Prospered Taxes Enterprise LLC - Client Intake Form

I’m Karen H. Bowman, your trusted Virtual Tax Professional. Thank you for choosing Prospered Taxes Enterprise LLC, where we are dedicated to "Planting Seeds of Prosperity, One Tax Return at a Time." I’m thrilled to work with you and make your tax filing experience seamless and stress-free!
PLEASE READ THIS ENTIRELY BEFORE PROCEEDING.If you are not filing your tax return with Prospered Taxes Enterprise LLC, kindly refrain from completing this form. Thank you for your understanding!
By completing the client intake form, I can efficiently file your tax return, review your refund or return details with you, explore cash advance loan options (if applicable), and provide documents for your review and signature.
Virtual Tax Professional

Please select below.
Karen H. Bowman
Taxpayer Information

Please answer all questions.
Filing Status*

SingleHead of HouseholdMarried Filing SeparatelyMarried Filing JointlyQualifying Widow(er) with dependent child(ren)
Head of Household Verification: You must be unmarried or considered unmarried and provide over half the financial support for your household and a qualifying person. Submit records of household bills, mortgage payments, lease agreement, property taxes, and essential expenses in your name that show your home address.

Cancelof
Taxpayer's Name*

First NameMiddle NameLast NameSuffix
Taxpayer's Occupation*
Submission Guidelines: Please specify the tax year for your submission and attach all documents.
Do you have any unfiled tax returns from previous years?*

Yes, I have previous years that need to be filed.No, my previous years have been filed.
Please select the year that you would like to file.*

202420232022202120202019
Do you have a copy of your prior year's tax return (for the 2024 tax year or the year you’re filing for)? (Please upload)*

YesNo
Upload Prior Year Tax Return or IRS Transcript:

Cancelof
Date of Birth *

MonthDayYear
Taxpayer's Social Security Number*
Upload Taxpayer's Social Security Card:*

Cancelof
Taxpayer's Unexpired Driver's License Number*
Upload Taxpayer's Unexpired Driver's License:*

Cancelof
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone*
Please enter a valid phone number.
Cell Phone*
Please enter a valid phone number.
Email*
example@example.com
Taxpayer's Spouse Information (if applicable)

First NameMiddle NameLast NameSuffix
Taxpayer's Spouse Occupation
Date of Birth

MonthDayYear
Taxpayer's Spouse Social Security Number
Upload Taxpayer's Spouse Social Security Card

Cancelof
Taxpayer's Spouse Unexpired Driver's License
Upload Taxpayer's Spouse Unexpired Driver's License:

Cancelof
Is the Taxpayer legally blind?*

YesNo
Is your Spouse legally blind?*

YesNoN/A
Is the Taxpayer disabled?*

YesNo
Is your Spouse disabled ?

YesNoN/A
Family and Dependent Information

Please answer all questions.
1. As of December 31, 2024, your martial status was:*

SingleMarriedLegally Separated
If married but filing separately: Did you live with your spouse during any part of the last six months of 2024?

YesNo

2. Please answer the questions below regarding who lived in your home and whom you supported over the past 12 months. (If not applicable, write "N/A" on line 1 of each section.)*

	Dependents First and last name (Do not enter your name or Spouse's name below)	Date of Birth	Social Security Number	Number of months lived in your home	Relationship to you (i.e. son, daughter, mother, sister)
1
2
3
4
5
6

Did you pay child care expenses (Daycare or an individual to babysit your child(ren)?*

Yes- please answer all questions related below.No- N/A
If yes, how much were your childcare expenses from January 1, 2024, to December 31, 2024?
Please provide the name of the Daycare/Individual
Social Security or EIN Number
Address of the Daycare/Individual

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please upload any supporting documents, such as your dependent(s) Social Security card(s), birth certificate(s), adoption papers, school records, daycare records, or similar documentation.

Cancelof
Can anyone else claim you, your spouse, or dependents on their tax return?*

YesNo
Have you, your spouse, or dependents received an Identity Protection PIN (IP PIN) from the IRS in the past?*

Yes, I/we have an IP PIN(s)No, I/we do not have an IP PIN(s)
Please enter the name and IP PIN for each person.
Did you, your spouse, and your dependents have health insurance within 12 months last year? (Please upload proof of 1095 or 1095-A if applicable)*

Yes- This would include: Employer, Spouse Insurance, Exchange/ Marketplace. Direct With Insurer, Medicare, or MedicaidNo
Did the taxpayer experience any impact from a natural disaster in the year 2024?*

YesNo
Did you reside in the federally declared disaster zone, and were you or your spouse displaced from your primary residence during the disaster's incident period?*

YesNo
Was your home damaged, and repairs were not covered by FEMA or insurance?*

YesNo
Please upload any documentation with a denial or proof of the claim paid by FEMA or insurance.

Cancelof
Income -In 2024, did you (or your spouse) receive:

Please answer all questions.
Wages (W2- Employee) or Salary*

YesNo
Self- Employment Income (such as earnings from contract labor and small business, etc.)*

YesNo
Do you have a 1099 MISC form?*

YesNo
Disability Income?*

YesNo
Unemployment Compensation?*

YesNo
Other income? (gambling, lottery, prizes, awards, jury duty, etc) If so, how much did you receive?*
Contributions to IRA, 401K, or other retirement account, including employer retirement account?*

YesNo
During 2024, did you or your spouse have one or both of these to take place?*

Receive - as a reward, award, or payment for property or services.Sell, exchange or otherwise dispose of a digital asset (or a financial interest in a digital assest)BothN/A
Upload all proof of income. (Last paycheck stubs are not accepted- W2, 1099, Self-employment/business profit/loss)

Cancelof
Do you own your home? If yes, include the mortgage statement, interest, and taxes documentation.*

YesNo
Have you made or planned to make any energy-efficient upgrades to your home (e.g., windows, doors, solar panels, insulation)? If yes, please provide details of the enhancements (e.g., type of improvement, installation date, cost, etc.)*

YesNo
Please upload any necessary documents related to your home.

Cancelof
Do you receive any form of government assistance or benefits? (Section 8/Housing, TANF, Food Stamps, SSI ,ETC)*

YesNo
Did you pay college tuition for yourself, your spouse, or your dependents during the 2024 tax year?*

YesNo
Did you incur any educational expenses in 2024, such as buying a computer, books, or other related materials?**

YesNo
Did you pay on any student loans this year?*

YesNo
Upload all documents related to school. (1098-T, and receipts for educational expenses)

Cancelof
Referral

Please let me know how you found out about me.
The full name of the person or organization must be listed to ensure the referral is paid. *
Refund Advance Loan Option

Please answer all questions.
Do you want to apply for a same-day Refund Advance Loan ?( Up to $7000, subject to bank approval.*

YesNo
Have you applied for a Refund Advance Loan with any other company approved and funded for the 2024 tax return?*

YesNo
Payment

Please answer all questions.
Please note: Tax preparation fees must be paid in full before the processing of your tax return. Your return will not be submitted until payment has been received." Do you agree?*

YesNo
If you are a due a refund, would you like direct deposit or a paper check? Please select only one option.*

Direct DepositPaper Check
Bank Name:*
Bank Routing Number:*
Bank Account Number:*
Consent to use Tax Return Information

Please read and sign.
I confirm that the information I have provided to Prospered Taxes Enterprise LLC is accurate and truthful. By submitting this form, I acknowledge that I am entitled to a complimentary 30-minute consultation to review my tax situation and associated fees upon request. Otherwise, communication will be conducted through email and the secure tax software portal. If I express interest in a Refund Anticipation Loan (RAL) or bank product for deduction of my tax preparation fee, I understand that eligibility will be determined by the bank based on the submitted information.

By signing this document, I confirm my decision to proceed with the tax preparation client intake process and understand that, if requested, the consultation will be conducted via video call or phone call within 72 business hours. I authorize Prospered Taxes Enterprise LLC to use my submitted documents exclusively for tax preparation purposes.

I understand that opting out of the tax filing process after the initiation of tax preparation services will result in a $75.00 non-filing fee to compensate for the time spent on my return. This fee must be paid immediately upon cancellation. If unpaid, I consent to an ACH withdrawal from the bank account I have provided. I acknowledge that failure to comply with payment may result in legal action to recover the outstanding amount.
ACH Authorization Disclosure

Please read and sign.
By signing this agreement, I authorize Prospered Taxes Enterprise LLC to initiate an ACH debit from the bank account I have provided for payment of any applicable fees, including the $75.00 non-filing fee if I choose to opt out of the tax filing process after initiation. I understand that this debit will be processed immediately upon service cancellation.

I further acknowledge that failure to provide payment or comply with this agreement may result in legal action to recover the owed amount. This authorization remains in effect unless revoked in writing prior to the processing of the debit.
Taxpayer Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Date
Spouse Signature (N/A if it does not apply)

Powered by Jotform SignClear
Date

MonthDayYear
Date
Do you fully understand all the information provided on this client intake form? Type yes or no. If yes, please submit the form. *
If no, call me at 1-800-317-6971, Monday-Saturday, from 10:00 a.m. to 6:30 p.m., or email: support@prosperedtaxes.com
Please verify that you are human*
Email
example@example.com
Should be Empty:

I’m Karen H. Bowman, your trusted Virtual Tax Professional. Thank you for choosing Prospered Taxes Enterprise LLC, where we are dedicated to "Planting Seeds of Prosperity, One Tax Return at a Time." I’m thrilled to work with you and make your tax filing experience seamless and stress-free!

PLEASE READ THIS ENTIRELY BEFORE PROCEEDING.If you are not filing your tax return with Prospered Taxes Enterprise LLC, kindly refrain from completing this form. Thank you for your understanding!

By completing the client intake form, I can efficiently file your tax return, review your refund or return details with you, explore cash advance loan options (if applicable), and provide documents for your review and signature.

Virtual Tax Professional

Taxpayer Information

Submission Guidelines: Please specify the tax year for your submission and attach all documents.

Family and Dependent Information

Income -In 2024, did you (or your spouse) receive:

Referral

Refund Advance Loan Option

Payment

Consent to use Tax Return Information

ACH Authorization Disclosure