Tax Preparation Client Intake Form

Tax Preparation Client Intake Form

Tax Preparation Client Intake Form
Filing Status

SingleHead of HouseholdMarried Filing SeparateMarried Filing JointQualifying Widower

Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Bank Routing And Account Number
Please make sure bank info is correct this is where your refund will be deposited.
Email
example@example.com
SSN #
Occupation
IRS IP PIN
If applicable
Are you a full-time student?

YesNo

Enter your dependents here

Rows	Name	Date of Birth	Relationship
1
2
3
4
5
6

Dependents SSN#
If applicable

Employment Status

EmployedUnemployedSelf-employed
File Upload

ID Front & Back
Cancelof
File Upload

W-2 , 1099-Misc/1099-Nec ,Self Employment expenses,Health Insurance  Marketplace/1095A (very important if had)
Cancelof

•By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Taxpayer Signature
Should be Empty: