New Levels Tax Client Intake Form

  • CLIENT INTAKE FORM

    PLEASE FILL OUT ALL INFORMATION APPLICABLE (If you have any Questions or Concerns please feel free to give me a call)
  • Are you a…
  • How did you hear about us?*
  • Date of Birth*
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  • Format: (000) 000-0000.
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  • Date of Birth
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  • Format: (000) 000-0000.
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  • Filing Status:*
  • HEAD OF HOUSEHOLD FILERS MUST PRESENT ONE OF THE FOLLOWING TO FILE THIS STATUS. PICK ONE OF THE 4 OPTIONS THAT YOU WILL SUBMIT TO BE APPROVED TO FILE HEAD OF HOUSEHOLD.
  • Did you pay over half the expenses of maintaining your residence for the entire year?
  • Do you receive any Government Assistance? (Housing,Foodstamp, ect.)? (this question is only ask to ensure that you are selecting the correct filing status)*
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  • *If any of your dependent(s) did not live with you during this filing year, please let your preparer know...

  • Date of Birth
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  • Did your dependents live with you for more than six months of the year?
  • Date of Birth
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  • Did your dependent live with you for more than six months of the year?
  • Date of Birth
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  • Did your dependent live with you for more than six months of the year?
  • Date of Birth
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  • Did your dependent live with you for more than six months of the year?

  • IF YOU ARE CLAIMING A DEPENDENT, PLEASE ANSWER THE QUESTIONS BELOW THAT PERTAINS TO YOUR DEPENDENT RELATIONSHIP. PER THE IRS REQUEST, WE MUST PROVE THAT NOBODY ELSE IS ELIGIBLE TO CLAIM YOUR DEPENDENT BUT YOURSELF.

  • Did you pay someone to watch your child/children?
  • Did you collect social security or retirement income?
  • Did you purchase health insurance through healthcare.gov marketplace (Obama Care)?*
  • If yes, did you receive a 1095-A Form from the marketplace?
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  • Were you ever disallowed the Earned Income Tax Credit (E.I.T.C)prior to this year?*
  • Did you receive unemployment compensation income (1099-G)?*
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  • Did you make college tuition payments and received a 1098-T Form last year?*
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  • Does your tax return require a Identity protection pin (IP pin) when filing?*
  • Do you have any other income than your w-2(s)?*
  • Were you self-employed last year?*

  • If you are a business owner, self-employed, or a 1099-NEC independent contractor,Please also fill out the Schedule C Due Diligence Form.

  • Do you owe any delinquent:*
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  • Can you the taxpayer provide school, medical, daycare, place of worship/birth certificates upon request from the government?
  • How would you like to receive your refund?*
  • Rows

  • Signatures: By signing below you represent that everything you stated in the above area is true and correct. You respresent that you have read and understand the questions asked and conditions herein. You will acknowledge receving a completed copy of this complete application, among other things, consent the collection authorization in the above information.

    I, hereby, state that all the information above is true to the best of my knowledge and that I am allowing New Levels Tax and Notary to prepare my taxes based on that fact. I understand that I am financially responsible for any outstanding balance due to any false information given.

    If there is a balance due, you must pay the tax preparation fee upfront. If for any reason you owe an entity and they take the entire refund, you are STILL responsible to pay the tax preparation fee for services rendered. 

    **Professional Services & Non-Engagement Fee Disclosure
    In accordance with applicable IRS regulations, including Circular 230, please be advised that fees charged by New Level Tax and Notary Services reflect professional time, due diligence, consultation, and preparation services rendered.

    If you choose to discontinue services, withdraw, or engage another tax preparation firm after work has commenced on your tax return, a non-refundable administrative fee of $150 will be assessed. This fee compensates for professional services already performed and is not contingent upon the filing of a tax return.

     By engaging our services, you acknowledge and agree to this policy.

    We appreciate your professionalism and understanding.

    *For any reason an amendment has to be filed with no fault of the tax preparer, an upfront fee of $150.00 is required! Please view your tax return, which is emailed to you (it is sent prior to submission). Any copy after the first copy is a fee of $10.00.

     ALL FEES (bank and service fees) are found in the return and are non-refundable nor negotiable! NO EXCEPTIONS TO THIS!!

    Please utilize www.irs.gov for all federal refund tracking. Please utilze your state Department of Revenue site for any State Refund tracking. Do NOT add the amounts together. Federal taxes are federal,  and state taxes are state when tracking your status. Please allow 8 weeks to surpass from the date of submission before calling the IRS, if you have any tracking questions. 

    For any direct assistance please email newlevelstaxes@gmail.com

    IRS Contact 800-829-1040

     

    Please click this link to check your federal refund status. You will need your filing status, social security number, and the total amount of the refund before fees

    https://sa.www4.irs.gov/irfof/lang/en/irfofgetstatus.jsp 

  • Date*
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  • FORM OF COMMUNICATION:
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