2023 CLIENT INTAKE FORM

Please Read and Sign and complete the form

CONSENT TO USE OF TAX RETURN INFORMATION For the purposes of this consent form, “we,” “us,” and “our” means D & M FINANCIAL SERVICES.  Federal law requires this consent form be provided to you. Unless authorized by law, we 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 in our tax return preparation services. If we obtain your signature on this form by conditioning our tax 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, you may still have your tax return prepared and electronically filed by us for a fee. For your convenience, we have entered into an arrangement with third parties to provide qualifying taxpayers with the opportunity to apply for an Electronic Refund Disbursement Service and/or Loan product. To determine whether these products may be available to you, we will need to use your tax return information in order to calculate 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 authorize us to use the information you provide 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. If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by e-mail at complaints@tigta.treas.gov

TERMS OF ENGAGEMENT 
 We will prepare your Federal and State income tax returns you request using information you provide. We may ask for clarification of some items, but we will not audit or otherwise verify the information you give to us. The Tax preparer has discussed, and reviewed intake sheet and forms listed in the client intake book with client and the client agrees and understands if audited by the IRS “THEY” must provide documentation for items listed on the tax return.

You are responsible to provide all the information required for the preparation of complete and accurate tax returns. You should retain all documents, cancelled checks, and other data that support your reported income and deductions. These may be necessary to prove the accuracy and completeness of the returns to a taxing authority.  You have the final responsibility for your income tax returns, and therefore, you should review them carefully before you sign them.  

 We’re responsible for taking the information given to us by you and ensuring your tax returns are accurate to the best of our knowledge. We’re also responsible for the timely electronic filing of your tax returns.

 During our engagement with you, we may provide you with an estimated refund date. We do not however have any influence over the IRS or STATE issuing your refunds. These authorities do not guarantee a specific date that a tax refund will be issued.

 Your tax returns may be selected for audit by a taxing authority. In the event of a tax examination, we can arrange to assist you with any correspondence or communication that is initiated by the IRS or STATE for an additional fee.

 It is our policy to keep record related to this engagement for 3 YEARS. However, we do not keep any of your original records, so you should retain these records in secure storage. Upon the expiration of the 3 years period, we are free to destroy our records related to this engagement.

Services may be provided with no payment due at the time of service but client agrees to pay the full amount for service within 90 days of service. Client understands that if fees are not received within the 90 days of service, we will turn your account over to magistrate court for collection and/or payroll garnishment. In addition to tax prep fees client agrees that they will be responsible for any court cost plus interest and any other applicable fees accrued in this collection process 

Clients that received the Holiday Advance Loan understand and agree that fees will be deducted from the refund amount.

To the best of my knowledge and belief the information provided is true, and correct and complete. I understand any false or misleading information may result in an incorrect tax refund/fraud. I also agree to and accept the Terms of Engagement.

Did you pay over half the expenses of maintaining your residence for the entire year? Upkeep expenses include rent, utilities, food eaten in the home, mortgage interest, real estate taxes, and insurance on the home. If you use payments you received under any public assistance program to pay for part of the cost of keeping up your home, you cannot count them as money you paid. However, you must include them in your total cost of keeping up your home to figure if you paid over half the cost. *By checking/answering “YES” you are confirming that if requested by the IRS, you can provide documentation that verifies you paid for over half the cost of keeping up the home, such as rent receipts, utility bills, grocery receipts, and other household bills.

I am giving D & M FINANCIAL SERVICES permission to prepare all forms related to my tax return and file my taxes electronically. I take full responsibilityfor the accuracy of this form and understand that D & M FINANCIAL SERVICES and /or affiliates hold no responsibility for any misrepresentation or false claims.