FAST FINANCIAL FIRM INTAKE FORM

TAX CLIENT INTAKE FORM
* PLEASE ENTER ALL INFORMATION ACCURATELY SO THAT WE MAY COMPLETE AN ACCURATE TAX QUOTE FOR YOU.
HOW DID YOU HEAR ABOUT US?*
REFERRING CLIENTS NAME*
FAST FINANCIAL FIRM TAX SPECIALIST YOU HAVE PREVIOUSLY SPOKE WITH?*
Please select from the dropdown list
ARE YOU A PREVIOUS CLIENT OF FAST FINANCIAL FIRM?*
Please select from the dropdown list
TAXPAYER INFORMATION
TAXPAYER NAME*

First NameLast Name
EMAIL ADDRESS*
example@example.com
TAXPAYER ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
TAXPAYER PHONE NUMBER*
Please enter a valid phone number.
CELL PHONE COMPANY*
Please select from the dropdown list
SECONDARY PHONE NUMBER*
Please enter a valid phone number.
TAXPAYER BIRTHDATE*

MonthDayYear
Date
TAXPAYER SOCIAL SECURITY #*
TAXPAYER DRIVERS LICENSE OR ID #*
ISSUING STATE OF LICENSE OR ID*
DATE LICENSE OR ID ISSUED *

MonthDayYear
Date
LICENSE OR ID EXPIRATION DATE*

MonthDayYear
Date
TAXPAYER OCCUPATION *
WHAT FILING STATUS WAS USED ON YOUR 2023 TAX RETURN? *
(If unknown, select unknown)
IF HAVE A PERSONAL IDENTITY PROTECTION PIN (IP PIN) PLEASE LIST IT HERE
PINS for other Spouses or Dependents may be listed later in this form
ARE YOU OR YOUR SPOUSE A BUSINESS OWNER (SELF-EMPLOYMENT)?*
If yes, you will have the opportunity to upload supporting business documents at end of this form (profit & loss, income statements, expense statements, registrations, etc)
DID YOU OR YOUR SPOUSE PURCHASE HEALTH INSURANCE THROUGH THE HEALTHCARE MARKETPLACE (OBAMACARE)?*
If yes, uplaod 1095-A
ARE YOU MARRIED OR FILING WITH A SPOUSE?*
SPOUSE INFORMATION

Please enter your spouses information
SPOUSE INFORMATION (leave blank if no Spouse)*

First NameLast Name
SPOUSE EMAIL*
example@example.com
SPOUSE ADDRESS (IF DIFFERENT THAN PRIMARY TAXPAYER)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
SPOUSE PHONE NUMBER*
Please enter a valid phone number.
SPOUSE CELL PHONE COMPANY*
Please select from the dropdown list
SPOUSE SOCIAL SECURITY #*
SPOUSE BIRTHDATE*

MonthDayYear
Date
SPOUSE DRIVERS LICENSE OR ID #*
ISSUING STATE OF LICENSE OR ID*
DATE LICENSE OR ID ISSUED *

MonthDayYear
Date
LICENSE OR ID EXPIRATION DATE*

MonthDayYear
Date
SPOUSE OCCUPATION *
IF SPOUSE HAS AN IDENTITY PROTECTION PIN (IP PIN) LIST IT HERE
DEPENDENT INFORMATION
HOW MANY DEPENDENTS DO YOU HAVE?*
ARE YOU BANNED FROM CLAIMING EARNED INCOME CREDIT?*
WERE ANY CREDITS DISALLOWED OR REDUCED IN A PREVIOUS TAX YEAR?*
ARE ANY OF THE DEPENDENTS DISABLED?*
IF YES, WHAT IS THE NATURE OF THE DISABILITY?
Be sure to upload supporting documents
DO YOU HAVE SUPPORTING DOCUMENTS TO PROVE YOUR RELATIONSHIP TO ALL DEPENDENTS? (BIRTH CERTIFICATE, SOCIAL SECURITY CARD, SCHOOL DOC, ETC)*
Be sure to upload documents
IN CASE OF AN AUDIT CAN YOU PROVE RESIDENCY AND RESPONSIBILITY FOR THE DEPENDENTS BEING CLAIMED?*
Be sure to upload documents
DID YOU PAY FOR CHILD OR DEPENDENT CARE TO ATTEND WORK OR WHILE LOOKING FOR WORK?*
Please discuss what supporting documents are needed with your preparer
DEPENDENT 1 DETAILS
DEPENDENT #1*

First NameLast Name
DEPENDENT #1 BIRTHDATE*

MonthDayYear
Date
DEPENDENT #1 SOCIAL SECURITY #*
Social Security
RELATIONSHIP TO TAXPAYER*
Can DEPENDENT #1 be claimed by anyone else?*
Did the dependent live in your home for 6 months or more in the past year?*
DEPENDENT #1 IDENTITY PROTECTION PIN (leave blank if none)
Enter Identity Protection PIN if dependent has one
DEPENDENT 2 DETAILS
DEPENDENT #2*

First NameLast Name
DEPENDENT #2 BIRTHDATE*

MonthDayYear
Date
DEPENDENT #2 SOCIAL SECURITY #*
Social Security
RELATIONSHIP TO TAXPAYER*
Can DEPENDENT #2 be claimed by anyone else?*
Did the dependent live in your home for 6 months or more in the past year?*
DEPENDENT #2 IDENTITY PROTECTION PIN (leave blank if none)
Enter Identity Protection PIN if dependent has one
DEPENDENT 3 DETAILS
DEPENDENT #3*

