Tax Preparation Client Form
Intake and Due Diligence
Which tax year are you filing?
*
Please Select
2024
2023
2022
2021
2020
Filing Status
*
Single
Head of Household
Married Filing Separate
Married Filing Joint
Qualifying Widower
Who is your tax preparer?
*
Rolinda Burks
Morgan Johnson
Talia Ransom
Lucretia Williams
Marneshia Berry
Taneisha Woods
Kimberly Clark
Elychia Tuck
LaStarria Clark
Whitney Jones
No preference
Taxpayer Information
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
*
Please enter a valid phone number.
Back-up Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
*
SSN
*
Are you a full-time student?
*
Yes
No
Are you totally and permanently disabled?
*
Yes
No
Are you legally blind?
*
Yes
No
Are you filing a dependent(s)?
*
Yes
No
Spouse Information
Name
First Name
Last Name
Age
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
SSN
Are they a full-time student?
Yes
No
Are they totally and permanently disabled?
Yes
No
Are they legally blind?
Yes
No
Are they your dependent?
Yes
No
If you were referred by someone, please type their name. Otherwise put N/A
*
Dependents
Enter your dependents here
Name
SSN
Date of Birth
Relationship
1
2
3
4
5
6
Does you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it?
Yes/No
Employer
Spouse Ins
Exchange/ Marketplace
Direct with Insurer
Medicare
Medicaid
Taxpayer
Yes
No
Spouse
Yes
No
Dependent 1
Yes
No
Dependent 2
Yes
No
Dependent 3
Yes
No
Dependent 4
Yes
No
Dependent 5
Yes
No
Tax Related Questions
Employment Status
*
Employed
Unemployed
Self-employed
Are you contributing to 401k or other pre-tax account?
Yes
No
Do you or any of your dependents have tuition expenses?
*
Yes
No
Do you have any expenses for child care?
*
Yes
No
Do you have energy star rated improvements to your home?
Windows
Doors
Furnace
Other
Are you currently renting?
Yes
No
Do you have your own home?
Yes
No
Do you have documents that shows you paid for property taxes?
Yes
No
Did you pay your vehicle tax?
Yes
No
Do you have mortgage interest?
Yes
No
Do you have real estate tax?
Yes
No
Did you file a tax return last year?
Yes
No
Are you a victim of identity theft?
Yes
No
Did you receive an identity protection pin?
*
Yes
No
If yes, provide pin
Please upload any documents or files to assist in your tax preparation.
Browse Files
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Taxpayer Expenses
Please fill-up the information for the current tax year only.
General Expenses
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
How would you like to handle your fees?
*
Pay Cash
Take it out of my return
Would you like to apply for an advance loan?
*
yes
no
Do you owe child support, student loans, back taxes, or any other government agency?
*
yes
no
Are you interested in getting more information about life insurance?
*
Yes
No
Are you interested in getting more information on an IUL?
*
Yes
No
Did you experience an unexpected theft or casualty/loss in 2024?
*
Yes
No
Were you the victim of a federal disaster in 2024?
*
Yes
No
How would you like to receive your refund?
*
Direct deposit
Check
Refund Advantage debit card
How would you like to receive your refund?
*
Please Select
Check
Direct Deposit
Refund Advantage Card
If Direct Deposit, input bank information below.
Account Number
Routing Number
Type of account
Checking
Savings
Name of Bank
Would you like to receive a text message concerning your refund or loan arrival??
*
yes
no
Phone Company
Proof of ID
*
Please Select
Drivers License
State Issued ID
Taxpayer's License/State ID Number
*
Taxpayer's State of Issuance
*
Issue Date
*
-
Month
-
Day
Year
Date
Expiration Date
*
-
Month
-
Day
Year
Date
Are you claiming a dependent(s)?
*
yes
no
If yes, what is your relationship to dependent being claimed?
Does the other parent reside with you? if no, please give a small reason.
If any, how much support was given by mother or father last year?
Do you have legal custody?
yes
no
If yes, can you provide documentaton?
yes
no
If no, can you provide letter from mother, father, or legal guardian giving you permission to file dependent?
yes
no
Did the dependent (s) live with you more than 6 months?
yes
no
HOH/ MFJ/ MFS
*This page is for all filing status except single*
Do you provide more than 50% of your household expenses?
yes
no
Do you receive government assistance?
yes
no
Do you have rent or utility bills in your name?
yes
no
Does anyone else provide more than half of the financial assistance to the household?
yes
no
Do you rent or own?
*
rent
own
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MARRIED FILING JOINTLY
*Do not complete if filing status is Single or HOH*
Are you married filing jointly?
yes
no
Do you have legal documentation of your marriage? if yes please upload.
yes
no
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Are you married filing separately?
yes
no
Are you legally separated or going through a divorce?
Separated
Going through a divorce
How long have you been separated?
American Opportunity Tax Credit
*Complete if you received a form 1098t*
If this apply, can you or your dependent prove you were in college?
yes
no
If yes, what proof and/or forms do you have of college enrollment?
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Self Employed & Businesses
*Applies to LLCs, S-Corp and/ or C-Corp*
Do you have a license or EIN?
yes
no
Please upload copies of all licenses and EIN
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Was your expenses related to start-up cost for your business?
yes
no
How long has your business been operating?
Do you have a business checking account?
yes
no
What records are you using to prove your income and expenses?
What kind if expenses did your business incur (i.e. rent, utilities, phone, supplies, maintenance, advertisement, insurance, entertainment, etc.)
Please upload all expenses used for business purposes (i.e. monthly, quarterly, yearly, etc)
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Do you use your home for business? or stand alone?
Home
stand alone
If home, do you use a small room, full home, or other part of home for business operation?
small room
full home
other part of home
Signatures and Uploads
Please verify that you are human
*
Please upload any documents or files to assist in your tax preparation.
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Additional comments
Upload
I confirmed that all information I entered here is accurate and true.
I allow In and Out Tax Service to capture my sensitive data like personal id, government id, social security number (SSN), and other information.
I have read the terms and conditions and privacy policy of In and Out Tax Service.
By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Taxpayer Signature
*
Date Signed
*
-
Month
-
Day
Year
Date
Spouse Signature
Date Signed
-
Month
-
Day
Year
Date
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