Tax Client Intake Form
Filing Status
Single
Head of Household
Married Filing Separate
Married Filing Joint
Qualifying Widower
Taxpayer Information
Name
First Name
Last Name
Age
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
SSN
Spouse Information
Name
First Name
Last Name
Age
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
Physical Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
SSN
Dependents
Enter your dependents here
Name
SSN
Date of Birth
Relationship
1
2
3
4
5
6
Tax Related Questions
Employment Status
Employed
Self-employed
Do you have any expenses for child care? If Yes, attach daycare statement with EIN number.
Yes
No
Did you take money from your 401?
Yes
No
Do you have mortgage interest?
Yes
No
Do you have an identity pin from the IRS?
Yes
No
Did you receive a federal tax refund last year?
Yes
No
Do you owe any state taxes?
Yes
No
Do you have any delinquent student loan accounts?
Yes
No
Additional comments
Acknowledgment & Signature
I confirmed that all information I entered here is accurate and true.
I allow IBA Tax Professionals 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 IBA Tax Professionals.
By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Date Signed
-
Month
-
Day
Year
Date
Taxpayer Signature
Date Signed
-
Month
-
Day
Year
Date
Spouse Signature
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