Client Intake Form

Dependents

Enter your dependents here (if you are married, do not include your spouse here)

	Full Name	SSN/ITIN	Date of Birth	Relationship	Months lived with you
1
2
3
4
5
6

Has the IRS ever reduced or disallowed credits you claimed for one of these dependents on a previous year's tax return?*

YesNo
If the IRS audits your return, can you provide documentation of your eligibility to claim these individuals as dependents (and obtain any associated tax credits) and/or qualify for Head of Household status.*

YesNo
Note Regarding Eligibility for Child Tax Credit / Additional Child Tax Credit / Credit for Other Dependents

If you are claiming one of these credits, the IRS requires that I tell you the following:
- You may not claim the Child Tax Credit or Additional Child Tax Credit if you did not lived with the child for over half of the year, even if you supported the child, unless the child's custodial parent has given you written permission to do so. (Children born during the year are considered to have lived with you for the entire year.)
- If you are divorced, separated, or otherwise live apart and are claiming a child or dependent tax credit, please review the special rules for determining tax credit eligibility in IRS Publication 596.

Nonresident Tax Return (Form 1040-NR)
In what country or countries do you hold citizenship?*
What is your country of residence for tax purposes?*
Do any of these situations apply to you?*

I had a valid US visa on December 31 of the tax yearI have filed a US tax return beforeI have changed my US visa or immigration status at some pointI have applied to be a lawful permanent resident (green card holder) of the United StatesI have been a US citizenI have been a US lawful permanent resident (green card holder)None of the above
What type of visa did you have on December 31?*
e.g. B1/B2
Please provide the date you changed your visa status, and what the change was*
e.g. On 4/15/2013 I obtained a B1/B2 visa because my L1 visa was no longer valid
For what year was your most recent US tax return filed?*
For a 2022 tax return filed in 2023, enter 2022.

Please provide the number of days you were in the US during the year and for the two prior years. (E.g. if you're filing a 2020 return, provide days for 2020, 2019, and 2018; for a 2023 return provide 2023, 2022, and 2021).*

	2024	2023	2022	2021	2020	2019
Number of days present in the US for any purpose

Rental Properties
Was the property or properties rented, or available to rent, for the entire year?*

YesNo
If not, please explain
e.g. "I stayed there for two weeks from December 15-30" or "it was being renovated until October 17"
What date was your property first "placed into service" (i.e. the date you started advertising it for rent)*

MonthDayYear

Rental Income and Expenses. If you are reporting multiple properties or multiple years, please use the extra columns for the additional businesses. (If you have a separate accounting statement, you can skip this section and just upload your doc to Verifyle.)

	Property/Year 1	Property/Year 2	Property/Year 3
Property Address or Year
Income
Cleaning and Maintenance
Commissions
Insurance
Legal/Professional
Management fees
Mortgage interest (not principal)
Other interest
Repairs
Supplies
Taxes (including property tax)
Utilities
Advertising
Bank Fees
Travel (not including meals)
Meals while traveling
Other expenses

If you entered values for Other Expenses, please describe the amounts here

If you used a personal vehicle for business:

	January-June	July-December
Business miles driven during the year
Total miles driven during the year

If you used a personal vehicle for business:

	Answer
Date you first used your vehicle for business
Amount paid for parking for business purposes
Amount paid for tolls when driving for business
Amount paid in interest on a car loan

Self-Employment, Small Business, and Gig Economy
Self-Employment Income

Self-Employment Income and Expenses. If you are reporting multiple businesses or multiple years, please use the extra columns for the additional businesses. (If you have a separate P&L, skip this section and just upload your doc to Verifyle.)

	Business/Year 1	Business/Year 2	Business/Year 3
Business Name or Year
Income
Bank Fees
Commissions / Fees
Consulting
Dues/Subscriptions
Education & Training
Health Insurance premiums paid
Insurance-Liability
Interest Paid
Internet
Legal/Professional
Meals and Travel Meals
Office Supplies
Outside Services
Phone
Postage and Shipping
Rental Equipment
Rents
Repairs and Maintenance
Security
Software
Supplies (other than office supplies)
Taxes (City, County, Sales, Payroll)
Travel
License Fees
Utilities
Web Services
Website Cost
Other expenses

Did you have a dedicated space in your home or apartment that was used regularly and exclusively for your business?*

YesNoNot SureOther
Square feet of your dedicated office space
Square feet of your total home/apartment

Any additional comments or questions?
I affirm that all of the information provided on this form is true to the best of my knowledge.*

Yes
Should be Empty:

	Amount paid to IRS	Date paid to IRS	Amount paid to state	Date paid to state
Payment 1
Payment 2
Payment 3
Payment 4
Paid with extension

	Arrival Date	Departure Date	Number of days in the US on business (if any)	Amount of money earned in the US (if any)	Notes
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2.
3.
4.
5.
6.
7.
8.
9.
10.

	Bank Name	Bank Address	Account Number	Maximum balance (include currency)	Account type (bank, securities, other)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

	Amount paid for entire home	Amount paid just for home office (if known)
Rent or Mortgage Interest
Utilities
Property Taxes
Insurance
Landscaping
Repairs & Maintenance
Supplies
Any major improvements over $2500?
Other Expenses

Tax Preparation Client Intake Form

Taxpayer Information

Spouse Information

Tax Questions

International Tax Issues

Nonresident Tax Return (Form 1040-NR)

Rental Properties

Self-Employment, Small Business, and Gig Economy