Clarity Taxes INTAKE FORM 2025

Clarity Taxes

TAX CLIENT INTAKE FORM
Filing Status

Other
Thank You for taking the time to complete the Clarity taxes client intake form.

This information is important and will help complete a correct and accurate tax filing. Please don't be in a rush to complete all questions and review all information before submitting. Please note if any documents are missing or incorrect this will result in a delay in processing your return.

Please wait until you have all your documents before submitting them.

Note: if claiming any dependents be sure to upload all documents such as Social security cards, Birth certificates School Records, etc, indicating the child is your dependent.

If you are filing multiple returns please submit a separate form.
Which Clarity Taxes Prep is Assisting you?
Check All that Apply

Other
Name

First NameLast Name
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
Date Of Birth

MonthDayYear
Date
Date of Death, if Deceased

MonthDayYear
Date
Social Security Number
Are you a US Citizen? Yes/No
Tax Payer Occupation/ Title
Taxpayer Legally Blind?
Can You be Claimed as a Dependent?
Did you receive last years tax return?
How did you hear about us ?
Were you previously issued an Identity Protection Pin( IP PIN) by the IRS?
Spouse Full Name
Spouse Date Of Birth
Spouse Name Email Address
Spouse Name Social Security Number
Spouse Name, Date Of Birth, Email Address and Social Security Number
Do you have Full Custody of dependent children?
How many dependents?
Dependent 1 Name
Dependent 1 Social Security Number
Sex Of Dependent
Dependent Date Of Birth
Is the child disabled?
If you are a single parent, where is the other parent of your children?
Do you provide more than 50% support?
Has the dependent lived with you at least half of the year?
Dependent 2 Name
Dependent 2 Social Security Number
Dependent 2 Date of Birth
Sex Of Dependent
Is the child disabled
Do you provide more than 50% support?
Has the dependent lived with you at least half of the year?
Dependent 3 Name
Dependent 3 Social Security Number
Dependent 3 Date of Birth
Do you provide more than 50% support?
Sex of Dependent
Has the dependent lived with you at least half of the year?
Did you pay any child care expenses last year?
How much did you pay in child care expenses?
Can anyone else claim your dependents? If yes, please explain
Please provide the name, address, and social security number or EIN # of your childcare provider
Have you ever been disallowed EITC/AOTC/ CTC? If so, when?
Do you have any debts with the IRS, US TREASURY, CHILD SUPPORT, FEMA, OR ANY. GOVERNMENT ENTITY?
If so, With whom and what is the EXACT amount?
Please list documents you have provided for proof of loss/profit for business/self employment (Example: Reciepts, P&L statement, bank statements, or written ledger (which is above spreadsheet)
Did you receive Unemployment? ( Pls upload 1099 G form)

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Upload Copy of W2, Last paycheck stub, 1099 NEC, 1099DIV, MISC

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Upload Social Security Cards, State Identification and Birth Certificates

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SCHEDULE C FORM

Businesses/hobbies
Fill Out Completely or Mark N/A, DO NOT Leave Blank.

Use A Separate Worksheet For Each SCH-C ** Please

Note: If Possible, It Is Preferred A Trial Balance, P&L, and Balance Sheet Be Provided By The Client. If Available, Write "See Next Page" Below And Put Under This Page.

IF NOT AVAILABLE, Please Use The Input Sheet Below.

Business Info: (Required For All) Taxpayer or Spouse
Name of Business
Address of Business
Business EIN
Date Business Started

MonthDayYear
Date
Did you Materially Participate in the business?
Total Sales
Other Income
General Expenses
Advertising
Auto Expense
Office Supplies
Commissions
Contractor Labor
Employee Benefit Program
Insurance (Other than Health)
Interest
Mortgage Interest
Legal And Professional Fees
Rent/ Lease
Vehicles
supplies
Taxes & Licenses
Travel
Meals
Utilities
Total expense
Total income - Total Expenses= Net Income
Please attach any supporting documents if applicable

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Client Signature, By signing below, I hereby certify the information given above is true and accurate
Student Acknowlegement Form
I Was A Student During 2024 School Year, And I certify That All Of The Information Found On This Form Is True And Accurate To The Best Of My Knowledge. I Understand It Is My Responsibility To Have All Valid Documents And Or Receipts, As Required To Apply For Any Type Of School Credit. Below Is A Recap Of All Information, Status, And Expenses I Have Encountered.
My Scholar Status
BELOW ARE MY TOTAL EDUCATIONAL EXPENSES
BOOKS
SUPPLIES
OTHER EXPENSES
TOTAL EXPENSES
How Would you like to recieve your Refund? Check one of the following
Would you like your refund deposited into your Checking or Savings Account?
Direct Deposit Routing Number: (Required if Direct Deposit was selected)
Direct Deposit Account# (Required if Direct Deposit was selected)
The following products require fees paid at the time of service
Are you interested in Audit Protection ? ( Mandatory for all Schedule C`s)
Are you interested in Credit Repair and or Business Credit Information?
DID YOU FINISH UPLOADING ALL THE NECESSARY DOCUMENTS?

IF DOCUMENTS ARE NOT UPLOADED THIS FORM WILL BE VOIDED!!!!!!!

CLIENT NON-PAYMENT/OFFSET CLAUSE:

Clarity taxes TAKES PRIDE IN ASSISTING ALL CLIENTS WITH THEIR INDIVIDUAL TAX NEEDS, HOWEVER, WE UNDERSTAND SITUATIONS WILL ARISE. IF YOU HAVE ANY OFFSETS BY THE IRS, STUDENT LOANS, OR CHILD SUPPORT YOU ARE STILL OBLIGATED TO PAY OUR COMPANY FEES ASSOCIATED WITH FILING YOUR TAX RETURN.

BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT IF PAYMENT IS NOT MADE IN FULL WITHIN 30 DAYS LEGAL ACTION WILL BE SOUGHT TO RESOLVE PAYMENT.

THANKS FOR YOUR BUSINESS!!!!
Any and all information has been filled out to the best of my knowledge. The data filled out by me (THE TAXPAYER) is accurate and truthful.
Printed First, Last NAME
Date of submission
Do you agree to your prep fees, processing fee bank fees, and audit protection fee.
Should be Empty:

Clarity Taxes

SCHEDULE C FORM

General Expenses

Student Acknowlegement Form