2024 Tax Client Intake Form

CLIENT INTAKE FORM
We want to thank you for choosing Keys to Abundance Co. for your professional Personal and Business Tax Services. We truly appreciate your business and do not take it for granted. Our client intake form is located below, Please take a moment to fill out the form so we can better assist you with filing your tax services. Thank you.

Keys To Abudance Co.

(We Provide Services in all 50 States)
- What is your filing status?
- Taxpayer Name
  
  First NameLast Name
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Email
  example@example.com
- Date Of Birth
  
  MonthDayYear
  Date
- Social Security Number
- What year are you requesting to file?
- Did you receive a W-2?
- Did you receive Unemployment Compensation? (Form 1099-G)
- Did you collect Social Security or Retirement Income?
- Did you or take an early withdrawal from your retirement account? (Form 1099-R)
- Did you pay more than half of the expenses at your residence for the entire year?
- Did you have Health Insurance the entire year?
- Did you receive any of the forms listed below regarding your Health Insurance? (Optional)
- What was your marital status at the end of the year?
- Did you receive a W-2?
- Do you own a home?
- Were you a First Time Home Buyer this year?
- Have you ever been denied the Earned Income Tax Credit (EITC) ?
- Can you or any dependents be claimed by anyone else?
- If yes, which dependent can be claimed by someone else?
- Did you receive your Economic Stimulus payments? If so, which round did you receive?
- Do you owe any of the following?
- Spouse Full Name (If Applicable)
  
  First NameLast Name
- Spouse Date of Birth
  
  MonthDayYear
  Date
- Spouse Social Security Number
- Spouse Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Spouse Email
- Did you receive Unemployment Compensation? (Form 1099-G)
- Did you or collect Social Security or Retirement Income?
- Did you or take an early withdrawal from your retirement account? (Form 1099-R)
- Did you pay more than half of the expenses at your residence for the entire year?
- Did you have Health Insurance the entire year?
- Did you receive any of the forms listed below regarding your Health Insurance? (Optional)
- What was your marital status at the end of the year?
- Did you receive a W-2?
- Do you own a home?
- Were you a First Time Home Buyer this year?
- Can you or any dependents be claimed by anyone else?
- If yes, which dependent can be claimed by someone else?
- If yes, which dependent can be claimed by someone else?
- Did you receive your Economic Stimulus payments? If so, which round did you receive?
- Do you owe any of the following?
- Will you claim any dependents whom lived with you or whom you supported for more then 6 months this year?
- Dependent #1 Full Name
  
  First NameLast Name
- Relationship to Taxpayer
  ex. daughter, son, niece, nephew, etc.
- Date of Birth
  
  MonthDayYear
- Social Security Number
- Dependent #2 Full Name
  
  First NameLast Name
- Relationship to Taxpayer
  ex. daughter, son, niece, nephew, etc.
- Date of Birth
  
  MonthDayYear
  Date
- Social Security Number
- Dependent #3 Full Name
  
  First NameLast Name
- Relationship to Taxpayer
  ex. daughter, son, niece, nephew, etc.
- Date of Birth
  
  MonthDayYear
  Date
- Social Security Number
- Did you or your spouse pay any daycare expenses for any dependents this year?
- Which dependent did you pay daycare for? (If Applicable)
- Did you receive any Child Tax Credit Advance Payments?
- How much did you receive total in Child Tax Credit Advance Payments?
- BUSINESS OWNER/SELF-EMPLOYMENT
- Business Occupation
- Did you or your spouse receive a 1099 Form?
- Did you or your spouse incur expenses for your business or self-employment?
- Did you, your spouse, or a dependent attend college this year?
- Who attended college? (If Applicable)
- Did this person receive a 1098T (Student Statement) Form from the college or university they attended?
- How would you like to pay for your Tax Services?
- How will you like to receive your refund?
- Are you interested in the Cash Advance option?
- BANK INFORMATION
- Name of Bank
- Type of Bank Account
- Bank Routing Number
- Bank Account Number
- Do you consent and opt-in to receive text messages regarding your tax return?
- What is the name of your cell phone carrier?
- How did you hear about us?
- If referred, please list the first and last name of the person who referred you.
- Driver's License/ID
  
  Taxpayer and spouse
  Cancelof
- Social Security Cards
  
  Cards for taxpayer, spouse, and dependents
  Cancelof
- Birth Certificates
  
  All dependents
  Cancelof
- Proof of Resident
  
  Utility Bill, Lease Agreement, etc.
  Cancelof
- Income Forms
  
  W2, 1099, Expense Report, Bank Statements, Receipts
  Cancelof
- 1098T
  
  College Tuition Form
  Cancelof
- Childcare Statement
  
  Form 2441
  Cancelof
- Please take a few moments to review and make sure that all the information you have inputted is complete and accurate.
- CLIENT NON PAYMENT/OFFSET AGREEMENT : Our goal is to ensure the very best tax experience to all of our clients. However, we do understand that situations arise unexpectedly. If your refund is offset for any reason such as the IRS, student loans, child support, or your check is mailed, you are still responsible and obligated to pay our company all fees associated with filing your tax return. By signing this agreement, you acknowledge that if payment is not made in a full 30 days then legal actions will be sought to resolve payment. I am giving Keys To Abundance Co and/or associated affiliates permission to prepare all forms related to my tax return. I will take full responsibility for the accuracy of the information on this Client Intake Form and understand that Keys To Abundance Co will not hold any responsibility for any misrepresented data or false claims. By signing below, you the client, consents to this agreement.
- Please type your full name below.
  
  First NameLast Name
- Signature
- Should be Empty:

CLIENT INTAKE FORM

BUSINESS OWNER/SELF-EMPLOYMENT

BANK INFORMATION