Sealed by MJ Tax Preparation Client Intake Form

Tax Preparation Client Intake Form

MJ Professional Tax & Notary Service
I would like to express my sincerest gratitude for choosing me as your Tax Preparation Specialist. I truly appreciate your trust and confidence in my services. In order to ensure a smooth and efficient process, the attached client intake form must be completed. This form is essential for us to move forward with your Tax Preparation needs.

Please make sure to fill out all the required areas./ UPLOAD ALL REQUIRED DOCUMENTS- INCLUDING UTILITY BILL FOR HOH FILING STATUS.

Self-Employed / Business Must Complete the Business Income & Expenses (Sole Proprietorship/Self Employment) Section below.

Upload Documents as Needed Below: Driver Lic./ W2/ SS Cards/1099/ ETC ( must be a Clear Image)-

If you have any questions or need any assistance, please do not hesitate to reach out to me.

Thank you once again for choosing me as your Tax Preparer. -MJ
New Client*
How Did You Hear About Us?*
CONSENT TO SUBSCRIBE TO EMAILS/ TEXT MESSAGES *
Referral Name
YesNo
HOW MUCH WAS YOUR REFUND LAST YEAR? *
Are you Interested in Buying, Selling or Investing in a Real Estate (Home)?*
Are you Interested Booking an upcoming Trip or Get-a-way? *

SingleHead of HouseholdMarried Filing JointMarried Filing SeparateQualifying Widower
Name*

First NameLast Name
Age*
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province/LIST COUNTY

Postal / Zip Code
Occupation*
SSN*
YesNo
YesNo

Name

First NameLast Name
Age
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
SSN
YesNo
YesNo
YesNo

Enter your dependents information here

Rows	Name	SSN	Date of Birth	Relationship	Disabled
1
2
3
4
5
6

Do you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it?

Rows	Yes/No	Employer	Spouse Ins	Exchange/ Marketplace
Taxpayer
Spouse
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5

YesNo

Type of Business or Profession:blanks

Did you receive a 1099? Yes or Noblank

Do you maintain separate credit or banking accounts to differentiate your transactions? Yes or No  blank

How do you Track Financial transactions and who is responsible?   blank

Business Name:   blank
Business Address:   blank
Accounting is Owned by:   blank
Inventory method:   blank
Did you materially participate in the business? Yes or No   blank
Check if this is the first year of business:     blank
Income/Cost of Goods Sold
Gross receipts or sales (INCOME): blanks
Purchases: blank
Other income:   blank
Cost of labor:   blank
Material and supplies:   blank
Other costs:  blank
End of year inventory:   blank

General & Business Expenses- FILL IN AREA THAT ONLY APPLIES TO YOU.

Rows	Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Rent,Building
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses fee
Payroll service/ Payroll tax
Health Insurance
Meals and entertainment
Travel
Licenses
Supplies
Advertising
Education ansd seminars
Office Expense
Vehicle Expense
Repairs/maintenance building
Rent, equipment
Utilities
Wages
Legal and accounting fees
Business Line
Vehicle Miles
Other: (Description)

Make & Model of Vehicle
Total Expenses
Business Use of Home
Do you use any part your home regularly and exclusively for business? Yes or No blank
Estimated percentage of time spent in home office compared to total time spent in this business activity.    blank%
Description of work done in home office   blank
Description of work done outside of work office   blank
Declaration: I declare under penalty of law that I have supplied and examined the information contained on this questionnaire and, to the best of my knowledge and belief, it is true, complete, and correct. I understand the penalty for willfully delivering a false return or document to MJ Professional Tax & Notary Services and the Internal Revenue Service is a fine or imprisonment or possibly both. The declaration of a paid preparer other than the taxpayer is based on all information of which the preparer has any knowledge. The Internal Revenue Service requires proof such as receipts, 1099's or ledgers for any expense. Failure to provide proof may lead to fines, penalties or an increase in tax liability. By signing, acknowledge all deductions to be true and my responsibility.
Signature*

Clear
Date*

MonthDayYear
Date

I blanks blank and   blank Authorize SEALED BY MJ PROFESSIONAL TAX & NOTARY to disburse my tax Refund via the indicated option below.

X-for Selection / NA- for Options not requested.
Direct Deposit   blank
PREPAID CARD   blankISSUED CARD   blank
LIVE CHECK   blank
   Saving   Checking*

Name on Account:blanks
Bank Name:   blank
Account Number #   blank
Bank Routing #   blank
Bank City/ State:   blank

LIVE CHECKS MAY BE PICKED UP AT
5798 MT MORIAH RD, MEMPHIS,TN 38115

YOU MUST PRESENT A VALID NON-EXPIRED PHOTO ID UPON PICK UP FOR ALL CHECKS AND/OR PAYCARDS.

Please Make Note that you MUST Confirm with YOUR Tax Preparer to Confirm Pick up Time and Day for your Refund if you receive a Check AND/OR Pre-Paid Card.

• I give Sealed by MJ Professional Tax Services permission to E-file my 2025 tax return on my behalf and transmit it to the Internal Revenue Service. Sealed by MJ Professional Tax Services assumes no responsibility for inaccurate information reported. The Taxpayer is ultimately responsible for the preparation and filing of your Federal & State Return. The Taxpayer above have provided to Sealed by MJ Professional Tax Services the attached & required information to the best of HIS/HER knowledge. This information is Accurate, Factual and Complete.
• I understand that if my tax refund is offset by the IRS for a debt, I agree to remain obligated to pay my tax preparation fees to Sealed by MJ Professional Tax Services for services rendered.
• I understand that if my tax return is offset by the IRS for a debt, my fees will not be reduced, and payment is still due or services rendered.
• PRIOR TAX RETURN SUBMISSONS: I understand that if Sealed by MJ Professional Tax Services prepares a prior tax year return, payment is due at the time of receipt. However, if a payment plan is established, Sealed by MJ Professional Tax Services is hereby authorized to submit the current year’s tax return to include the prior year’s fee for tax preparation.
• SELF-EMPLOYED: I understand that by filing self-employed if the IRS requests supporting documentation Sealed by MJ Professional Tax Services is not liable nor responsible for providing documentation.• I acknowledge that the new rules, and regulations to claim EITC have been explained to me by my preparer.

• By signing below, you verify that all the above information was provided by you and is true to the best of your knowledge. I am aware that in the event of an audit, this information will be given to the Internal Revenue Service.
• I acknowledge that the new rules, and regulations to claim EITC have been explained to me by my preparer.

• I acknowledge and understand that if I request additional copies of my Personal Tax File once received from MJ Professional Tax Company that a $25.00 Replacement Fee will be paid to the Tax Preparer Prior to receiving the file.
INITIAL*

Clear
Taxpayer Signature*

Clear
Date Signed*

MonthDayYear
Date
Spouse Signature

Clear
File Upload

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Should be Empty:

Tax Preparation Client Intake Form

Income/Cost of Goods Sold

Business Use of Home