Bashia's Consulting LLC Taxes Client Intake Form

Bashia's Consulting LLC Taxes Client Intake Form

(Please provide a copy of last year's tax return)
Please complete this form to provide us with the information to best serve you and click SUBMIT. Upload all documents at the end of the form. NOTE: If claiming dependents, be sure to upload their social security cards. If you have any questions please call 936-500-0340 or email bashiasconsulting@bashiastaxes.net me and my Team look forward to working with you.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Tax Professional your working with *
Were you referred to us if so by who? *
Phone Number *
Please enter a valid phone number.Format: (000) 000-0000.
Todays Date *

MonthDayYear
Date
Email *
example@example.com
Did you pay for child daycare? (If so Make sure you Upload Daycare Form)*

YesNo
Are you or your spouse permanently disabled? *

YesNo
Do your Children reside with you but are being claimed by someone else?*

YesNo
Did you or any Dependents receive insurance through the market place?*

YesNo
Did you File last year *

YesNo
Have you ever received a letter or notification from the IRS in the past three years? *

YesNo
Do you owe the IRS or any government agencies *

YesNo
Tax Payers Date of Birth *
Tax Payers Social Security Number *
DO YOU HAVE IPIN ?

YESNO
How many W’2s OR 1099's Does the taxpayer have? *
Do you have A real bank Account? Please usterstand that you can not use any Prepaid bank such as Green dot, Cash app, Sutton bank, or any other prepaid banking insututions. your refund will get rejected if you are in Chexsystems or Earlywarning contact our office so we can assist you 936-500-0340.
How would you like your refund? *

Direct DepositCheck
Name of the Bank *
Routing Number *
Bank Account Number *
Do you own a business or side gig? (You will have a Schedule C form to fill out we will send it you)

YesNo
Enter the amount of Profit was made. *Certify this is true with signature below*
How many Dependents are you claiming?
Please upload taxpayer DL, SS Card, W2, Dependents SS card, Dependents Birth Certificates, lease , or light bill. Please note that you are giving permission for Bashia Johnson (Owner of Bashia's taxes ) and her team to prepare all forms related to my tax return. I take full responsibility for the accuracy of this client intake form and I understand that Bashia Johnson or her Staff holds no responsibility for any misrepresentation of false claims.
File Upload

Cancelof
READ AND UNDERSTAND

BASHIA JOHNSON CEO and Her employees will comply with all of the provisions of the Revenue procedure for electronic filing or individual and business income tax returns, and related publications of each year of our participation.Under the penalty of perjury, I/We declare that I/We have read and examined this application and accompanying information, and hereby certify that the information being provided above is true, complete, correct, and accurate to the best of my/our knowledge and belief. I certify that I have submitted ALL forms and documents for my 2025-year tax return. I understand that any amendments or adjustments needing to be made due to lack of submission will be subjected to additional fees up to $250. By signing this form, I am acknowledging and certify that I understand this council.** WE WILL PROVIDE A FREE COPY OF YOUR TAX RETURN AT FILING COMPLETION. ANY ADDITIONAL COPIES WILL BE $25.00**
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Bashia's Consulting LLC Taxes Client Intake Form

READ AND UNDERSTAND