Tax Preparation Form Intake

AKAYLA L. DUNCAN, LLC INTAKE FORM

Thank you for taking the time to complete the intake package. For new clients, this information is critical to ensure an accurate filing of your federal & state tax returns.

For existing clients, while we may have some of this information from past engagements, we kindly request you provide it again so we can make sure our records are 100% accurate and up to date. .

Here is a list of documents to have handy before submitting this form

*ALL DOCUMENTS MAY NOT APPLY TO YOUR SITUATION
- VALID State Issued ID or Drivers License
- Birth certificates of ALL dependents
- Social Security Cards of everyone on tax return
- Proof of head of household (electric bill , mortgage statement , rent receipt,social service statement)
- Tax Forms (W2’s, 1099’s)
- Child care provider EIN /or SSN, amount paid
- 1098-T school form
- Proof of insurance , 1095 -A, B, C or exemption certificate
- Proof of Business Income/Self Employment (Sch C log books, notebooks, appointment books, business receipts, bank/credit statements, profit/loss statements, EIN/LLC documents, flyers,business card, website)
- Direct deposit info
Note: If you are claiming any dependents, be sure provide their SS CARDS & atleast one document for each dependent that shows their address is the same as yours. (e.g. school records, medical records, doctor bills, Medicaid Statement, SNAP, Social Services Records).

If you encounter any issues with any missing documents or would like to speak to a tax professional before filing, please call (318)987-8208 during normal business hours where a dedicated team member will be awaiting to answer any questions you may have.

ALL documents can be uploaded at the end of the form.

Click SUBMIT when finished..
Choose Your Preparer
How did you hear about us? *
If someone referred you, please type his or her name here.
Type of Client*

NewReturning Client
Tax Year Preparation Requested*
Do you owe the IRS, Child Support or in default with student loans?
Filing Status
Select Filing Status *
FILING STATUS WILL BE ULTIMATELY DETERMINED BY INFORMATION GIVEN AND TAX PREPARERS DISCRETION
Number of Dependents *
Taxpayer

ENTER IN YOUR INFORMATION
Taxpayer Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Social Security Number *
JOB TITLE*
Taxpayer Phone Number*
Taxpayer Email*
Taxpayer VALID STATE ID or DRIVER'S LICENSE*

Cancelof
TAXPAYER IP PIN (IDENTITY PROTECTION PIN )
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Can someone else claim you as a dependent?*
Spouse

YOUR SPOUSES INFORMATION, IF LEGALLY MARRIED OR PRESUMED MARRIED BY COMMON LAW STATUTE IN THE STATE YOU RESIDE IN
Spouse Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Spouse Social Security Number *
Occupation*
Spouse Phone Number*
Spouse Email*
Spouse VALID STATE ID or DRIVER'S LICENSE*

Cancelof
DID YOU AND YOUR SPOUSE LIVE APART FOR MORE THAN 6 MONTHS IN 2023?
SPOUSE IP PIN (IDENTITY PROTECTION PIN)

CHILDCARE INFORMATION
CHILDCARE PROVIDER 1 NAME
CHILDCARE PROVIDER 1 SSN OR EIN
AMOUNT PAID FOR CHILDCARE
WHICH CHILD RECIEVED THE CHILDCARE?
CHILDCARE PROVIDER 1 ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
HIGHER EDUCATION

COLLEGE AND TUITION INFORMATION
HAVE YOU CLAIMED THE AMERICAN OPPORTUINITY EDUCATION CREDIT IN THE PAST?

YESNOUNSURE
ITEMIZED DEDUCTIONS
MEDICAL

THE TOTALS
OUT OF POCKET MEDICAL EXPENSES
TAXES PAID BY YOU

THE TOTALS
STATE AND LOCAL TAXES OR GENERAL SALES TAX PAID
STATE AND LOCAL REAL ESTATE TAX
STATE AND LOCAL PERSONAL PROPERTY TAX
ANY OTHER STATE AND LOCAL TAX
HOME MORTGAGE INTEREST
GIFTS TO CHARITY

THE TOTALS
CHARITY 1 AND THE AMOUNT DONATED
CHARITY 2 AND THE AMOUNT DONATED
CHARITABLE CONTRIBUTION DOCUMENTS

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SOLAR POWER/ENERGY EXPENSES
ENERGY/SOLAR POWER COST?
UPLOAD PROOF/DOCUMENTS FOR ENERGY/SOLAR POWER (WE MAY REQUEST PRIOR YEAR TAX RETURN TO CONFIRM)

Cancelof
UNEMPLOYMENT
DID YOU RECIEVE ANY UNEMPLOYMENT OR PAY ANY UNEMPLOYMENT OVERPAYMENTS BACK?*

YESNOUNSURE
Have any credits been disallowed or reduced in a previous year such as EITC/AOTC/CTC/ACTC?*

YESNOUNSURE
Did you withdraw from your 401K in 2023?*
Do you receive any Government Assistance Programs such as Food stamps, TANF, Medicaid, or Medicare?*
Was your insurance through the Affordable Care Act (The Marketplace)? *
Do you have gambling winnings?*

Misc.
Choose Your Vacation Incentive Destination
How would you like to receive your refund*

Direct DepositCheck (printed in office)Prepaid Debit Card
Bank Name*
ROUTING NUMBER*
ACCOUNT NUMBER*
Upload Direct Deposit Info (Bank Name, Routing & Account Number)*

Cancelof
WOULD YOU LIKE TO APPLY FOR THE REFUND ADVANCE? (Jan 1-March 15, 2023

YESNO

Letter of Engagement

Thank you for choosing AKAYLA L. DUNCAN, LLC to assist you with your requested year taxes. This letter confirms the terms of our engagement with you and outlines the nature and extent of the services we will provide.

We will prepare your requested federal and state income tax returns. We will depend on you to provide the information we need to prepare complete and accurate returns. The law imposes penalties when taxpayers underestimate their tax liability. We may ask you to clarify some items but will not audit or otherwise verify the data you submit.

We will perform accounting services only as needed to prepare your tax returns.

Accordingly, our engagement should not be relied upon to disclose errors, fraud, or other illegal acts, though it may be necessary for you to clarify some of the information you submit. We will, of course, inform you of any material errors, fraud, or other illegal acts we discover.

I acknowledge that all information provided to AKAYLA L. DUNCAN, LLC is true and accurate to the best of my knowledge. I understand that I am required to have any supporting documentation to validate the information provided. Furthermore, I understand that knowingly providing false information on my tax return and 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 imprisonment. I waive AKAYLA L. DUNCAN, LLC and the preparer of any error due to incorrect information provided by me. By signing below, I authorize AKAYLA L. DUNCAN, LLC to file my tax return.

I acknowledge by signing this form if I and/or my spouse owes a federal/government debt such as IRS, child support, student loans etc., I/we are still responsible for tax preparation fees due to AKAYLA L. DUNCAN, LLC at the time of service. Also, if the federal refund amount is mailed, I/we are still responsible for the tax preparation fees stated on the invoice. If the tax preparation fees are not paid, I understand AKAYLA L. DUNCAN, LLC will take legal action to collect the unpaid tax preparation fees. I also agree that client won’t dispute tax preparation fees for services rendered due to IRS delays.

Invoices are due and payable upon presentation. We will return your original records to you at the end of this engagement. You should securely store these records, along with all supporting documents, canceled checks, etc., as these items may later be needed to prove accuracy and completeness of a return. We will retain copies of your records and our work papers for your engagement for three years, after which these documents will be destroyed. Paper copies of the tax return and other documents will be available for a $25 fee after the first copy has been issued.

Our engagement to prepare your tax returns will conclude with the delivery of the completed returns to you (if paper-filing), or your signature and our subsequent submittal of your tax return (if e-filing). If you have not selected to e-file your returns with our office, you will be solely responsible to file the returns with the appropriate taxing authorities. Review all tax-return documents carefully before signing them. You agree to allow AKAYLA L. DUNCAN, LLC to file your tax return and understand we do not give quotes to be comparable to DIY tax software. By signing this agreement your signature is now transferrable to the forms 1040, 8879, 7216, and all other applicable form in the finalized tax return from this document, for submission.

You also agree to receive text messages and emails from AKAYLA L. DUNCAN, LLC about your tax return.

By signing this form you agree that the bank account on file will be drafted a processing fee of $100 (1) in the event your return is rejected due to you already filing or applying for a loan with another tax firm, (2) in the event our office completes your return and you do not sign your return within 24 hours of us notifying you that your return is ready for signature (we will consider your return filing abandoned and that you have filed elsewhere, and deactivate your return in our system)

To affirm that this letter correctly summarizes your understanding of the arrangements for this work, you agree to allow AKAYLA L. DUNCAN, LLC to file your tax return and not just give a quote and your signature is transferrable to the tax return from this document, please sign this letter in the space below.
Taxpayer Signature*

Clear
Spouse Signature

Clear
Date*

MonthDayYear
Date
CONSENT TO USE OF TAX RETURN INFORMATION
Federal law requires this consent form be provided to you. Unless authorized by law, we cannot use, without your consent, your tax return information for purposes other than the preparation and filing of your tax return. However, federal law also prohibits us from revealing any personal or financial information to any third party. Therefore, we will never reveal your financial or personal information in any way, to anyone, unless you specifically request, we do so, and provide in writing to us the specific person or persons to whom you wish that disclosure to be made. For the purposes of this consent form please note we are seeking consent only to satisfy requirements set forth by federal law so we may speak with you on the phone, send you email correspondences of any kind, send you mailings, newsletters, email reminders, holiday and occasional cards and greetings, and reminders of upcoming deadlines, etc.

You are not required to complete this form. If we obtain your signature on this form by conditioning our service on your consent, your consent will not be valid. Your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for a period of three years from the date you have signed the consent.

The undersigned hereby consents to the use; by AKAYLA L. DUNCAN LLC, its owner, employees, and staff; of any and all tax return information pertaining to:

• Direct questions, inquiries or requests you make regarding your tax returns, situation, or issues.
• Requests you make for copies of your documents, figures, numbers, or information.
• Upon your direct request in order to connect you with another professional in another field or profession so you may gain further information on a certain topic not available or in the realm of expertise of this firm.
• Notification of important tax law changes.
• Notification of changes or information that will impact our engagement, such as a change of firm website address, email address, physical location, or other such contact, biographical or geographical information.
• Other reasonable business purposes including but not limited to: appointment reminders, holiday mailings, birthday greetings and other informational mailings.

The tax information may not be disclosed or used by AKAYLA L. DUNCAN, LLC, its owner, employees, or staff, for any purpose other than that which is permitted by this consent document.

If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484 by email at complaints@tigta.treas.gov.
Taxpayer Signature*

Clear
Spouse Signature

Clear
Date*

MonthDayYear
Date
Should be Empty:

Filing Status

Taxpayer

Spouse

Dependents

Credits

CHILDCARE INFORMATION

HIGHER EDUCATION

ITEMIZED DEDUCTIONS

MEDICAL

TAXES PAID BY YOU

GIFTS TO CHARITY

SOLAR POWER/ENERGY EXPENSES

UNEMPLOYMENT

INCOME AND WAGES

Upload Additional Documents

Misc.

CONSENT TO USE OF TAX RETURN INFORMATION