Tax Intake Form

How did you hear about us?

FacebookInstagramReferralPrevious Client

If someone referred you, please type his or her name here.

Do you have an ID.ME account setup ? If No please have an account setup https://api.id.me/en/session/new

YesNo

Email

example@example.com

Tax Payers Name

First NameLast Name

Taxpayer's Phone Number*

Example: xxx-xxx-xxxx

Taxpayer's Job Title

Taxpayer's Date of Birth*

Example: 01/01/2001

Taxpayer's SSN

Example: xxx-xx-xxxx

Taxpayer's Email Address*

Spouse's Full Name

First Name

Spouse's SSN

Example: xxx-xx-xxxx

Name

First NameLast Name

Spouse's Date of Birth

Example: 01/01/2001

Spouse's Phone Number

Example: xxx-xxx-xxxx

Spouse's Email Address

Example: example@example.com

Taxpayer's SSN

Example: xxx-xx-xxxx

Spouse's Job Title

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Do you own your home ? If yes please be sure to provide your 1098 mortgage statement, also include any enegery efficent updates done in 2024.

YesNo

Are you self employed?*

YesNo

Do you have a profit and loss statement for 2024 for your business ?

YesNo

Do you file ?*

SingleHead of HouseholdMarried Filing JointMarried Filling separately (Spouse information required)

Did you pay over half the expenses of maintaining your residence for the entire year?*

YesNo

Did you support a child or family member for more than 6 months out of the year?*

YesNo

If yes, did you live together at any time after June 30, 2024.*

YesNoNot Applicable

Are you on any Government Assistance*

YesNoNot Applicable

How many dependents are you claiming?*

Dependent #1

First NameLast Name

Dependent #1 Date of Birth

01/01/2001

Dependent #1 SSN

What is Dependent #1's Relationship to you (son, daughter, etc.)?

How many months did Dependent #1 live with you in 2024? (If all year, enter 12)

Dependent #2

First NameLast Name

Dependent #2 Date of Birth

Example: 01/01/2001

Dependent #2 SSN

How many months did Dependent #2 live with you in 2024? (If all year, enter 12)

What is Dependent #2's Relationship to you (son, daughter, etc.)?

Dependent #3

First NameLast Name

Dependent #3's Date of Birth

01/01/2001

How many months did Dependent #3 live with you in 2024? (If all year, enter 12)

Dependent #3s SSN

Example: xxx-xx-xxxx

Dependent's #3 SSN

What is Dependent #3's Relationship to you (son, daughter, etc.)?

Dependent #4's First Name

First Name

Dependent #4's Last Name

Last Name

Dependent #4's Date of Birth

01/01/2001

Dependent #4's SSN

Example: xxx-xx-xxxx

What is Dependent #4's Relationship to you (son, daughter, etc.)?

How many months did Dependent #4 live with you in 2024? (If all year, enter 12)

Dependent #5's First Name

First Name

Dependent #5's Last Name

Last Name

Dependent #5's Date of Birth

01/01/2001

Dependent #5's SSN

Example: xxx-xx-xxxx

What is Dependent #5's Relationship to you (son, daughter, etc.)?

How many months did Dependent #5 live with you in 2024? (If all year, enter 12)

Are there any dependents in daycare? If yes, please upload the form you received from your daycare provider.

YesNo

Would you like to apply for a cash advance ?

YesNO

How would you like to receive your tax refund?

Check (Only available for in office visits)Direct DepositPrepaid Card

Name of Bank

Which type of account would you like your refund deposited into?

Checking AccountSavings AccountOther

Routing Number

Bank Account Number

Can someone else claim you as a dependent?

YesNo

Did you have health insurance in 2024 ?

YesNo

Did you have health insurance for the entire year?

YesNo

Who was your insurance cover through in 2024?

Have you ever been denied the Earned Tax Credit (EITC)?

YesNo

Did you trade any Virtual Currency

YesNo

Were you or any of your dependents in college in 2024?

YesNo

Have you already claimed a college credit in past tax years

YesNo

Do you have a 1098-T Form for either you or your dependents?

YesNo

Are you interested in AUDIT PROTECTION? There is a fee associated within your tax return.

YesNo

CLIENT NON PAYMENT/OFFSET CLAUSE

At J.Williams Consulting and Tax LLC, we strive to assist all of our clients in their tax needs, however we understand that situations arise. If your refund is offset by the IRS, student loans, child support or your check is mailed, you are still obligated to pay our company the fees associated with filing your tax return.

By signing this agreement you acknowledge that if payment is not made in full with in 30 days legal actions will be sought to resolve payment.

EMAIL ALL DOCUMENTATION TO INFO@JWCONSULTINGANDTAX.COM

Please confirm you have read the above statment by typing Yes and your name.

Primary Taxpayer's Signature

I am giving J.Williams Consulting and Tax LLC permission to prepare all forms related to my tax return; to apply for and secure RAC's and RAL's on my behalf; and sign all necessary forms and file my taxes electronically. I take full responsibility for the accuracy of this form and understand that J. Williams Consulting and Tax LLc and/or associated affiliates hold no responsibility for any misrepresentation or false claims.

Date

Taxpayer's Signature (If no spouse, leave blank)

Spouse's Signature (If no spouse, leave blank)

Date

Type a question

Date

CLIENT FORM