Virtual Intake Form

Virtual Intake Form

Thank you for being a JRB Tax Service client. The official tax season begins January 2,2026. By completing this form, you are completing you 2025 taxes virtually. Please note, taxes will not be submitted until you as the Taxpayer agrees to all terms and fees. By completing this form, there are no upfront cost, all fees are discussed after all paperwork has been completed. All documents that you submit you are stating that are accurate. I can be reached by email at kanderson.jrbtax@gmail.com or (904)575-1112. If I am unreachable please allow me up to 24 hours to respond. Thanks for choosing JRB and allowing me to be your tax preparer!!!
Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Social Security Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Filing Status
ITEMS NEED TO UPLOAD:

W2, 1098T, 1099, AND SELF EMPLOYMENT VERIFICATION. ONLY UPLOAD WHAT PERTAINS TO YOU!
Tax Documents

Cancelof
ITEMS NEED TO UPLOAD:

DRIVERS LICENSE OR STATE ID (TAXPAYER)

SOCIAL SECURITY CARDS (TAXPAYER AND DEPENDENTS)

BIRTH CERTIFICATES (DEPENDENTS)
Drivers License, Social Security Cards and Birth Certificates (Taxpayer and Dependents)

Cancelof
Number of Dependents
Dependent Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Social Security Number
Relationship
Dependent Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Social Security Number
Relationship
Dependent Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Social Security Number
Relationship
Dependent Name

First NameLast Name
Date

MonthDayYear
Date
Social Security Number
Relationship
Direct Deposit Information:
Bank Name
Routing Number
Account Number
Do you want the Advance
Advance Amount (Based on Tax Refund Amount)
Taxpayer Signature
By signing, you are stating all documents and information is accurate and filled out by the Taxpayer.
Preference of Contact
Appointment
Should be Empty: