Client Intake Form 2021

CLIENT INTAKE FORM

PLEASE FILL OUT ALL INFORMATION APPLICABLE
Letter of Engagement

Welcome To The File Clerk Tax & Financial Services. "WE MAKE IT OUR BUSINESS TO GROW YOUR BUSINESS!"
Tax Year: 2025

Dear Valued Customer,

This letter is to confirm and specify the terms of our engagement with you and to clarify the nature and extent of the services we will provide. To ensure an understanding of our mutual responsibilities, we ask all clients for whom returns are prepared to confirm the following arrangements. By providing us with your signature, you are accepting the terms and conditions specified in this letter.

► We will prepare your 2025 federal, state, and local income tax returns from the information you will provide for us.
► We will not audit or otherwise verify the data you submit, although it may be necessary to ask you to clarify some of the information.
► We will also furnish you with questionnaires and worksheets to guide you while gathering the required information.

We reserve the right to assess additional document preparation and filing fees
(automatically added to invoice). There is a $500 non-refundable retainer fee for services that exceed $1000.00. Balances must be paid in full before submission.

It is your responsibility to provide all information required for the preparation of complete and accurate returns. Please retain all documents, canceled checks, and other data that form the basis of income, expenses, credits, and deductions for up to three years. These items may be necessary to prove accuracy and completeness of the returns to a taxing authority. As the client, you have the final responsibility when it comes to your returns accuracy, therefore, we encourage our clients to review each portion of your return carefully before you sign.

Our work in connection with the preparation of your income tax returns does not include any procedures designed to discover defalcations and/or irregularities, should any exist. We will render such bookkeeping assistance as determined to be necessary to prepare the income tax
returns. The law provides various penalties that may be imposed when taxpayers
understate their tax liability.

If you would like information on the amount or the
circumstances of these penalties, please view the IRS website (IRS.gov).
Your returns may be randomly selected for review by the taxing authorities. Any
_ _proposed_adjustments_by the examining_agent are_subject_to certain_rights _of appeal.

ATTESTATION AND DISCLAIMER
The File Clerk Tax & Financial Services is not responsible if the taxpayer provides us with incorrect information (i.e. social security numbers for self, spouse, or dependents, last names, birth dates). This may delay your refund.

The File Clerk Tax & Financial Services is not responsible for any IRS audits. All
information obtained from the taxpayer and/or spouse must be presentable if the IRS audits your tax return.

The File Clerk Tax & Financial Services is not responsible for
any incorrect tax figures provided by the taxpayer and/or spouse. If your tax figures change, you will need to make an Amendment to your return. Amendments preparation fees may vary.

If you have any federal or government debts (i.e. school loans, child support, DPP,
DFCS, etc....) there is a chance that your refund will be applied towards your debt.

You can call the offset department at 1-800-304-3107 or 1-800-829-7650 to see if your refund will be partially or fully taken. If your refund is fully taken, YOU are responsible for paying the preparation fees.

The File Clerk Tax & Financial Services provides the taxpayer with ONE
complimentary copy of their tax return. Should you need any additional copies, there is a $25 fee per copy. (Paper Tax Returns Only)

The File Clerk Tax & Financial Services is not responsible for
any discussions or changes the IRS or bank may make on disbursement dates, filing status or any other required information from the IRS.

The File Clerk Tax & Financial Services is not responsible for any IRS glitch issues or problems that may cause a delay in your tax refund.

We DO NOT reimburse any bank fees in the event of this occurrence.

SIGNATURE PAGE

If the above set forth your understanding, please sign this letter in the space indicated.

This letter will apply for all tax returns prepared for you by our tax preparers.
I understand that this information is being provided to the IRS and State Revenue. My tax preparer advised that any false and misleading information that I provide for income tax filing purposes is against the law and is subject to penalties. I understand that The File Clerk Tax & Financial Services is only liable for any Error and Omission on their part and responsible for any interest and penalties and not tax due.

PRICING INFO

Thank you for choosing The File Clerk Tax & Financial Services for your upcoming Tax Return Preparation. We are excited to assist you with all inquiries and concerns that you may have regarding your documents and return that you are filing. Please have your government issued 1D/DL, social security cards (Dependents included), W2's and all other 2024 forms uploaded for your future appointment.

Each Tax Return this upcoming season (2025) will be priced starting at $399 based on the following:

Basic Return
$399 - $499
Basic Return w/ Dependents
Starting at $499
Return with Misc Docs (Sch C, 1098-T, 1098 - R, etc.)
Starting at $699
Return w/ Multiple W2's
Starting at $499
Returns w/ Schedule A (Itemization)
Starting at $599

Our pricing fluctuates based on time, and services provided during the preparation process. We are not able to provide a prep fee quote until after documentation is reviewed.

***Please note that by signing this form you have fully read and understand everything listed above. You are in full agreeance with The File Clerk Tax & Financial Services completing your tax return, and making sure that we have applied all of the available deductions per your tax filing status and circumstances. Your tax return is based off your own unique circumstances, therefore we CANNOT GUARANTEE the outcome of what happens after the return is sent to the IRS. If your return is occupied to satisfy an offset or federal/state tax liabilities, this DOES NOTY RELIEVE YOU OF YOUR OBLIGATION TO PAY for the services that have been provided to you.***
Name

First NameLast Name
Signature
Name

First NameLast Name
Social Security Number*
Date of Birth*

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

First NameLast NameSuffix
Social Security Number
Date of Birth

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

NO P O BOX/ PHYSICAL ADDRESS ONLY

Street Address Line 2

CityState / Province

Postal / Zip Code
Signature
SingleMarried Filing JointlyMarried Filing SeparatelyHead of HouseholdQualifying Widow
LeaseUtility BillMortgage Statement
File Upload One Of The Options above*

Cancelof
Dependent 1

First NameLast NameSuffix
Social Security Number
Date of Birth

MonthDayYear
Relationship
Dependent 2

First NameLast NameSuffix
Social Security Number
Date of Birth

MonthDayYear
Relationship
Dependent 3

First NameLast NameSuffix
Date of Birth

MonthDayYear
Social Security Number
Relationship
Dependent 4

First NameLast NameSuffix
Date of Birth

MonthDayYear
Social Security Number
Relationship
File Upload a Social Security Card for All Dependents

Cancelof
IF YOU ARE CLAIMING A DEPENDENT, PLEASE ANSWER THE QUESTIONS BELOW THAT PERTAINS TO YOUR DEPENDENT RELATIONSHIP. PER THE IRS REQUEST, WE MUST PROVE THAT NOBODY ELSE IS ELIGIBLE TO CLAIM YOUR DEPENDENT BUT YOURSELF.
If claiming son/daughter, where is the other parent of the dependent/dependents? Is the other parent providing any financial support?
If claiming niece, nephew, aunt, or uncle, how are you related to the dependent? Where are the parents to the dependent/dependents?
If claiming brother or sister, how are you related to the dependent? Why are the parents not claiming the dependent/dependents?
Birth Certificate (Must Have)Social Security Card (Must Have)
Dependent's Identity Protection Pin (Include: Full Name, IP Pin Number-Taxpayer N Child #123123
School RecordsMedical RecordsShot RecordsGovernment Statements (ie,SNAP or HOUSING)Other (see preparer for this option)
YesNODeceased
How many months did you recieve support from the other biological parent
Did you receive any additional income support for your dependent(s) in 2023? (Gifts, Loans, family assistance, credit cards, etc.) If yes, how much did you receive?
YESNO
YESNO
YesNo
YesNo
YesNo
YESNO
RegularPUA
YESNO
YESNO
Please list all other income. Ex Interest Income from 1099-INT, Business Income from Self-Employment, 1099-K (Business Income received over $20K and over 200 transactions from payment apps), Rent Income, Capital Gains, etc.
Child SupportAlimonyStudent LoansBack TaxesState TaxesNone of the above
YESNO
Student Acknowledgement
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
How did you hear about us?
Supporting Documents
Supporting Documents/State ID, Social Security Card(s), Passport, BC*

Cancelof
Lease, School Records, Vaccination Cards, Award Letter from Gov Assistance (Proof of Residency, HOH, and Dependent Care)*

Cancelof
Additional File Upload (W2s, 1099s, )

Cancelof
Additional File Upload

Cancelof
Provide 1098-T, Child Care Forms, any other Government Documents, Alimony, Proof of Charitable Contributions, Taxes Paid, Medical/Dental Expenses

Cancelof

Refund Transfer Direct DepositRefund Transfer Debit CardRefund Transfer Paper Check

Bank Information

Rows	Name of Bank	Routing Number	Account Number
ENTER BANK DATA

I, hereby, state that all the information above is true to the best of my knowledge and that I am allowing On Time Taxes to prepare my taxes based on that fact. I understand that I am financially responsible for any outstanding balance due to any false information given.

If there is a balance due, you must pay the tax preparation fee upfront. If for any reason you owe an entity and they take the entire refund, you are STILL responsible to pay the tax preparation fee for services rendered.

*For any reason an amendment has to be filed with no fault of the tax preparer, an upfront fee of $150.00 is required! Please view your tax return, which is emailed to you (it is sent prior to submission). Any copy after the first copy is a fee of $10.00.

ALL FEES (bank and service fees) are found in the return and are non-refundable nor negotiable! NO EXCEPTIONS TO THIS!!

Please utilize www.irs.gov for all federal refund tracking. Please utilze your state Department of Revenue site for any State Refund tracking. Do NOT add the amounts together. Federal taxes are federal, and state taxes are state when tracking your status. Please allow 8 weeks to surpass from the date of submission before calling the IRS, if you have any tracking questions.

For any direct assistance please email tfctaxfinancial@gmail.com

IRS Contact 800-829-1040

Please click this link to check your federal refund status. You will need your filing status, social security number, and the total amount of the refund before fees

https://sa.www4.irs.gov/irfof/lang/en/irfofgetstatus.jsp
By signing below, I hereby certify the information provided above is true and accurate to the best of my knowledge. As the taxpayer, I have been informed that claiming a dependent for EITC/CTC/AOTC/HOH can result in audit, fines, and other consequences if the information provided is incorrect.
Taxpayer's Signature*
Spouse's Signature (if applicable)
Name of Tax Preparer
***Call, text, or email your preparer once form is completed, and all documents are loaded, so that you will be in queue to have your return completed. All services will be provided in the order in which your intake form is received.
Date

MonthDayYear
How did You Hear about Us? (Who referred You)
Should be Empty:

CLIENT INTAKE FORM

Letter of Engagement

Student Acknowledgement

Supporting Documents