intake Form

1
Name* This field is required.
First Name
Last Name
2
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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
3
Phone Number* This field is required.
Please enter a valid phone number.
4
Email* This field is required.
example@example.com
5
Which of the following applies to you?* This field is required.
new client
returning client
6
Tax Professional name* This field is required.
Please Select
Please Select
Shawitekia Johnson
Shakela Lott
Talisha Myricks
Deanna Mcgahee
Tamara Hatcher
Latanza Burnett
anyone that's affiliated with SMJ Tax Firm and Associates
7
What tax year are you filing?* This field is required.
Please Select
Please Select
2023
2022
2021
2020
8
What's your marital status as of December 31,2023* This field is required.
single
head of household
married filing jointly
married filing separately
qualifying widower
9
Taxpayer Social Security Number *
10
Date * Taxpayer Date of Birth.
11
If dependent/dependents is not your child why are the parents not claiming them? if this does not apply to you put N/A *
12
How many dependents are you claiming * This field is required.
Please Select
Please Select
0
1
2
3
13
Dependent #1 name
First Name
Last Name
14
Date Dependent #1 Date of Birth
15
Dependent 1 gender
female
male
16
Dependent #1 Social Security #
17
Dependent #2 name
First Name
Last Name
18
Date Dependent #2 Date of Birth
19
Dependent 2 gender
female
male
20
Dependent #2 Social Security #
21
Dependent #3 name
First Name
Last Name
22
Date Dependent #3 Date of Birth
23
Dependent 3 gender* This field is required.
female
male
dont apply to you
24
Dependent #3 Social Security #
25
How many months have the dependents lived with you. if the dependent/ dependents lived with you all year but 12 months. *
26
Is the child #1 a US Citizen, US National or US Resident?
YESNO
27
Is the child #2 a US Citizen, US National or US Resident?
YESNO
28
Is the child #3 a US Citizen, US National or US Resident?
YESNO
29
Which of the following applies to you?
I paid daycare or a nanny to care for my child 13 years or younger while I worked or looked for work. I can get a statement with their EIN/SSN to provide this claim
I attended a college/ universities/community college/post-secondary school/career school and paid eligble expenses that can be proven with a 1098T form
i paid charity, tithes, or given donations to community organizations and/or religious organizations.
I paid over $12,400 in expenses for itemization
I paid student loan interest and received a 1098E.
I had eligible medical expenses
I sold and/or purchased a home
I had a baby, or adopted a child
I am in the military and had to move
I am separated/divorced paid or received alimony
none of the above
30
Are there any dependents in daycare? If yes, please upload the form provided by your childcare provider.
YESNO
31
Upload a copy of your daycare from here.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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32
Who was your healthcare provider?* This field is required.
Please Select
Please Select
Medicaid
The Marketplace Insurance
Employer
Private Insurance
Did not have any
33
Have you ever been denied the Earned Income Tax Credit* This field is required.
YESNO
34
Were you or any of your dependents in college during the year or part time?* This field is required.
YESNO
35
Do you owe student loans, taxes, or other government entities that might offset your taxes? * This field is required.
YESNO
36
Did you receive any unemployment? * This field is required.
YES I will upload my 1099GNO
37
Are you self-employed (1099NEC, or 1099MISC)?* This field is required.
YESNO
38
Did you operate in any goods or services during the tax year totaling $400 or more? * This field is required.
YESNO
39
If yes what is the Name of your Business and Job title?
40
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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
41
Business EIN (if Applicable)
42
Date Business Started
43
What document do you have to support your business income/expenses? such as bank statement, profit and loss statement, cash app, Zelle, Apple Pay, PayPal, or chime or etc. summary report.
44
If you don't currently have the supporting documents, will you be able to produce them in case of audit?
YESNO
45
Upload supporting business income and expenses
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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46
If you don't have any expenses please explain why?
Huge
Large
Normal
Small
Ok
Ok
47
Signature* This field is required.By signing below, I hereby certify the information given is accurate and true.
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48
Did you trade and Virtual Currency?* This field is required.
YESNO
49
Are you trying to purchase a home within the next 2 years?
YESNO
50
* How much was your last year tax return?
51
How would you like to receive your tax refund?* This field is required.
Check (Only available for in office visits)
Direct Deposit
Debit Card
52
Banking Information* This field is required.
bank name
Bank Account Number
Routing Number
53
Are you requesting a Cash Advance?* This field is required.
Yes
No
Undecided, Let's Discuss the terms and conditions.
54
If you're new client upload the last two tax return
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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55
Primary Taxpayer's Signature* This field is required.
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56
Spouse Signature if applicable
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57
Closure Agreement* This field is required. Closure Agreement between Client and SMJ Tax Firm and Associates A voluntary closing agreement between client and SMJ Tax Firm and Associates is when a taxpayer inadvertently fails to meet the requirements and obligations of SMJ Tax Firm and Associates tax processing policy(s). If a taxpayer inadvertently fails to meet the requirements of their tax return; and does not receive a tax return regardless of the violations or deficiencies on their part. The taxpayer will be liable within 10 days from the date of being notified by SMJ Tax Firm and Associates to set up payment arrangements. If the taxpayer fails to set up payment arrangements the taxpayer will be legally obligated to pay all court costs, filing fees, and all other fees associated with the non-compliant activities.
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58
Acknowledgement* This field is required.I hereby authorize SMJ Tax Firm and Associates to electronically file my tax return on my behalf. I understand that e-filing is a secure and efficient method of submitting my tax documents to the relevant tax authorities. I acknowledge that my tax return will be prepared in accordance with the information provided by me and that I am responsible for the accuracy and completeness of this information. I further understand that e-filing requires my consent and acceptance of any applicable terms and conditions set forth by the Internal Revenue Service (IRS) or other relevant tax authorities. I authorize SMJ Tax Firm and Associates to act as my authorized representative for e-filing purposes, including but not limited to, signing and submitting my tax return electronically, receiving electronic acknowledgments, and providing any additional information to support my tax filing. I acknowledge that once my tax return is successfully e-filed, it is considered filed and no paper return with the same information will be submitted. I confirm that I have read and understood the e-filing process and authorize SMJ Tax Firm and Associates to proceed with electronic filing on my behalf.
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59
Date
60
Taxpayer's/ spouse Driver License
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Select files to upload
Max. file size: 10.6MB
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61
Take Photo* This field is required.For you protection Against fraud Please Take A selfie to Ensure your identity is not compromised
62
File Upload* This field is required.Taxpayer's and Dependent(s) Social Security Card (s)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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63
File Upload* This field is required.Taxpayer's/ spouse W-2/ 1099's
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
64
Dear Valued Client,

