Client Intake Form

CLIENT INTAKE
Thank You for taking the time to complete your Client Intake Form. This information is critical to ensure your tax return is filed accurately. Please take your time and review all information before you submit. Please note that if documents are missing or information is incorrect this will result in a delay in processing your return.
Who will file your tax return?
How did you hear about us?
If someone referred you, please type his or her name here.
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
- Taxpayer's Name*
  
  First NameLast Name
- Taxpayer Social Security Number*
- Taxpayer's Date of Birth*
  
  MonthDayYear
  Date
- Taxpayer's Job Title
- Taxpayer's Phone Number*
  Please enter a valid phone number.
- TaxpayerHome Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Taxpayer's Email Address*
  example@example.com
- Taxpayer Occupation*
- Check all that apply:*
  
  Can you be claimed as a dependent on someone else's return.Were you over age 18 and a full-time student at an eligible educational institution..Taxpayer is blind.Taxpayer is deceased.Taxpayer or Spouse served in a combat zone during the current tax year.Taxpayer wishes to elect to use their 2019 earned income to figure their 2021 earnedincome credit and/or child tax credit.Taxpayer or Spouse was affected by a natural disaster during the current tax year.Taxpayer has received, sold, sent, exchanged, or otherwise acquired financial interest in virtual currency during the current tax year.Taxpayer prefers to receive written communications from the IRS in a language otherthan English.Taxpayer prefers to receive written communications from the IRS in an accessibleformat.
- What is your marital status as of December 31st?*
  
  SingleMarriedDivorcedSeparatedSurviving Spouse
- Spouse Name
  
  First NameLast Name
- Spouse Date of Birth
  
  MonthDayYear
  Date
- Spouse Occupation
- Spouse Phone Number
  Please enter a valid phone number.
- Spouse Home Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Spouse Email Address
  example@example.com
- Check all that apply:*
  
  Can you be claimed as a dependent on someone else's return.Were you over age 18 and a full-time student at an eligible educational institution..Taxpayer is blind.Taxpayer is deceased.Taxpayer or Spouse served in a combat zone during the current tax year.Taxpayer wishes to elect to use their 2019 earned income to figure their 2021 earnedincome credit and/or child tax credit.Taxpayer or Spouse was affected by a natural disaster during the current tax year.Taxpayer has received, sold, sent, exchanged, or otherwise acquired financial interest in virtual currency during the current tax year.Taxpayer prefers to receive written communications from the IRS in a language otherthan English.Taxpayer prefers to receive written communications from the IRS in an accessibleformat.
- Upload Taxpayer's Driver's License/ State ID (Stand directly over the item on a flat surface and zoom in for a clear shot)*
  
  Cancelof
- Upload Taxpayer's Social Security Card (Stand directly over the item on a flat surface and zoom in for a clear shot)*
  
  Cancelof
- Dependent (1) Name*
  
  First NameLast Name
- Dependent (1) Social Security Number*
- Dependent (1)* Date of Birth*
  
  MonthDayYear
  Date
- Upload Dependent (1) Social Security Card
  
  Cancelof
- Upload Dependent (1) Birth Certificate, or the following: School Records, Lease, Shot Records, Govt Asst Award Letters
  
  Cancelof
- Dependent (2) Name*
  
  First NameLast Name
- Dependent (2) Social Security Number*
- Dependent (2) Date of Birth*
  
  MonthDayYear
  Date
- Upload Dependent (2) Social Security Card
  
  Cancelof
- Upload Dependent (2) Birth Certificate, or the following: School Records, Lease, Shot Records, Govt Asst Award Letters
  
  Cancelof
- Dependent (3) Name*
  
  First NameLast Name
- Dependent (3) Social Security Number*
- Dependent (3) Date of Birth*
  
  MonthDayYear
  Date
- Upload Dependent (3) Social Security Card
  
  Cancelof
- Upload Dependent (3) Birth Certificate, or the following: School Records, Lease, Shot Records, Govt Asst Award Letters
  
  Cancelof
- Were you previously issues an Identity Protection Pin (IPPIN) by the IRS?
- IPPIN IDENTITY THEFT IF (APPLICABLE) (Stand directly over the item on a flat surface and zoom in for a clear shot.)
  
  Cancelof
- DID YOU RECEIVED HEALTH COVERAGE (INSURANCE) THROUGH YOUR STATE MARKETPLACE OR HEALTHCARE.GOV? IF SO, PLEASE UPLOAD YOUR FORM 1095A
  
  Please upload 1095A
  Cancelof
- Do you have a "Special Needs" child?*
  
  YesNo
- Can someone else claim you as a dependent?*
- What is the Name of person that can claim you?
- What is your relationship to that person? (I.e. Mother, Father, etc.)
- How much support did they provide for you?
- Do you owe the IRS, Child Support or in default with student loans?*
- Have you ever been disallowed for EITC/AOTC/CTC/ACTC?*
- Are you self employed?*
- Did you buy or trade Crypto Currency? (Bitcoin)
- Which currency did you buy or trade?
- How much currency did you buy or trade?
- Do you have gambling winnings for the year?
- Where are your winnings from?
- How much did you win?
- Upload W2-G Section
  
  Cancelof
- Did you make any charitable contributions during the year?
- Who did you make charitable contributions to?
- How much did you contribute?
- Did you withdraw from your 401K during the year ?
- How much did you withdraw?
- How much Federal taxes were withheld?
- Upload W2 statements (Stand directly over the item on a flat surface and zoom in for a clear shot.)
  
  Cancelof
- Upload 1099 NEC (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 NEC. (Stand directly over the item on a flat surface and zoom in for a clear shot.)
  
  Cancelof
- 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?
- Which program(s) did you receive?
- How much did you receive from the program(s).
- Do you have a 1098 Mortgage Interest Statement?
- 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-A Form IF APPLICABLE (Stand directly over the item on a flat surface and zoom in for a clear shot.)
  
  Cancelof
- Did anyone in your household attend college for the selected tax year?*
- What was the Name of the person who attended college?
- What was the name of the college they attended?
- Form 1098-T (School Credit) Stand directly over the item on a flat surface and zoom in for a clear shot.
  
  Cancelof
- What is the name of your business?
- Enter EIN- Employer Identification Number
- Legal Address of Business
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- What is your business email address?
  example@example.com
- What is your business phone number?
  Please enter a valid phone number.
- What is your business entity?
  
  Sole PropriotorLLC - Single MemberLLC - SCropLLC - Multi-MemberC - CropS - CropNonprofit
- How much money did you make from your business?
- Upload Detailed Summary of Expenses (Stand directly over the item on a flat surface and zoom in for a clear shot.)
  
  Cancelof
- Did you receive the ERC Tax Credit?
  
  YesNo
- How much did you receive?
- Please Upload ALL supporting documents associated with your ERC Application and Approval. (Stand directly over item on a flat surface and zoom in for a clear shot.)
  
  Cancelof
- Did you receive the PPP loan?*
- Did you receive the second round of the PPP 2*
- What Was Your Gross Income For the year?
- How long have you owned your business?
- What services do you perform?
- How many clients do you have?
- Do you have a website or is your business on social media?
- If other, please list here.
- What types of items do you need to operate?
- Do you travel for business?
- How do you track of mileage?
- When and where do you have to travel for business?
- Please provide documentation of Business License and Registration if Applicable
  
  Cancelof
- Did you receive payments from a 3rd Party Network such as Cash App, PayPal, or Venmo ?
  
  YesNo
- How much did you receive in payments from a 3rd Party Network? (If over $20,000 please upload your 1099 K form.
- Upload your 1099 K document below. (Stand directly over item on a flat surface and zoom in for a clear shot.)
  
  Cancelof
- Who maintains the business records?
- Do you maintain separate banking accounts for personal and business transactions?
- How do you differentiate between personal and business transactions and monetary assets?
- What form of records were provided?
- Please upload supporting business documents. (ex P&L, 1099 NEC, Summary of Income, Spread sheet with expenses). (Stand directly over item on a flat surface and zoom in for a clear shot.)
  
  Cancelof
- Are you claiming any dependents on your tax return?*
- How many dependents are you claiming?*
- (8812 CTC) Did you receive monthly IRS Advance Tax Credit payments?
- Please Upload IRS Forms 6419 Advanced Child Tax Credit Payment Received for Children (Stand directly over the item on a flat surface and zoom in for a clear shot.)
  
  Cancelof
- Are you interested in Audit Protection? (Mandatory For ALL Schedule C'S)
- Are you interested in Credit Repair?
- STOP!
  
  Did you finish uploading your documents?
  
  IF YOU DID NOT UPLOAD ALL NECESSARY DOCUMENTS YOUR INTAKE FORM WILL BE VOIDED.
- 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
- Primary Taxpayer's Signature*
  
  Clear
- Taxpayer's Signature
  
  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.
  
  BY SUBMITTING THIS FORM, YOU AUTHORIZE US TO PREPARE AND FILE YOUR INCOME TAXES.
- Should be Empty:

CLIENT INTAKE

STOP!

Did you finish uploading your documents?

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

BEFORE YOU SUBMIT GO BACK AND REVIEW