• 2023 Tax Return Intake Form

    Please fill out entire form
  • *
  • Date of Birth
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Spouse (if married)

  • Date of Birth
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Dependent(s)

  • Dependents
    Rows
  • 3rd Round Stimulus
  • Income
  • Itemized Deductions
  • Health Insurance Questionnaire

  • Health Insurance Type
  • Earned Income Credit

    Additional due Diligence
  • Areas of Emphasis Around 60% of all mistakes in EITC are results of 3 main areas: 1. The child might not meet the age, residency, or relationship requirement. 2. The case might be that someone is filing as single or HOH when he/she is actually married. 3. A mistake might arise when reporting income or expenses. Special attention has to be paid when the client is answering these questions. The people who are eligible for EITC: 1. Have earned income2. Have a valid Social Security Number3. Are filing separately and not as married4. Are not a nonresident alien5. Are not a qualifying child of another person6. Are not filing Form 2555 or Form 2555-EZ7. Have limited investment income.

  • Select Type of Assistance Received
  • Child Care credit

    Provider Information
  • Select if ID Number is a SSN, ITIN, or EIN
  • Format: (000) 000-0000.
  • Education

    (Please Provide 1098-T and Supporting Documents)
  • Business Expenses

  • Tax Preparation Checklist Please provide the following documentation: All Forms W-2 (wages), 1099-INT (interest), 1099-DIV (dividends), 1099-B (proceeds from broker or barter transactions), 1099-R (pensions and IRA distributions), Schedules K-1 from partnerships, S corporations, estates and trusts, and other income reportingstatements, including all copies provided from the payer. Form 1095-A (for health insurance purchased through a public exchange), Form 1095-B (for health insurance purchased outsideof a public exchange), or Form 1095-C (for employer-provided healtinsurance coverage). If you are a new client, provide copies of last year’s tax returns. The completed Individual Income Tax Organizer. Note: If you choose not to fill out the organizer, you must at least answer the “Yes” or “No” questions under “Questions — All Taxpayers.” Copy of the closing statement if you bought or sold real estate. Mileage figures for any automobile expenses claimed, including total mileage, commuting mileage, and business mileage. Detail of estimated tax payments made, if any. Income and deductions categorized on a separate sheet for business or rental activities. List of itemized deductions categorized on a separate sheet for medical, taxes, interest, charitable, and miscellaneous deductions. Copy of all acknowledgement letters received from charitable organizations for contributions in the current tax year.
    Tax Return Preparation We will prepare your tax return based on information you provide. In the event your return is audited, you will be responsible for verifying the items reported. It is important that you review the return carefully before signing to make sure the information iscorrect. Unless otherwise stated, the services for preparation of your return do not include auditing, review, or any other verification or assurance.
    Taxpayer Responsibilities You agree to provide us all income and deductible expense information. If you receive additional information after we beginworking on your return, you will contact us immediately to ensure your completed tax returns contain all relevant information. You affirm that all expenses or other deduction amounts are accurate and that you have all required supporting written records. In some cases, we will ask to review your documentation. You must be able to provide written records of all items included on your return if audited by either the IRS or state tax authority.We can provide guidance concerning what evidence is acceptable. You must review the return carefully before signing to make sure the information is correct. Fees must be paid before your tax return is delivered to you or filed for you. If you terminate this engagement before completion,you agree to pay a fee for work completed. A retainer is required for preparation of late returns. You should keep a copy of your tax return and any related tax documents. You may be assessed a fee if you request a copy in thefuture. Signatures. By signing below, you acknowledge that you have read, understand, and accept your obligations and responsibilities. For a joint return, both taxpayers must sign

  • Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Date
     - -
    2 digit month, 2 digit day, 4 digit year
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