Tax Preparation Client Intake Form

Tax Preparation Client Intake Form
Client Status*

NewExisting
Filing Status*

SingleHead of HouseholdMarried Filing SeparateMarried Filing JointQualifying Widower
How did you hear about us?*

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

Taxpayer Information
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
SSN*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Spouse Information
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
SSN
Are they a full-time student?

YesNo
Are they totally and permanently disabled?

YesNo
Are they legally blind?

YesNo
Are they your dependent?

YesNo

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

YesNo

Enter your dependents here (Existing Clients Please Fill Out)

	Name	SSN	Date of Birth	Relationship
1
2
3
4
5
6

Expenses
Please fill-up the information within the current year only.

General Expenses

	Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses

Total Expenses
Additional comments

CLIENT NON PAYMENT/OFFSET CLAUSE
At J&K Business Solutions 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.
Signature*

Clear
Date

MonthDayYear
Date

7216 - Consent to Disclosure of Tax Return Information to Other Firms
7216 - Consent to Disclosure of Tax Return Information to Other Firms

Federal law requires this consent form be provided to you ('you' refers to each taxpayer, if more than one). Unless authorized by law, we ('we', 'us,' and 'our' refers to the tax preparer and the tax preparation firm) cannot disclose your tax return information to third parties for purposes other than those related to the preparation and filing of your tax return without your consent. If you consent to the disclosure of your tax return information, Federal law may not protect your tax return information from further use or distribution.

You are not required to complete this form. Because our ability to disclose your tax return information to another tax return preparer affects the tax return preparations service(s) that we provide to you and its (their) cost, we may decline to provide you with tax return preparation services or change the terms (including the cost) of the tax return preparation services that we provide to you if you do not sign this form. If you agree to the disclosure of your tax return information, your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature.

In order to process your return we must disclose all of your 2023 tax return information to other firms (franchise/network) that we partner with in order to provide certain services.

If you will allow us to disclose your 2023 tax return information to the other firms for this purpose, sign and date your consent to the disclosure of your tax return information.

By signing below, you (including each of you if there is more than one taxpayer) authorize us to disclose to the other firm all of your 2023 tax return information.

If you are not willing to authorize us to share your tax return information with the other firms, you can still choose to have your tax return prepared and filed by us for a fee.
Taxpayer Signature*

Clear
Spouse Signature

Clear
Date Signed*

MonthDayYear
Date
Date Signed

MonthDayYear
Date

7216 Consent to Use
Federal law requires this consent form be provided to you ('you' refers to each taxpayer, if more than one). Unless authorized by law, we ('we,' 'us,' and 'our' refers to the tax return preparer and tax return preparation firm) cannot use your tax return information for purposes other than the preparation and filing of your tax return without your consent.

You are not required to complete this form to engage our tax return preparation services. If we obtain your signature on this form by conditioning our tax return preparation services on your consent, your consent will not be valid. Your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature.
If you do not consent, then you may still have your tax return prepared and electronically filed by us for a fee.

For your convenience, we have entered into arrangements with a third party to provide qualifying taxpayers with the opportunity to apply for financial products (Loan, Electronic Refund Check, or Electronic Refund Deposit). To determine whether these products may be available to you, we will need to use your tax return information by analyzing it and calculating the amount of your anticipated refund.
If you would like us to use your tax return information to determine whether these products may be available to you while we are preparing your return, please sign and date this consent to the use of your tax return information.

By signing below, you (including each of you if there is more than one taxpayer) authorize us to use the information you provided to us during the preparation of your 2023 tax return to determine whether to present you with the opportunity to apply for these products and services.

Electronic signatures
Taxpayer Signature*

Clear
Spouse Signature

Clear
Date Signed*

MonthDayYear
Date
Date Signed

MonthDayYear
Date

Acknowledgment & Signature
- I confirmed that all information I entered here is accurate and true.
- I allow J&K Business Solutions LLC l to capture my sensitive data like personal id, government id, social security number (SSN), and other information.
- I have read the terms and conditions and privacy policy of J&K Business Solutions LLC.
- By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
- I am giving J&K Business Solutions LLC permission to prepare all forms related to my tax return; to file on my behalf; and file my taxes electronically. I take full responsibility for the accuracy of this form and understand that J&K Business Solutions and/or associated affiliates hold no responsibility for any misrepresentation or false claims.
Taxpayer Signature*

Clear
Spouse Signature

Clear
Date Signed*

MonthDayYear
Date
Date Signed

MonthDayYear
Date
Should be Empty: