Enrollment Form: Taxes

PFI Tax Preparation Client Intake Form-2024

Thank you for choosing our tax preparation services. Please complete the following form below to provide us with the necessary information to prepare your taxes. If you have any questions prior to completing this form, please do not hesitate to reach out to me via email: contact@praisefinancialinstitute.com
What Tax Year Are You Filing?*
Ex. 2024
Filing Status*
Marital Status*
Head of Household Supporting Documents

Upload a document that reflects your ability to claim head of household. An example would be a mortgage interest statement, rental agreement, rent receipts, property tax payments, utility bill, etc.
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Taxpayer Name*

First NameLast Name
Taxpayer Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Taxpayer Phone Number*

Area CodePhone Number
Taxpayer Email*
example@example.com
Taxpayer Date of Birth*

MonthDayYear
Date
Taxpayer Social Security Number*
IP PIN (identity protection pin issued by irs)
Upload Photo ID *

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Upload SSN Card*

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Taxpayer Occupation*
Are you a U.S. Citizen?*
Do you rent or own your home? *
Did you receive any government assistance in 2024?
Ex. Section 8, Rental Assistance
Are you a full-time student? *
If yes, please upload your 1098-T form.

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Are you filing an eligible spouse on your return?*
Are you totally and permanently disabled?*
Are you legally blind?*
Did you, your spouse or your dependents receive health insurance through MARKETPLACE (Obama care)?*
If yes, please upload your marketplace insurance 1095-A form.

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Did you, your spouse or your dependents receive MEDICAID? *
Did you have healthcare coverage (health insurance) for you, your spouse or dependent(s) through your employer in 2024?*
If yes, please upload your document.

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Did you receive a refund last year?*
Were you AUDITED by the IRS last year? *
Do you owe child support, student loans, etc?*
Do you have any credits that were disallowed or reduced?*
If you have any credits that were disallowed or reduced, please enter here.

Did you receive a W-2 for this tax year?*
If yes, upload W-2 form

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Did you receive any 1099 forms?*
Examples: freelance work, interest, dividends, etc
If yes, please upload your document(s).

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Other sources of income*
Examples: Self-Employment, Rental Income, Unemployment Income, Household Employee, Investments, etc
If yes, please upload your document(s).

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Are you interested in Credit Repair?

Are you filing a joint return?*
If yes, please enter your spouse's information below. If no, please skip this page.
Spouse's Name
Spouse's SSN
Spouse's DOB
Spouse's Phone Number
Spouse's IP PIN (identity protection pin issued by irs)
Spouse's Occupation
Upload spouse's W2 or other sources of income

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Did your spouse attend college in 2024?
If yes, please upload your spouse's 1098-T form

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Are you claiming any dependents? If NO, please skip the next page.*
If yes, please enter dependents information below. If no, please skip this page
Dependent 1
Full Name
SSN
DOB
Relationship
Months lived in home 2024
College Student? (Y/N)
IP PIN (identity protection pin issued by irs)
Dependent 2
Full Name
SSN
DOB
Relationship
Months lived in home 2024
College Student? (Y/N)
IP PIN (identity protection pin issued by irs)
Dependent 3
Full Name
SSN
DOB
Relationship
Months lived in home 2024
College Student? (Y/N)
IP PIN (identity protection pin issued by irs)
Dependent 4
Full Name
SSN
DOB
Relationship
Months lived in home 2024
College Student? (Y/N)
IP PIN (identity protection pin issued by irs)
Additional dependent information
Be sure to enter any additional dependents information here. Answer ALL questions to ensure we have the correct information to file a complete tax return.
Do any of the children have a disability? If yes, list the child/children names below:
Please upload Social Security Card for each dependent listed above

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Please upload your dependent (s) 1098-T form (school form).

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Please upload proof of residency for dependent(s).

Ex. School record, medical record, shot records, government statement (SNAP or Housing).
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Deductions and Credits
Did you make any charitable donations?*
If yes, please upload your document(s).

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Do you have education expenses?*
Example: Student loans, tuition
If yes, please upload your document(s).

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Do you have any medical or dental expenses?*
If yes, please upload your document(s).

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If you are a homeowner, do you have any homeowner expenses?
Example: Interest paid on the mortgage, property tax
If yes, please upload your document(s).

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Did you have any childcare or dependent care expenses?*
If yes, please upload your childcare or dependent care form.

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Self-Employed or Small Business Information (if applicable)
Are you self-employed or a business owner?
If yes, I will send you a Schedule C-Affidavit to complete. If no, skip this section.

Banking Information
How would you prefer to receive your refund, if eligible?*
Which type of account would you like your tax refund to deposit into?
Bank Name
Bank Routing Number
Bank Account Number
Are you interested in Audit Protection?
$92.00 for the 2024 tax year
I agree that all information provided is true and factual. I understand that falsifying information is against the law. I agree that upon completion of my tax return, if my return is intercepted and not paid, I am responsible for all preparation feees to be paid to my Tax Specialist. If you agree, please sign below:
Signature*

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PFI Tax Preparation Client Intake Form-2024