I hope this letter finds you in great spirits! We are thrilled to welcome you to SMJ Tax Firm and Associates, your dedicated partner in navigating the intricate world of tax laws. It is our pleasure to have you on board, and we're looking forward to a productive and successful collaboration.

Our Commitment: At SMJ Tax Firm and Associates, we are committed to providing you with expert tax services tailored to your unique needs. With our team of experienced professionals, you can rest assured that your tax matters are in capable hands. Whether you're an individual, a small business owner, or managing a corporation, we are here to simplify the complexities of tax laws and ensure you receive the maximum benefits.

Understanding Tax Laws: Tax laws can indeed be confusing but worry not! We are here to guide you through every step. Our knowledgeable experts will explain the nuances of tax regulations, making sure you understand your obligations and opportunities. We believe that informed clients make the best decisions, so feel free to ask any questions you might have. Your understanding is our priority.

How to Reach Us: If you have any queries, concerns, or simply want to discuss your tax situation, don't hesitate to contact our office. You can reach us at 706-690-5047 or drop us an email at smjtaxfirmandassociates@gmail.com. We value your time, and we are here to assist you promptly and efficiently.

Once again, welcome to SMJ Tax Firm and Associates! We are honored to have the opportunity to serve you. As tax season approaches, we are ready to work diligently to ensure you receive the best tax outcomes.

Wishing you a prosperous and stress-free tax season ahead!

Warm regards,

Shawitekia Johnson
Owner, SMJ Tax Firm and Associates
65
Terms & Conditions* This field is required.I agree to all the terms and conditions listed above.
YESNO
Should be Empty: