Tax Preparation Client Intake Form

Taxpayer Information
Filing Status*

SingleHead of HouseholdMarried Filing SeparateMarried Filing JointQualifying Widower
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation*

Tax Related Questions
Did you file taxes last year?*
How much was your return last year?*
Did you receive a 1095A form? *
EX: Marketplace Healthcare, ObamaCare
Do you have any dependents? If so, how many and how old are they? *
EX: 1 Child 7 yrs
Do you have any other income besides your W-2 ? *
This could be any services you were paid to do. (Ex. Hairstylist, handyman, Sitter )
Did you complete identity verification through ID.me

YesNoUnsure
File Upload*

Please upload tax documents here (W2/ID)
Cancelof
Should be Empty:

Client Information Sheet