New Client Intake Form

Have you received an Ipin from the IRS*
Were you affected by a Natural Disaster?

YesNo
If yes, Please provide the State and which the disaster Occurred
Do you currently owe any of the following Govt Entity?*

Child SupportUnemploymentIRSStudent Loans
Did you operate a Business this year in 2025?*
If yes please provide the following information: Business name, EIN, Business Type
Did you receive any 1099s?*
How would you like to receive your tax refund?*
Would you like to apply for a Tax Advance?*

YesNo
Please Provide a Void Check or Direct Deposit Slip for account information*

Cancelof
Refund Offset & Payment Responsibility
I understand that if my tax refund is reduced, delayed, or fully offset for any reason (including but not limited to prior tax debts, child support, student loans, or government obligations), and the tax preparation fee is not paid from my refund.

I am responsible for paying the full tax preparation fee directly to the office.
Do you agree to the statement listed ABOVE*
Please review your tax return carefully to ensure all information is accurate. After confirming its accuracy, please sign off so we may proceed with filing it with the IRS. I declare that I understand the above questions and have answered them truthfully and to the best of my ability. *
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