Knowledge Solutions Tax Form

Name*

First NameLast Name
Age
Date of Birth

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
SSN
Your information is encrypted and only used for preparing and filing your tax return.
Are you a full-time student?

YesNo
Dynamic Dropdowns
Are you totally and permanently disabled?

YesNo
Are you legally blind?

YesNo
Is this individual dependent of other?

YesNo

Name

First NameLast Name
Age
Date of Birth

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

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
SSN
Are you a full-time student?

YesNoIf you are a student do you have documentation to prove school status
Are you totally and permanently disabled?

YesNo
Are you legally blind?

YesNo
Is this individual dependent of other?

YesNo

Enter your dependents here

Does you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it?

General Expenses

Rows	Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses
Dependent care

Business Expenses

Rows	Amount
Advertising
Contract Labor/ Wages
Commission and fees
Utilities
Insurance (other than Healthcare)
Office Expenses
Rent or Lease of Equipment
Rent or Lease Of Property
Repairs and Maintenance
Pension and Profit Sharing
Supplies
Taxes and Licenses
Travel
Other Expenses

Tax Preparation Client Intake Form