Tax Year 2024 Client Intake Form

Tax Year 2024 Client Intake Form

For this current tax year
To properly fill this form for submission, you will need to have handy: driver's license, social security cards for yourself and dependents if claiming any, W-2s or other documents supporting income, 1099s that you may have received, 1098-T for students
Select Your Preparer
Referred By:
Or workplace you were referred from
Filing Status?*
Your Full Name*

First NameMiddle NameLast NameSuffix
Birthdate*

MonthDayYear
Date
Social Security Number*
Mobile Phone Number*
Please enter a valid phone number.
Email
example@example.com
Gender
Occupation*
Driver's License Number*
State Driver's License was Issued*
Driver's License Issue Date*
Driver's License Expiration Date*
Upload Photo of Driver's License*

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Upload Photo of Social Security Card*

If you do not have SSN Card, photo of temporary SSN from SSA is acceptable
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Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you eligible to be claimed as a dependent on another person's tax return?*
Do you have healthcare through the Marketplace? (Affordable Healthcare Coverage/ www.healthcare.gov)?*
Were you in school in 2023?*
Did you invest in an IRA, annuity, or any other retirement plan outside of your job?
Do you own a business?*
Business EIN
Did you claim this business on your last year's return?
For business owners only
What is the make, model and year of your vehicle?
For business owners only
Did you work for any courier service or host AirBnB?*
DoorDash, Uber, AirBnB, Turo or other similar businesses
Upload W-2 Forms and Other Supporting Documents for Income*

1099s. 1098-T
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Qualifying Dependents
Do you have any eligible dependents you wish to claim on your Tax Return?*

Enter Dependents

	Name	Full SSN ###-##-####	Birthdate	Relationship
1
2
3
4
5
6
7
8

Did dependent(s) live in your care for 12 months?
Upload Dependent's Social Security Card or Supporting Documents

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Was there child care paid for the 2023 tax year?

General Expenses

	Amount
Medical Expenses
Dental Expenses
Insurance Premiums Paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Investment Expenses

IT'S MY REFUND & I WANT IT NOW!
Do you want to apply for Cash Advance?*
**Refund Advance Loans are subject to approval and we have no bearing on who is approved and who is denied. Advances range from $500-$7000 and are available January 2nd to March 15th. The amount of the loan and applicable interest will be deducted from tax refunds and reduce the amount that is paid directly to the taxpayer from the refund. Fees for other optional products or product features may apply and will be disclosed at the time of application. Refund Advance Loans will be issued by check or loaded on a Prepaid Visa, both of which can be picked up in the office or mailed via certified mail.**
Choose the method in which you would like to receive your refund*
Did you receive a return last year?*

YesYes, but it was taken. I have an OFFSETNo, I did not file
How much did you receive in your prior year tax return?*
If you have any student loans, do you know what status they are in?
Do you know of any OFFSETS (delinquent student loans, child support, tax liens, owe federal back tax, owe state tax, etc.) with the IRS that may prevent you from receiving your 2023 Tax Return?*
If you are unsure, please consult with your tax preparer to complete this question. If you suspect that you have an offset, call (800)304-3107
FOR DIRECT DEPOSIT ONLY
Financial Institution Name
Bank Routing Number
Bank Account Number
Type of Account

Tax Year 2024 Client Intake Form

Qualifying Dependents

IT'S MY REFUND & I WANT IT NOW!