Tax Preparation Client Intake Form

Taxpayer Information
RETURNING CLIENTNEW CLIENT
Name*

First NameMiddle NameLast NameSuffix
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
SSN*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
Filing Status*

SingleHead of HouseholdMarried Filing SeparateMarried Filing JointQualifying WidowerNot Sure

Enter your dependents here

Expenses
Please list any expense totals you would like to discuss or be included with your return.

General Expenses

	Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses

Acknowledgment & Signature
Thank you for choosing MY TAX ANGEL to assist you with your tax matters. With this form you are engaging us to prepare your current federal and state income tax returns unless given authorization by you to prepare additional returns.

We will depend on you to provide the information we need to prepare complete and accurate returns. Fees for our services will be charged according to our standard fee schedule. Invoices for our services are due and payable upon presentation. Past due balances may be subject to interest and collection charges.

Your signature below authorizes the terms set forth above.
Additional comments
Date Signed*

MonthDayYear
Date
Taxpayer Signature*

Clear
Please choose one*

I have made or will make an appointmentI'll just upload or drop off all of my tax documents and MY TAX ANGEL can contact me to complete my return (usually within 48 hrs)
Should be Empty: