Thank you for your interest in being a client of Rich Roots Financial Services. This form is used to collect information to submit your 2024 tax return. This information is for internal purposes only. The information you provide is confidential and will be treated accordingly. Please ensure everything is accurate. If more information is required, we will discuss and we will guide you through out the process.
How did you hear about us?
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Other
If you were referred, please enter the persons name & phone number
Please select your filing status
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TaxPayer Information
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Spouse Information
Did you/spouse have health coverage?
Yes
No
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Dependents and/or Qualifying Children
Did you/spouse provide over 50% of total support for each dependent?
Yes
No
Did your EIC qualifying chldren live with you in the same main home in the US?
Yes
No
Do your EIC qualifying child(ren) meet any one of these requirements? Please select all that applies.
Under the age of 19 and lived in the taxpayers home for more than one half of 2024?
Under the age of 19, foster child of taxpayer and lived in taxpayers home for a the full year?
Full time student age 19 to 23
Totally disabled and can provide proof?
Did any of the dependents have health coverage?
Yes
No
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Tax Decleration
Did you, spouse and/or dependent(s) receieve social security?
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Yes
No
Did you, spouse and/or dependent(s) receieve unemployment?
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Yes
No
Did you, spouse and/or dependent(s) (19-24 years old) attend school for at least 6 months?
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Yes
No
Are you and/or your spouse a business owner, self employed or have unreported income?
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Yes
No
Do you have health insurance coverage?
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Yes
Yes, thru Obamacare/Market Place
No
Do you have any debts with the IRS, US Treasure, Child Support, Student Loans, FEMA or any government entity?
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Yes
No
Are you legally married based on your state's definition of marriage?
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Yes
No
Can someone else claim you or your spouse as a dependent?
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Yes
No
Did you or your spouse recieve any kind of military pay earnings?
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Yes
No
Did you or your spouse live with anyone with a higher adjusted gross income?
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Yes
No
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Documents
Please ATTACH all neccessary documents. Attachments must be clear and LEGIBLE. Take pictures with the least amount of background as possible. Please skip anything that does NOT apply to you.
Please upload a driver's license or ID for ALL taxpayers
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Please upload social security cards for EVERYONE on the tax return
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Please upload a birth certificate for EVERY DEPENDENT on the tax return
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Please upload proof of residency for each dependent
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A document with dependents name and address showing they live with you. This is required for every dependent on the tax return. Ex: Lease, Medical Document, Award Letter, School document, etc
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Please upload W2
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If you have multiple multiple W-2 for 2023, please upload them all
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Please upload 1099-R (Retirement)
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Please upload childcare/daycare letter
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Please upload 1098 (Mortgage Interest Statement)
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Please upload tithes letter
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Please upload tax return from previous year
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Please upload any additonal documents
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Would you like direct deposit or a check?
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Direct Deposit
Check
If you would like direct deposit, please provide the following
If you were referred, please enter the person's name and phone number below. This person will recieve $25 for referring you. You too, can earn $25 per referral!
Please add any notes for your tax preparer
Rich Roots Financial Services Truth Statement
I acknowledge that all information provided to Irby Tax Services is true and accurate to the best of my knowledge. I understand that I am required to have any supporting documentation to validate the information provided. Furthermore, I understand that knowingly providing false information on my tax return and reporting it to the IRS, that I am taking part in a potentially criminal penalty situation and is punishable by law including but not limited to: facing court dates, restitution, and possible imprisonment. I waive Irby Tax Services and the preparer of any error due to incorrect information provided by me.
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