Tax Client Intake Form
please complete form accurately to ensure your return is filed in a timely matter. If you have any questions feel free to contact me sbconsultservice@gmail.com or 804-251-4066
Appointment
What tax year?
*
2023
2022
2021
2020
Personal Information
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
SSN
*
Date Of Birth
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Do you have a IRS IP-PIN
*
YES
NO
Enter your IRS IP-Pin
Upload ID Clear Picture
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Filing Status
Please Select
Single
Married filing Joint
Married fling Separate
Head of Household
Back
Next
Spouse Information
this information is required if filing a spouse
Email
example@example.com
Spouse Name
*
First Name
Last Name
Spouse DOB
Spouse SSN
*
Spouse Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What county are you located?
Phone Number
*
Please enter a valid phone number.
D0 you have IRS IP-PIN?
*
Yes
NO
Enter your IRS IP-PIN
Upload ID Clear Picture
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Back
Next
Dependent Information
Do you have a dependent
*
Yes
NO
Enter Each Dependent Personal Information
Rows
Name
Date Of Birth
Social Security number
Relationship
Disabled yes or no
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Do you pay for child care
*
YES
NO
Childcare Information
Rows
Childcare Provider Name
EIN or SSN (put NP for Nonprofit)
Address of Provider
Provider Phone number
Amount Paid to Provider
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Upload Childs Social Security Card/shot record/school record/birth certificate
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Back
Next
Are you or any of your Dependents in College?
YES
NO
Upload Form 1098T
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Do you own or rent out Property for profit
*
YES
NO
Income From Real estate and royalties
Rows
Physical Address of Property
Type of Property(Single,family,multi-family,vacation etc)
Rents Received
Royalties Receive
Property 1
Property 2
Property 3
Property 4
Loss from real estate or royalties
Rows
Advertise
Auto, Travel
Cleaning and maintenance
commissions
Insurance
repairs, utilities and supplies
Property 1
Property 2
Property 3
property 4
Additional Information regarding real estate property
Do you have a cash Business?
YES
NO
Name of Business
Type of Business
Business Structure
Sole Proprietor
LLC
Partnership
Business EIN
Business Gross Profit Earnings (Before expenses)
Was a Vehicle used for your business
Yes
No
Vehicle expenses
Rows
Vehicle Type
Month, Date and Year vehicle was placed in service
Mileage January-June
Mileage July-December
Vehicle 1
Vehicle 2
Business Documents(receipts, ledgers,1099k,1099NEC,1099 MISC,Profit/loss statements)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Back
Next
Do you owe the IRS or any other debt which may cause garnishment of your tax return?
*
Yes
No
Unsure
Do you have marketplace health insurance?
*
Yes
No
If yes how much do you owe?
*
Enter amount of refund received in previous tax season
Previous Years AGI?
Back
Next
Payment Information
Thia information determines how you will receive your refund.
How would you like to receive your refund?
Direct Deposit
Check
Name of the Bank?
Routing Number
Account Number
Type of Account
Checking
Savings
Back
Next
Upload all applicable Documents(W2,1099,1095-A,1098T)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Additional Information like me to know
How did you hear about Sbconsultservice?
Enter name if referred by someone
Read Client Engagment Contract
CLICK HERE
By signing this form you acknowledge that you will abide by the agreement
In Consideration for tax preparation services rendered you (taxpayer) agrees to promptly pay all tax preparation fees and associated charges. In the event of non-payment within three business days from the receipt of the refund, you authorize direct debit from your account. Failure to collect the fees may result in legal action against you. This applies only if the IRS send you a check and not direct deposit.
*
Agree
Disagree
Continue
Continue
Should be Empty: