NouveauRiché Client Intake

Nouveau Riché Tax Prep Client Intake

Thank You For Choosing Us!
YEAR OF TAX PREP *
NEW OR RETURNING CLIENT*

NEWRETURNINGUNSURE
FILING STATUS
Select Filing Status *
FILING STATUS WILL BE ULTIMATELY DETERMINED BY INFORMATION GIVEN AND TAX PREPARERS DISCRETION
Number of Dependents *
TAXPAYER

ENTER IN YOUR INFORMATION
Name*

First NameLast Name
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
DATE OF BIRTH*

MonthDayYear
Date
Social Security Number *
Occupation*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Upload Driver's License or State Id*

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TAXPAYER IP PIN (issued from IRS yearly)
SPOUSE

YOUR SPOUSES INFORMATION, IF LEGALLY MARRIED OR PRESUMED MARRIED BY COMMON LAW STATUTE IN THE STATE YOU RESIDE IN
Name*

First NameLast Name
Date Of Birth*

MonthDayYear
Date
Social Security Number *
Occupation*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Spouse's Driver's License or State Id*

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SPOUSE IP PIN (issued from IRS yearly)

CHILDCARE INFORMATION
CHILDCARE PROVIDER 1 NAME
CHILDCARE PROVIDER 1 SSN OR EIN
AMOUNT PAID FOR CHILDCARE
WHICH CHILD(REN) RECIEVED CHILDCARE?
CHILDCARE PROVIDER ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
HIGHER EDUCATION

COLLEGE AND TUITION INFORMATION
UPLOAD SCHOOL TAX FORM(S) (1098-T)

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HAVE YOU CLAIMED THE AMERICAN OPPORTUNITY EDUCATION CREDIT IN THE PAST?

YESNOUNSURE
UPLOAD STUDENT LOAN INTEREST FORM (1098-E)

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ITEMIZED DEDUCTIONS
MEDICAL
OUT OF POCKET MEDICAL EXPENSES
STATE AND LOCAL TAXES OR GENERAL SALES TAX PAID
STATE AND LOCAL REAL ESTATE TAX
STATE AND LOCAL PERSONAL PROPERTY TAXES
ANY OTHER STATE AND LOCAL TAXES PAID
INTEREST YOU PAID
HOME MORTGAGE INTEREST YOU PAID
UPLOAD YOU 1098-MORTGAGE STATEMENT

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GIFTS TO CHARITY
CHARITY 1 NAME AND AMOUNT DONATED
CHARITY 2 NAME AND AMOUNT DONATED
CHARITABLE CONTRIBUTION DOCUMENTS

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SOLAR POWER EXPENSES
ENERGY/ SOLAR POWER COST
UPLOAD PROOF/ DOCUMENTS FOR ENERGY/ SOLAR POWER COST

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UNEMPLOYMENT
DID YOU RECIEVE ANY UNEMPLOYMENT OR PAY ANY UNEMPLOYMENT OVERPAYMENTS BACK?

YESNOUNSURE
UPLOAD ANY UNEMPLOYMENT DOCUMENTS RECIEVED

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MISC.
Who Is Your NOUVEAU RICHE Tax Professional? Please type the preparer's name below:
REFUND DISBURSEMENT
How would you like to receive your refund?*

Paper Check Printed in OfficeDirect Deposit into my accountPRE-PAID Debit Card
BANK NAME
ROUTING NUMBER
ACCOUNT NUMBER
Would you like to apply for the REFUND Advance? (January 1-March 1, 2023)

YESNO
By completing this intake form, you agree that the information provided is true and accurate to your knowledge.
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Nouveau Riché Tax Prep Client Intake