First NameLast Name
DEPENDENT #3 BIRTHDATE*

MonthDayYear
Date
DEPENDENT #3 SOCIAL SECURITY #*
Social Security
RELATIONSHIP TO TAXPAYER*
Can DEPENDENT #3 be claimed by anyone else?*
Did the dependent live in your home for 6 months or more in the past year?*
DEPENDENT #3 IDENTITY PROTECTION PIN (leave blank if none)
Enter Identity Protection PIN if dependent has one
DEPENDENT 4 DETAILS
DEPENDENT #4*

First NameLast Name
DEPENDENT #4 BIRTHDATE*

MonthDayYear
Date
DEPENDENT #4 SOCIAL SECURITY #*
Social Security
RELATIONSHIP TO TAXPAYER*
Can DEPENDENT #4 be claimed by anyone else?*
Did the dependent live in your home for 6 months or more in the past year?*
DEPENDENT #4 IDENTITY PROTECTION PIN (leave blank if none)
Enter Identity Protection PIN if dependent has one
DEPENDENT 5 DETAILS
DEPENDENT #5*

First NameLast Name
DEPENDENT #5 BIRTHDATE*

MonthDayYear
Date
DEPENDENT #5 SOCIAL SECURITY #*
Social Security
RELATIONSHIP TO TAXPAYER*
Can DEPENDENT #5 be claimed by anyone else?*
Did the dependent live in your home for 6 months or more in the past year?*
DEPENDENT #5 IDENTITY PROTECTION PIN (leave blank if none)
Enter Identity Protection PIN if dependent has one
BANKING INFORMATION
Would you like to apply for a Refund Advance Loan*
Refund Advances are subject to bank approval.
How would you like to receive your refund?*
Bank Name*
Type of Account*
Account Number*
Routing Number*
TAXPAYER AGREES THAT IF HE/SHE OWES ANY TAXES, PRIOR OBLIGATIONS, OR BACK TAXES (OFFSETS), ALL FEES WILL HAVE TO BE PAID UPFRONT BEFORE THE RETURN IS FILED*
DID YOU OR YOUR SPOUSE RECEIVE UNEMPLOYMENT DURING 2024?*
Upload 1099-G
BUSINESS INFORMATION
AS A BUSINESS OWNER ARE YOU LOOKING TO GROW YOUR BUSINESS THIS YEAR?*
Let us help you grow your business this year
ARE YOU INTERESTED IN STARTING YOUR OWN BUSINESS THIS YEAR?*
STUDENT INFORMATION
DID YOU, YOUR SPOUSE, OR ANY DEPENDENT ATTEND ANY POST-SECONDARY EDUCATION? (COLLEGE, TRADE SCHOOL, ETC)*
If yes, upload form 1098-T
SUPPORTING DOCUMENTS UPLOAD
IDENTITY DOCUMENTS
DRIVERS LICENSE/STATE ID, SOCIAL SECURITY CARDS, BIRTH CERTIFICATES, etc

Please upload all relevant documents
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PRIMARY INCOME DOCUMENTS
W2, 1099(S), and/or INCOME AND EXPENSE DOCUMENTS FOR SELF-EMPLOYED*

Discuss Self Employment verification with your tax preparer
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ADDITIONAL INCOME DOCUMENTS
1098-T, CHILD CARE FORMS, ANY OTHER GOVERNMENT DOCUMENTS TO SUPPORT THE ADVANCED CHILD TAX CREDIT, ECONOMIC IMPACT PAYMENTS*

Please upload all documents related to other income you may have
Cancelof
VERIFICATION DOCUMENTS
LEASE, SCHOOL RECORDS, VACCINATION CARDS, AWARD LETTERS FROM GOV ASSISTANCE (PROOF OF RESIDENCY, HOH, AND DEPENDENT CARE)*

Please upload all relevant documents
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{name}

{name19}

{address}

By signing below, I hereby certify the information provided above is true and accurate to the best of my knowledge. As the taxpayer, I have been informed that claiming a dependent for EITC/CTC/AOTC/HOH or any other credits or deductions that i am not legally eligible for can result in audit, fines, and other consequences if the information provided is incorrect and/or fraudulent.

Direct Deposit Banking information belongs to the firm.

Your personal banking information is hidden in the system.

I give consent to have my taxes electronically filed i with the information i provided and i attest that it is accurate to the best of my knowledge.
Signature*

Clear
TODAYS DATE

MonthDayYear
***Thank you for your submission. Our office will be in contact with you as soon as possible but no later than 24hrs from now. Thank you for the opportunity to earn your business it is greatly appreciated.
Should be Empty:

TAX CLIENT INTAKE FORM

TAXPAYER INFORMATION

SPOUSE INFORMATION

DEPENDENT INFORMATION

DEPENDENT 1 DETAILS

DEPENDENT 2 DETAILS

DEPENDENT 3 DETAILS

DEPENDENT 4 DETAILS

DEPENDENT 5 DETAILS

BANKING INFORMATION

BUSINESS INFORMATION

STUDENT INFORMATION

SUPPORTING DOCUMENTS UPLOAD

IDENTITY DOCUMENTS

PRIMARY INCOME DOCUMENTS

ADDITIONAL INCOME DOCUMENTS

VERIFICATION DOCUMENTS

{name}

{name19}

Direct Deposit Banking information belongs to the firm.

Your personal banking information is hidden in the system.

I give consent to have my taxes electronically filed i with the information i provided and i attest that it is accurate to the best of my knowledge.