New Tax Clients Intake Form

New Client Tax Preparation/Intake Form

Please enter your information as accurately as possible. Please UPLOAD your REQUIRED DOCUMENTS that are needed to process your 2023 Tax Return. Please upload your required documents that are needed to process your 2023 tax return.
Name*

First NameLast Name
If we were comunicating via facebook messenger, what is your facebook name?
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What county do you live in?
If your address is different then the one that's on your State DL/ID; please indicate the reason why.
Enter FULL SSN*
Enter Date of Birth*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Please indicate identification type.*
Enter the ISSUING STATE of DL/STATE ID.*
Enter DL/State ID Number*
Enter the ISSUED DATE of State DL/ID.*
Enter EXPIRATION DATE of State DL/ID.*
Have you been a victim of identity theft?
If your answer is YES, the IRS, would have provided you with an IP Pin. Please enter it in the box below. (It is a 6 digit number)
Please list your OCCUPATION.*
What type of industry do u work in?
What type of machines do u work with?
Filing STATUS
Did you recieve a refund last year?
Did You Have Market Place Insurance?
If you are claiming HEAD OF HOUSEHOLD; what documents will you be providing for verification?*
Are you buying a house in the next 2 years?
Were You Audited By The IRS Last Year?
Please anwser, only if applicable: If your income is at or below $13,000.00 & you have 2 or more children, how are you able to maintain the household. For example, did you receive government assistance, as such as: section 8, public housing, SNAP benefits, or other.
Please Upload Front and Back of State DL/ID*

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Please Upload Front and back of Social Security Card *

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Upload W-2 or 1099.

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Spouse Information

**If applicable**; IF APPLICABLE ALL FIELDS REQUIRED
Enter Spouse

First NameLast Name
Spouse Date of Birth
Spouse SSN
Spouse EMAIL
Please indicate if SPOUSE has a Driver's License or State ID.
Enter SPOUSE Issuing State of DL/ID.
Enter SPOUSE DL/ID number.
Enter SPOUSE ISSUED DATE of DL/ID.
Enter SPOUSE EXPIRATION DATE of DL/ID.
Enter SPOUSE occupation.
Upload FRONT and BACK of SPOUSE DL/ID.

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Upload FRONT and BACK of SPOUSE Social Security Card

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Upload SPOUSE W-2 or 1099

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DEPENDENT INFORMATION

**If Applicable**; IF APLLICABLE ALL FIELDS REQUIRED
Are all of the dependents being claimed related to the taxpayer by birth or bloodline? If not, please identify which child is not related to you?
Please anwser if applicable, if your last name is different than your dependent's last names, that you are filing, what is the reason why? Please indicate the reason why there is a difference in the last names between you and your dependents.
If you are the father of the child and claiming the child. Please indicate the reason why the child is living with you and not the mother. Please outline the support you have provided to the child.
If applicable, please indicate why you are claiming a dependent that is not related to you. What are the circumstances that you have supported this dependent for at least 6 months of 2023. Please outline the support you have provided to this dependent.
Dependent #1

First NameLast Name
Dependent #1 SSN
Dependent #1 Date of Birth
Dependent #1 Relationship
Upload Dependent #1 Front and Back of Social Security Card

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Upload Dependent #1 Proof of RESIDENCY. For example: school report card, doctor letter, or lease with childs name on it.

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Dependent #2

First NameLast Name
Dependent #2 SSN
Dependent #2 Date of Birth
Dependent #2 Relationship
Upload Dependent #2 Front and Back of Social Security Card

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Upload Dependent #2 Proof of RESIDENCY. For Example: school report card, doctor letter, or lease with childs name on it.

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Dependent #3

First NameLast Name
Dependent #3 SSN
Dependent #3 Date of Birth
Dependent #3 Relationship
Upload Dependent #3 Front and Back of Social Security Card

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Upload Dependent #3 Proof of RESIDENCY. For Example: school report card, doctor letter, or lease with childs name on it.

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Upload W-2/ or 1099 (if needed)

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Upload W-2 or 1099 (if needed)

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Additional Documents (if needed)

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Additional Documents (if needed)

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Additional Documents (if needed)

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Do you want a "MAX REFUND?"
If YES to "MAX REFUND"; year, make, and model of your vehicle.
How much did you pay for your car?
How many square feet is your home?
How many miles do you commute to work one way?
Did you have a business in 2023 or 1099? For example: UBER, LYFT, UBER EATS, INSTACRT, DOOR DASH, BABYSITTING, NANNY, HAIRSTYLIST, BARBER, BRAIDER, and etc...
Do you have any hobbies? *
If YES please list hobbies.(N/A *
If so please state the NAME AND TYPE of BUSINESS
If you have an EIN for your business, please provide. *not required*
Do you have BUSINESS EXPENSES?
How do you want to receive your refund?
DIRECT DEPOSIT INFORMATION

*If Applicable*
Bank Name
Bank Routing Number
Bank Account Number
Did someone refer you? If so, please insert their name. *
Please verify that you are human*
Today's Date

MonthDayYear
Date
TAX PAYER Signature (MUST BE LEGIBLE)

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SPOUSE Signature (MUST BE LEGIBLE)

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*****ONCE YOUR FORM HAS BEEN COMPLETED YOU WILL BE CONACTED BY YOUR TAX PREPARER TO ACKNOWLEDGE RECEIVED.

DUE TO HIGH VOLUME YOUR RETURN WILL BE PROCESSED IN 24-48HRS AND YOU WILL BE NOTIFIED WHEN THE PROCESS HAS STARTED AT THE CONTACT NUMBER ENTERED ON THE FORM. *****
By clicking the "SUBMIT" button, I agree to the Terms and Conditions. I acknowledge that all information provided to EMPRESS CONSULTING FIRM LLC is TRUE and ACCURATE to the best of my knowledge. I understand I am required to have any supporting documentation to validate the information provided. I understand that knowingly providing false information on my tax return an reporting it to the IRS, that I am taking part in a potentially criminal penalty situation and is punishable by law including but not limited to facing court dates, restitution, and possible imprisionment. I waive EMPRESS CONSULTING FIRM LLC the preparer of any error because of incorrect information provided by me.
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New Client Tax Preparation/Intake Form

Spouse Information

DEPENDENT INFORMATION

DIRECT DEPOSIT INFORMATION