Client Intake Form
Are you a new client OR an existing client ?
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New Client
Existing Client (you filed with me BEFORE )
PLEASE ENTER YOUR FULL NAME
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Client Intake Form
Taxpayer FIRST name
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Taxpayer LAST name
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ADD JR OR ll , if this applies to you
Taxpayer SSN
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Do you have a IPIN (identity protection pin )
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Yes
No
What's your IPIN (identity protection pin)
Taxpayer DOB
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(Numbers only) dont put -
Taxpayer AGE
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How old are you
Taxpayer Phone Number
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Taxpayer Email
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example@example.com
Did your address change from last year (YES OR NO)
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you owe childsupport ? Do you owe anything other than child support? If so how much ?
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Call the offset line at (800)-304-3107 to see if you owe a debt to anyone . If you know u owe childsupport call 800-252-8014 to see how much .
URBER , LYFT , DOOR DASHERS what is the MAKE AND YEAR OF CAR ?
MAKE and YEAR OF CAR
What is the name of your business ? Type of business ? and EIN # ?
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DEPENDENTS / CHILDCARE
Child/Dependent Care Expenses
Dependents Care Providers Name
Providers EIN/SSN (I NEED THIS INFO )
Providers Address:
City & State
Zip Code
Amount Paid :
Put 300/week OR 6000 yearly
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Dependent Information (Do Not Enter MIDDLE NAME )
Rows
Dependent name
(Include suffix)
SSN
Date Of Birth
Boy OR GIRL
Relationship This is my … niece , son , daughter , cousin , nephew , mother ?
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Direct Deposit
BANK Name
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Bank ROUTING number
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Bank ACCOUNT number
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Bank account type
Checking
Savings
What is your mothers Maiden name (last name )
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They ask this for verification when I put your bank info in (this is something new )
What city and state were you born in
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I need this just in case I have to call the IRS you
I certify that I verified the correct banking information and understand that once the tax return has been submitted by my tax preparer no chances can be made to any of the bank payout options:
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I CERTIFY I WOULD LIKE TO HAVE MY TAX RETURN PREPARED IN ACCORDANCE WITH THE INFORMATION I HAVE PROVIDED
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Date Signed
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-
Month
-
Day
Year
Date
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Upload Documents
For you and dependents
PLEASE UPLOAD A VALID ID/DRIVERS LICENSE
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
PLEASE UPLOAD A VALID Social Security card for you and your dependents *******************************YOU CAN UPLOAD MORE THAN 1 document at a time
Browse Files
Drag and drop files here
Choose a file
Cancel
of
How many W-2 forms do you have ? Your w-2’S MUST SAY 2025.—> Do not upload A w-2 if it doesn't say 2025
I DO NOT FILE PRIOR RETURNS (only current year)
UPLOAD W-2’s *******************************YOU CAN UPLOAD MORE THAN 1 document at a time
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Upload 1099’s *******************************YOU CAN UPLOAD MORE THAN 1 document at a time
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Upload health insurance forms (1095-A , HSA ) *******************************YOU CAN UPLOAD MORE THAN 1 document at a time
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Take a Selfie HOLDING UP 3 fingers *******************************this is required , due to fraud )
*
Back
Next
Upload Documents
For you and dependents
PLEASE UPLOAD A VALID ID/DRIVERS LICENSE
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
PLEASE UPLOAD A VALID Social Security card for you and your dependents *******************************YOU CAN UPLOAD MORE THAN 1 document at a time
Browse Files
Drag and drop files here
Choose a file
Cancel
of
How many W-2 forms do you have ? Your w-2’S MUST SAY 2025.—> Do not upload A w-2 if it doesn't say 2025
I DO NOT FILE PRIOR RETURNS (only current year)
UPLOAD W-2’s *******************************YOU CAN UPLOAD MORE THAN 1 document at a time
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Upload 1099’s *******************************YOU CAN UPLOAD MORE THAN 1 document at a time
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Upload health insurance forms (1095-A , HSA ) *******************************YOU CAN UPLOAD MORE THAN 1 document at a time
Browse Files
Drag and drop files here
Choose a file
Cancel
of
If your address , phone number , bank account changed or you need to add a dependent ENTER IT HERE .***************************** Bank name Checking or saving Dependent name DOB SSN (your relationship to the dependent (niece or nephew ) , BOY OR GIRL 🚨🚨whatever ADDRESS and BANK ACCOUNT I have on file for you before is what I’ll be using if you don’t put the new one in this box 🚨🚨
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If nothing CHANGED TYPE N/A
Taxpayer Phone Number
*
Taxpayer Email
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example@example.com
Take a Selfie HOLDING UP 3 fingers *******************************this is required , due to fraud )
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Submit
Should be Empty: