Tax Client Intake Form

Please complete all parts of this intake form. This information will be used to prepare your tax return. You are responsible for the information on your return. Please provide complete and accurate information. If you have questions, please contact our office.

Part 1 - Your Information

Part 2 - Martial Status and Household Information

Part 3 - Income

Part 4 - Expenses

Part 5 - Life Events

Consent to Disclose and Use

Federal Disclosure:
Federal law requires this consent form be provided to you. Unless authorized by law, we cannot disclose your tax return information to third parties for purposes other than the preparation and filing of your tax return without your consent. If
you consent to the disclosure of your tax return information, Federal law may not protect your tax return information from further use or distribution.
You are not required to complete this form to engage our tax return preparation services. If we obtain your signature on this form by conditioning our tax return preparation services on your consent, your consent will not be valid. If you agree
to the disclosure of your tax return information, your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature.

Terms:
You have indicated that you are interested in receiving an Electronic Disbursement Service from a bank of our affiliation. In order to provide you with the opportunity to apply for one of these Products or Services, we must disclose all of your
2022 tax return information necessary for evaluating the request to the affiliate bank. If you request a more limited disclosure of tax return information, you will not be eligible to submit an application request for these Products or Services. If you would like us to disclose your 2022 tax return information for this purpose, please sign and date your consent to the disclosure of your tax return information. By signing below, you authorize us to disclose to our affiliate bank(s) all of your 2022 tax return information necessary for the evaluation and processing of your request for a Product or Service. You understand that if you are unwilling to authorize the disclosure and sharing of your tax return information with our affiliate bank(s), you will not be able to obtain a Product or Service, but you may still choose to have your tax return prepared and filed by us for a fee.

Consent:
I/we, the taxpayer, have read the above information.
I/we hereby consent to the disclosure of tax return information described in the terms above and allow the tax return preparer to enter a PIN in the tax preparation software on my behalf to verify that I/we consent to the terms of this
disclosure.

Please upload the following documents:

• All Tax related documents and forms such as Form W-2, 1099, 1098, 1095, etc.
• Social Security Cards or ITIN letters for all persons on your tax return.
• Unexpired Picture ID's for you and your spouse such as a valid driver's license.
• Self Employment Income and Expense statements, if applicable.

If you are unsure on what documents to upload, please contact our office. Failure to upload proper documentation can delay the preparation of your Tax Return.