New Client - Personal Tax Preparation Intake Form

New Client Personal Tax Preparation Intake Form

Name

First NameLast Name
Social Security Number
Date of Birth

MonthDayYear
Date of Death (if applicable)
Occupation
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Are they totally and permanently disabled?

YesNo
Are they legally blind?

YesNo
Full time student? (If yes, upload tuition statement)

YesNo
Can be claimed as a dependent on another return?

YesNo
Upload Drivers License

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Identity PIN from the IRS?

Current Address*

Street Address

Street Address Line 2

CityState

Zip Code
Did you live here on December 31 of last year?*

YesNo, please include previous address
Did you move last year?*

Yes, please include previous addressNo
Date Moved

MonthDayYear
Date
Old Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Enter your dependents here

Rows	First and Last Name	Social Securty Number	Birth Date	Relationship
1
2
3
4
5
6

The IRS is no longer sending paper checks for refunds - all refunds will be sent via direct deposit
Bank Name*
Checking or Savings*

CheckingSavings
Bank Routing Number*
Bank Account Number*
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 the balance of our fee auto deducted from your federal refund (if applicable) (additional fee will apply)*

YesNo

Are you currently renting?*

YesNo
Did you rent there all last year?

YesNo (please list all addresses and rent)
Landlord's Name
What is the monthly rent amount?
Landlord's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Landlord's Name
What is the monthly rental amount?
Landlord's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Do you have mortgage interest?*

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

YesNo
Property Taxes Paid

Please include any other applicable expenses

Rows	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/Notes to Preparer

A deposit must be submitted with the form.

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

Please allow up to 7 days for turnaround!

Income Statements
- W-2's (please also include last checkstub if overtime pay was received)
- 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)
- Form 1099-K (Payments Received from Third Party Vendors)
- Schedule K-1 (Partnership or S-Corporation Income)
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
- Mileage (if applicable)
- Lyft/Uber/Shipt/Doordash Yearly Report - often available in online account
Self Employment Income and Expenses

Rental Income and Expenses

Copy of Previous Year's Tax Return
*

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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
prevnext( X )
Tax Preparation Deposit
Fee will be applied to final invoice

$100.00

Subtotal

$0.00

Tax

$0.00

Total

$0.00
Review Answers In Order To Submit Documents and Payment
Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info

Should be Empty:

New Client Personal Tax Preparation Intake Form