TAXPAYER APPLICATION w/Self Employed

TAX PAYER APPLICATION
Thank you for allowing us to prepare your tax return. It is very important for you to complete the application below to help our tax preparer complete an accurate tax return. If you have any questions, please ask. Please review and complete the entire form and also provide us with the additional items we need below to complete your tax return.

Tax information such as W-2s, 1099s, 1098s.

Social security cards or a letter from the SSA for you and all persons on your tax return.

Proof of Identity (such as current Driver's license or State ID

Part I. Your Personal Information 1. Your First Name
1. Your First Name
MIDDLE INITIAL
Last Name
Social Security No.
2. Spouse's First Name
M.I.
Last Name
Social Security No.
3. Mailing Address
Apt#
City
State
Zip Code
4. E-mail
example@example.com
HOME PHONE
Format: (000) 000-0000.
CELL PHONE
Format: (000) 000-0000.
5. Your Date of Birth

MonthDayYear
Date
6. Your Occupation
7. Are you Legally Blind

YESNO
8. Spouse's Date of Birth

MonthDayYear
Date
9. Spouse's Occupation
10. Is Spouse Legally Blind?

YESNO
11. Can your parents or someone else claim you or your spouse on their tax return?

YESNO
Part II. Family and Dependent Information
1. As of December 31, 2025 your marital status was: (Check answer)

SINGLEMARRIED
Married: Did you live with your spouse during any part of the last six months of 2025?

YESNO
2. List the names of everyone below who lived in your home that you supported during the past 12 Months.

Do not enter your name or Spouse's name below.
DEPENDENTS FIRST AND LAST NAME
DATE OF BIRTH (M/D/Y)
SOCIAL SECURITY NUMBER
ENTER THE NUMBER OF MONTHS LIVED IN YOUR HOME FOR 2025
Relationship to you (i.e. son, daughter, mother, sister)
FIRST AND LAST NAME
DATE OF BIRTH (M/D/Y)
SOCIAL SECURITY NUMBER
NUMBER OF MONTHS LIVED IN YOUR HOME FOR 2025
RELATIONSHIP TO YOU
FIRST AND LAST NAME
DATE OF BIRTH (M/D/Y)
SOCIAL SECURITY NUMBER
NUMBER OF MONTHS LIVED IN YOUR HOME FOR 2025
RELATIONSHIP
FIRST AND LAST NAME
DATE OF BIRTH (M/D/Y)
SOCIAL SECURITY NUMBER
NUMBER OF MONTHS LIVED IN YOUR HOME FOR 2025
RELATIONSHIP TO YOU
FIRST AND LAST NAME
DATE OF BIRTH (M/D/Y)
SOCIAL SECURITY NUMBER
NUMBER OF MONTHS LIVED IN YOUR HOME FOR 2025
RELATIONSHIP TO YOU
Rental Assistance (check one that applies to you)

Privately owned subsidized housingPublic HousingHousing Choice Voucher Program (Section 8)Live with someone
Part III. Income - In 2025, did you (or your spouse) receive:

(Check Yes or No to all questions below)
1. Wages (W-2 Employee) or Salary

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

YESNO
3. Did you receive a 1099 MISC form?

YESNO
4. Disability Income If so, what is the amount?

YESNO
Total Disability Income
5. Unemployment Compensation If so, how much did you receive?

YESNO
Total Unemployment Income
6. Other Income: (gambling, lottery, prizes, awards, jury duty, etc

YESNO
7. Contributions to IRA, 401 k, or other retirement account, including employer retirement account

YESNO
8. Do you own your home? If yes, include mortgage statement interest and taxes.

YESNO
Mortgage Interest
Property Taxes
9. Do you pay child care expense (Daycare or an individual to baby sit your children) If yes, how much was your child care expense from January 1, 2025 to December 31, 2025?

YESNO
CHILD CARE AMOUNT
Name of Daycare/Individual
SSN or EIN Number
Address
City
State
Zip Code
10. Do you pay a HEAT BILL out of pocket?

YESNO
If yes, how much did you pay from January 1, 2025 to December 31, 2025?
Name of Company you paid your heat bill too
11. Do you rent your home? If yes, identify landlord and address and monthly rent.

YESNO
If yes, identify landlord and address and monthly rent.
Landlord Name
Address
City
State
Zip Code
Part VI. Schooling - In 2025 Did you (or your spouse):
1. Pay college tuition for yourself, your spouse, or your dependents for the 2025 Tax Year?

YESNO
2. Did you have any educational expenses this year (Such as a computer, books, etc?

YESNO
3. Did you pay on a student loan this year?

YESNO
Part V. Referral - Please check one of the following below:

How did you hear about us?
Church

YESNO
Name of Church
Flyer/Door Hanger

YESNO
Radio

YESNO
Name of Radio Station?
REFERRED

YESNO
Relative/Friend - Please write first and last name of referrer
Returning Client

YESNO
Other
Consent to Use of Tax Return Information
Federal law requires this consent form be provided to you ("you" refers to each taxpayer, if more than one Unless authorized by law, we cannot use, without your consent, your tax return information for purposes other than the preparation and filing of your tax return.

You are not required to complete this form. If we obtain your signature on this form by conditioning our 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.

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 bank to provide qualifying taxpayers with the opportunity to apply for 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 provide to us during the preparation of your 2025 tax return to determine whether to present you with the opportunity to apply for these products and services and you attest under penalty of perjury that the above information is true.
Printed name of Taxpayer
Taxpayer Signature
Date

MonthDayYear
Date
Printed Name of Joint Taxpayer
Joint taxpayer Signature
Date

MonthDayYear
Date
File Upload

Cancelof
Net Proﬁt From Business Worksheet

(Please include a copy of your last year’s return)
PRINCIPAL BUSINESS OR PROFESSION
BUSINESS NAME
BUSINESS ADDRESS, CITY, STATE, ZIP (if any)
EMPLOYER ID NUMBER (if any)
ARE YOU THE OWNER OF THE BUSINESS? if yes, use schedule C

YESNO
IS THE BUSINESS A D.B.A? if yes, use schedule C

YESNO
IS THE BUSINESS A PARTNERSHIP? if yes, use form 1065 K-1

YESNO
IS THE BUSINESS AN LLC? if yes, the default filing for an single member LLC if filing schedule C with the individual return. The default for a multi-member LLC is filing form 1065 as a partnership unless the entity has applied to be taxed as a different type of entity.

YESNO
IS THE BUSINESS A CORPORATION? if yes, a corporation will be file either form 1120S or 1120C, depending on the type of corporation.

YESNO
DID YOU USE A LOG BOOK TO DETERMINE YOUR GROSS RECEIPT?

YESNO
IF YOU DID NNOT USE A LOG BOOK, CAN YOU REASONABLY RECONSTRUCT YOUR GROSS RECEIPTS?

YESNO
DID YOU USE A LOG BOOK TO DETERMINE YOUR EXPENSES?

YESNO
IF YOU DID NOT USE A LOG BOOK, CAN YOU REASONABLY RECONSTRUCT YOUR EXPENSES?

YESNO
HOW WERE YOU PAID (check all that apply)?

CASHCHECKOTHER
DID YOU RECEIVE A FORM 1099-MISC OR 1099-NEC?

YESNO
DID YOU RECEIVE ANY OTHER INCOME NOT REPORTED FOR FORM 1099-MISC?

YESNO
INFORMATION ABOUT YOUR VEHICLE

Complete this section only if you are claiming vehicle expenses (Note: Driving to and from work is considered commuting and generally is not deductible)
WHAT ARE YOU USING THE VEHICLE FOR IN YOUR BUSINESS?
WHEN DID YOU PLACE YOUR VEHICLE IN SERVICE FOR BUSINESS PURPOSES? (MONTH/DAY/YEAR)
WHAT WAS THE COST TO PURCHASE THE VEHICLE?
WHICH METHOD ARE YOU USING THIS YEAR?

STANDARD MILEAGE RATEACTUAL EXPENSES
WHICH METHOD DID YOU USE IN THE FIRST YEAR YOU USED YOUR VEHICLE FOR BUSINESS?

STANDARD MILEAGE RATEACTUAL EXPENSES
OF THE TOTAL NUMBER OF MILES YOU DROVE THE VEHICLE DURING 2025, HOW MANY MILES WAS THE VEHICLE USED FOR:
DO YOU HAVE WRITTEN EVIDENCE TO SUPPORT YOUR DEDUCTION?

YESNO

SUMMARY OF GROSS RECEIPTS

Rows	INCOME
JANUARY
FEBRUARY
MARCH
APRIL
MAY
JUNE
JULY
AUGUST
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER

SUMMARY OF EXPENSES
ADVERTISING
VEHICLE EXPENSES
CONTRACT LABOR
PRIOR DEPRECIATION (PROVIDE COPY OF LAST YEAR'S DEPRECIATION WORKSHEET)
PURCHASED ITEMS TO USE IN THE BUSINESS WITH A USEFUL LIFE OF OVER A YEAR (LIST)
EMPLOYEE BENEFITS PROGRAM
INTEREST ON BUSINES LOANS
LEGAL AND PROFESSIONAL SERVICES
TRAVEL EXPENSE
OFFICE EXPENSE
RENT OR LEASE a) VEHICLES, MACHINERY, EQUIPMENT
RENT OR LEASE b) OTHER BUSINESS PROPERTIES
REPAIRS AND MAINTENACE
SUPPLIES USED IN THE BUSINESS
TAXES AND LICENSES
DEDUCTIBLE MEALS WHILE AWAY OVERNIGHT
RENTAL OR LEASE PAYMENTS
NECESSARY ENTERTAINMENT EXPENSES
UTILITIES (TELEPHONE ONLY IF A SECOND LINE IN HOME)
OTHER EXPENSES
IF YOU DO NOT HAVE ANY BUSINESS EXPENSES, PLEASE PROVIDE AN EXPLANATION.
I ACKNOWLEDGE THAT I HAVE RECEIPTS AND RECORDS REGARDING MY PERSONAL BSUINESS IN MY POSSESSION. I HAVE PROVIDED THE ABOVE SUMMARY TO blanks field. FOR THE PREPARATION FOR MY 2025 INDIVIDUAL TAX RETURN BUT DID/DID NOT PROVIDE THEM WITH ALL OF THE RECEIPTS AND RECORDS
Signature
Date

MonthDayYear
Date
Name

First NameLast Name
YOUR SSN

Type a question

Rows	NAME	PHONE NUMBER	SERVICE PROVIDED	HOW LONG HAVE YOU PROVIDED SERVICE FOR THIS CLIENT	METHOD OF PAYMENT
CLIENT 1
CLIENT 2
CLIENT 3
CLIENT 4
CLIENT 5

Signature
Date

MonthDayYear
Date
SELF-EMPLOYMENT

DUE DILIGENCE WORKSHEET
WHEN OR HOW OFTEN DO YOU WORK?
WHERE DID YOU PERFORM THE WORK?
HOW MANY CUSTOMERS/CLIENTS DO YOU HAVE?
HOW DO YOUR CUSTOMERS/CLIENTS FIND OUT ABOUT YOU?
DID YOU MAINTAIN ANY RECORDS OF INCOME EXPENSES OR MILEAGE?
Signature
Date

MonthDayYear
Date
Number*
Should be Empty:

TAX PAYER APPLICATION

Net Proﬁt From Business Worksheet

INFORMATION ABOUT YOUR VEHICLE

SUMMARY OF EXPENSES

SELF-EMPLOYMENT