.

  • Select your filing status*
  • Are you legally married?*
  • If filing Head of Household, you must present one of the following to use this filing status. Select the one that you will upload to be approved for HOH filing status.
    • Taxpayer Information 
    • Date of Birth*
       - -
    • Format: (000) 000-0000.
    • Are you a college student? If yes, you must provide 1098-T to substantiate.
    • If you are a college student, has the AOTC already been claimed in 4 prior tax years?
    • Are you totally and/or permanently disabled?
    • Are you legally blind?
    • Can you be claimed as a dependent on another taxpayers return?*
    • Spouse Information 

    • This section only needs to be completed if you are Married Filing Separately or Married Filing Jointly. Otherwise, you make skip to the next section.

    • Spouse Date of Birth
       - -
    • Did you and you spouse live together for at least 6 months during the tax year?
    • Dependent(s) Information 

    • If claiming dependents, please answer the questions below to confirm your eligibility under IRS guidelines. 

    • Did you provide more than 50% of household expenses?*
    • Did the dependents live with you for more than 6 months of the tax year?*
    • Did you pay anyone to watch dependents? Such as a babysitter or daycare?*
    • Did you pay any tuition expenses for dependent(s)?
    • Rows
    • Do you have health insurance through the healthcare marketplace? You would have received tax form 1095-A (formerly know as ObamaCare)*
    • Tax Questionnaire 
    • Please select employment status*
    • If self-employed do you have receipts, bank statements, etc., to substantiate business income and expenses?
    • Do you owe any delinquent debt? Please check all that apply*
    • Would you like your return(s) electronically filed?
    • Did you receive a distribution from or make a contribution to a retirement plan (401(k), IRA, etc.)?
    • Have you made any solar energy improvements to your home?
    • Are you a home owner?
    • Do you have documentation verifying that you paid property taxes?
    • Did you pay mortgage interest?
    • Did you file your 2024 tax year return?
    • Have you ever been disallowed the EITC, AOTC, or CTC?
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    • Would you like to receive your refund up to 5 days sooner with our Fast Forward program? a $25 fee applies.
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    • We request that you upload a recent photo of yourself. This additional security measure is implemented to prevent tax and identity fraud. Your cooperation in ensuring the accuracy and authenticity of the information provided is appreciated.

    • Acknowledgment & Signature 
      • I confirm that all information provided is true and accurate.
      • I authorize Integrity Tax Firm to capture sensitive data such as my driver's license, social security number (SSN), taxpayer signature, and other information.
      • By signing below you consent to Integrity Tax using the information provided to file your tax return and/or give a tax refund or tax liability estimate.
      • If additional information is required, we will reach out to you promptly. We appreciate your cooperation and look forward to assisting you with your tax needs.
    • Date Signed
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    • Should be Empty: