Non-Profit Client Intake
Note: Must be updated yearly.
Please select the tax year for which you are filing.
Please Select
2019
2020
2021
2022
2023
Non-profit's Representative
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Name
Last Name
Representative's Email
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example@example.com
Representative Phone Number
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Please enter a valid phone number.
Non-profit Name
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Non-profit Phone Number
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Please enter a valid phone number.
Non-Profit Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Non-profit Date of Incorporation
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Month
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Day
Year
Date
Non-profit State of Incorporation
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Non-profit Description of Service
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EIN Number
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Non-profit Organizational Structure
Provide details on the structure of your organization.
Select your Organization Type
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Please Select
501(c)(3) Organization
501(c)(4) Organization
501(c)(6) Organization
501(c)(7) Organization
501(c)(8) Organization
501(c)(10) Organization
501(c)(19) Organization
501(c)(23) Organization
501(c)(27) Organization
If you have a 501(c)(3), please provide the specific organization type. Examples of organizations include: Charitable, Religious, Educational, Scientific, Literary, Public Safety, Amateur Sports, Prevention of Cruelty to Children or Animals
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Please upload your Governing Documents
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Names and addresses of officers, directors, and key employees
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Financial Information
Provide details regarding the organization's finances.
Check applicable Revenue Sources.
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donations
grants
program service fees
public support
Accounting Method
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Cash
Accrual
Other
Total Revenue for tax year
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General Admin and Operation Expenses:
Advertising
Commissions and fees you paid:
Contract labor:
Interest paid in relating to the business:
Taxes and License paid:
Legal and professional services :
Office expense (Postage, Delivery, Cleaning & Etc):
Pension and profit-sharing plans:
Rent or lease of equipment
Repairs and maintenance
Travel, meals, and entertainment
Travel (air fare, land, car rental & etc)
Wages for employees
Expenses related to general fundraising
Non-Profit Utilities
Telephone
Cellphone
Light/Water/Gas
Supplies (Stationanaries & etc)
Internet
Non-Profit Office Expenses:
Estimated Office Area:
square footage
Building or Organization Insurance
Non-Profit Mortgage Expenses
Non-Profit Property Tax
Non-Profit Rent
Non-Profit Utilities
Gas, Electric, Water, Security, Heater & etc.
Other Expenses:
List all the other expenses here with the exact amount in $. Please list details of any significant transactions or financial activities.
Vehicle Expenses
Parking and Toll for business
Estimated Miles Driven for non-profit business:
Personal Miles (vacation, family and etc.)
Gas, Car Insurance, Repairs & Maintenance, Tires, and etc
What vehicle did you use (Car, SUV, Van etc.)?
What is the purchase cost of the car?
What is the approximate date place in service for your business?
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Month
-
Day
Year
Date
What is the estimated FMV of your car if you sell it now?
Receipts and Summary if there are any:
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Bank, Credit Card, or Financial Statements for non-profits:
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Tax & Reporting Compliance
Provide any information about any changes in tax-exempt status. Type "N/A" if not applicable.
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If you support or are supported by Lobbyist, please provide details to ensure compliance with lobbying and political activities regulations.
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Percentage of revenue generated by public support
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Provide your history of filing Form 990-EZ and other relevant forms. Upload a copy of last year's 990.
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Note: Acknowledgements by Client. The law provides various penalties and interest that may be imposed when taxpayers underestimate their tax liability. You acknowledge that any such understated tax, and any imposed interest and penalties, are your responsibility, and that we have no responsibility in that regard. If you would like information on the amount or circumstances of these penalties, please contact us.Client also acknowledges that applicable tax laws are changed from time to time, and that such changes are sometimes retroactively effective. Firm provides no warranty that any such changes will not adversely impact the amount of any refund or credit which might otherwise have been payable to Client or the amount of tax which Client might otherwise have been required to pay.Confidentiality. Under the law, some communications between a client and a tax preparer are privileged and not subject to disclosure to the IRS. However, any information you furnish to us for preparing your tax returns is not protected by this privilege and consequently may be discovered by the IRS.7. Client Responsibilities. It is your responsibility to provide Firm with all the information needed to prepare complete and accurate returns. The Fee shall be paid in full prior to the filing of the tax returns and/or delivery of returns to Client. 5. Audit Assistance. Tax returns are subject to audit by the taxing authorities. If your returns are audited, you may be required to furnish source documents to the tax authorities to substantiate information you provided and that Firm reported on your return. If your returns are selected for audit, Firm can assist you in preparing for the audit; however, this service is not included in the Fee specified in Section 4, and will require a separate letter of engagement. In this regard, you should retain backup documents for your tax return for at least seven (7) years after the returns were filed.
Any penalties or issues with previous filings? Detail below.
Signature of the authorized person certifying the accuracy of the information provided.
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Date
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Month
-
Day
Year
Date
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