Tax Preparation Client Intake Form

Tax Preparation Client Intake Form
Filing Status

SingleHead of HouseholdMarried Filing SeparateMarried Filing JointQualifying Widower

Enter your dependents here

Tax Related Questions
Employment Status

EmployedUnemployedSelf-employed
Does your dependents have tuition expenses?

YesNo
Do you have any expenses for child care?

YesNo
If yes how much per year?
Did you receive a federal tax refund last year?

YesNo
Additional comments
Please upload:

W2,Social Security Cards, 1099's, 1098's or any forms you were provided to file your taxes.
File Upload

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Acknowledgment & Signature
- I confirmed that all information I entered here is accurate and true.
- I allow Prime Tax USA 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 Prime Tax USA.
- By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
No mobile information will be shared with third parties/affiliates for marketing/promotional purposes.
Date Signed

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Date
Taxpayer Signature

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Date Signed

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Date
Spouse Signature

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