New Client - Personal Tax Preparation Intake Form

New Client Personal Tax Preparation Intake Form
Basic Tax Info
Filing Status*

SingleHead of Household (rules apply)Married Filing Separate, please list spouse name and SSN belowMarried Filing JointQualifying Widower
Specify what tax years you need prepared*
If due a refund, do you want to receive a check or direct deposit?*

Direct Deposit, submit banking infoCheck
If you owe, do you want to mail a check or pay by auto debit when efiling?*

Auto Debit, submit banking infoMail a Check
Are you interested in having our fee auto deducted from your federal refund (additional fee will apply)*

YesNo
Banking Information
Bank Name
Checking or Savings

CheckingSavings
Bank Account Number
Bank Routing Number

Spouse Information
Name

First NameLast Name
Social Security Number
Date of Birth

MonthDayYear
Phone Number
Please enter a valid phone number.
Email
example@example.com
Identity PIN from the IRS?
Occupation
Are they totally and permanently disabled?

YesNo
Are they legally blind?

YesNo
Upload Drivers License

Cancelof

Dependents

Enter your dependents here

	First and Last Name	Date of Birth	Social Security Number	Relationship
1
2
3
4
5
6

Itemized Deductions
Do you have mortgage interest?*

Yes, upload 1098-ENo
Do you pay property taxes?*

YesNo
Mortgage Interest Paid
Property Taxes Paid

Please include any other applicable expenses

	Amount
Medical Expenses
Dental Expenses
Insurance Premiums Paid
Long Term Care Premiums
Prescription Drugs and Medications
Investment Interest
Cash Contributions
Non-Cash Contributions (clothes, furniture, etc)

Additional comments

Acknowledgment
Payment must be submitted with the form

We will let you know if we need any additional information
Please make sure to submit requested documents below with your questionnaire. Any required documents not submitted will hold up the return process. If you have any questions please feel free to call, text or email. Thank you!

Income Statements
- W-2's
- 1099R (Pension, IRA's, Distributions from 401K)
- 1099SA (Social Security)
- 1099 INT (Interest)
- 1099 DIV (Dividends)
- Combined Statements from Brokers (usually stock sales)
- Form 1095-A (Health Insurance Marketplace)
Deductible Expenses
- 1098 (Mortgage Interest Statement)
- 1098T (Tuition and Fees)
- 1098E (Student loan Interest)
- Child Care records including: Name, address, EIN/SSN and amount paid per child
- Records of Charitable deductions and Medical Expenses
Self Employment Income and Expenses

Rental Income and Expenses

Copy of Previous Year's Tax Return
Please upload all required documents*

Cancelof
By acknowledging below:
- I confirmed that all information I entered here is accurate and true.
- I allow Alexander Accounting, LLC to capture my sensitive data like personal id, government id, and other information.
- I understand that the total fee is based on the preparation of the tax return and final payment is due before efiling (unless deducting from refund).
Date Acknowledged*

MonthDayYear
Date
Deposit Payment*
prevnext( X )
Tax Preparation DepositFee will be applied to invoice
$100.00

Total

$0.00

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty:

New Client Personal Tax Preparation Intake Form

Basic Tax Info

Banking Information

Payment must be submitted with the form