Client Intake Form

Client Intake Form
Thank you for choosing Perkins Tax Services and Welcome to the Family! Please take time to complete our Client Intake Form. This information is critical to ensure your tax return is filed accurately. Review all information and uploaded items before you submit. Please note that if documents are missing or information is incorrect this will cause a delay in processing your return. SAVE YOUR PROGRESS BY SCROLLING TO THE BOTTOM OF THE SCREEN AND CLICK "SAVE". YOU WILL RECEIVE A LINK IN YOUR EMAIL WHICH WILL ALLOW YOU TO CONTINUE. ONCE YOU SUBMIT YOU WILL NOT BE ABLE TO ADD OR DELETE INFORMATION.

This intake form will take 20- 30 minutes to complete.

Please complete this form in its ENTIRETY and click SUBMIT when finished. Input N/A (Not Applicable) for items not pertaining to you.

Please wait until you have ALL documents before submitting this form. INCOMPLETE FORMS WILL NOT BE FILED UNTIL ALL CURRENT AND VALID DOCUMENTS HAVE BEEN PROVIDED. Note: If you are claiming any dependents, be sure to upload their SS CARDS, BIRTH CERTIFICATES, and all items that show their address is the same as yours. (e.g. school records, medical records, doctor bills, Medicaid Statement, Daycare and/or Dependent Care Records, Social Services Records, and anything that shows your dependents name and current address).
ATTENTION!

PLEASE READ THROUGH THIS FORM IN ITS ENTIRETY.

DO NOT SUBMIT THIS FORM UNTIL YOU HAVE ALL SUPPORTING DOCUMENTS.

BY NOT FOLLOWING DIRECTIONS YOUR INTAKE FORM WILL NOT BE PROCESSED.

BE SURE ALL SUPPORTING DOCUMENTS ARE VALID AND CURRENT.

BE SURE LEASE AND OTHER FORMS HAVE THE DEPENDENTS NAME ON THEM IF APPLICABLE.

LASTLY PLEASE ENSURE THAT ALL UPLOADED IMAGES/ PHOTOS, NUMBERS, AND DATES ARE VISIBLE AND CLEAR TO ENSURE ACCURACY
How did you hear about us?
Name of person who referred you
First Time Client with Perkins Tax Services? Please upload your previous year’s tax return (If you can not get a physical copy from your previous tax provider you can obtain it by logging into your account on www.irs.gov).

Cancelof
IF YOU ARE FILING MULTIPLE YEARS YOU MUST COMPLETE A SEPARATE FORM FOR EACH YEAR.
Which Tax Year Are You Filing For?
Will this be an amended (corrected) return?*

YesNo
Are you interested in a tax advance loan?*

YesNo

INCOME
Upload W2 statements (Stand directly over the item on a flat surface and zoom in for a clear shot.)

Cancelof
1099 NEC & Independent Contractors (Stand directly over the item on a flat surface and zoom in for a clear shot.)

Cancelof
Did you receive unemployment during the year?
Upload other Misc. Income Documents such as 1099 INT, 1099 DIV, 1099 MISC. (Stand directly over the item on a flat surface and zoom in for a clear shot.)

Cancelof

CURRENT LIVING SITUATION
Do you receive Subsidized Housing or Section 8?
Do you receive any Government Assistance Programs such as Food stamps, TANF, Medicaid, or Medicare in during the year?
HOME OWNERS!!!! Upload your 1098 Mortgage Interest Statement Here. (Stand directly over the item on a flat surface and zoom in for a clear shot.)

Cancelof
Was your insurance through the Affordable Care Act (The Marketplace), current employer, or state?*

The MarketplaceEmployerStateNo insurance
Do you have 1095A, 1095B, or 1095C form?

YesNo
PLEASE UPLOAD YOUR 1095 Form IF APPLICABLE (Stand directly over the item on a flat surface and zoom in for a clear shot.)

Cancelof
Did you or a dependent in your household attend college for the selected tax year?*
What was the Name of the person who attended college?
How many years has this person been in college?
How many times has the AOTC education credit been claimed for this student?
How many years has this person been in college?
What was the name of the college they attended and degree program?
COLLEGE STUDENT?!?!?!?! Form 1098-T (School Credit) *Please upload all school related expenses such as parking permits, tuition breakdown, breakdown lab fees, etc.. This information can be found in the student portal.

Cancelof

ACKNOWLEDGMENT & SIGNATURE
Are you interested in Audit Protection? (Mandatory For ALL Schedule C'S)
Are you interested in Credit Repair?
Are you interested in tax planning for next year?

YesNo
Are you interested in our travel agency services?

YesNo
STOP!

Did you finish uploading your documents?

IF YOU DID NOT UPLOAD ALL NECESSARY DOCUMENTS YOUR INTAKE FORM WILL

BE CONSIDERED INCOMPLETE AND THE PROCESSING OF YOUR RETURN DELAYED.

CLIENT NON-PAYMENT/OFFSET CLAUSE

Here at Perkins Tax Services, we strive to assist all our clients in their tax needs, however, we understand that situations do arise. If your refund is offset by the IRS, student loans, child support or your check is mailed, you are still obligated to pay our company the fees associated with filing your tax return.
By signing this agreement, you acknowledge that if payment is not made in full within 30 days legal actions will be sought to resolve payment.
How would you like you refund disbursed if receiving on?

Direct DepositCheckBy MailN/A
Name of Bank
Routing Number
Bank Account Number
Please upload voided check

Cancelof
I am giving Perkins Tax Services permission to prepare all forms related to my tax return. To apply for and secure RAC's and RAL's on my behalf, sign all necessary forms and file my taxes electronically. I take full responsibility for the accuracy of this form and understand that Perkins Tax Services and/or associated affiliates hold no responsibility for any misrepresentation or false claims.
Primary Taxpayer's Signature*

Clear
Spouse’s Signature (If applicable)

Clear
Date

MonthDayYear
Date
BEFORE YOU SUBMIT GO BACK AND REVIEW

Make sure you have uploaded current and valid documents. If we find that you are missing documents or documents are not valid, we will place your return on hold and WILL NOT EFILE until we receive the proper documents.

Due Diligence Notice:

At Perkins Tax Services we strive for 100% Compliance with all IRS Requirments. Certain tax benefits, such as the earned income tax credit (EITC), child tax credit (CTC), including additional child tax credit (ACTC), credit for other dependents (ODC), American opportunity tax credit (AOTC) and/or the head of household (HOH) filing status, as defined by IRS Section IRC 6695(g) require a certain level of Due Diligence on our part and our clients. For this reason we may request certain forms of proof and ask questions so we can better understand how to dictate to the IRS your elegibility for the credits you rightfully deserve. If you have any questions/concerns about this process we are only a phone call away. Thank you in advance for assisting in the process.
Should be Empty: