Legacy Financial 2024 Tax Intake Form

Legacy Financial Tax Client Intake Form 2024

YOUR GATEWAY TO FINANCIAL
Thank you for taking the time to complete your client intake form. If you are a new client, this information is important for us to file an accurate and maximized tax return. If you are a returning client, LEGACY FINANCIAL requests that you provide this information again to ensure our records are 100% accurate and up to date.

This questionnaire will take you up to 30 minutes to complete. Please take the time to organize your tax documents prior to completetion of this form.

IMPORTANT: UPON COMPLETION OF ALL APPLICABLE PARTS OF THIS FORM YOU MUST CLICK THE "SUBMIT" BUTTON AT THE BOTTOM OF THE FORM TO SEND THIS INFO TO OUR OFFICE. CLOSING YOUR BROWSER BEFORE CLICKING THE "SUBMIT" BUTTON WILL DELETE ALL INFO WITHOUT SENDING TO US. UPON CLICKING THE SUBMIT BUTTON YOU WILL GET A CONFIRMATION EMAIL THAT WE RECEIVED YOUR INFO!

THANK YOU FOR BEING A LEGACY FINANCIAL CLIENT !
TAXPAYER / SPOUSE PERSONAL INFORMATION
Please Note:

Head of Household can ONLY be claimed by taxpayers with a Qualified Dependent AND who are:

Single and paying more than ½ (50%) cost of keeping up a home OR

Married but did not live with your spouse AT ANY TIME in the last 6 months of the year OR

Divorced or LEGALLY seperated (Attach copy of Decree or Separation Agreement)
Taxpayer Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Taxpayer SSN*
Taxpayer filing status
Taxpayer Date of Birth*

MonthDayYear
Date
Taxpayer Email*
example@example.com
Taxpayer Phone Number*
Please enter a valid phone number.
Did the taxpayer work in 2024?
What is your occupation? (job title)
EmployedSelf EmployedRetiredActive Military, National Guard, ReservedCollege StudentUnemployedOther
Do you need to file previous years tax return? If YES, please enter the year(s).
Were you previously issued an identity protection pin (IP PIN) by the IRS? If YES, provide the number. (Your TAX RETURN will REJECT without this number)
How did you hear about Legacy Financial? (Facebook, Instagram, TikTok, Threads) If you were referred please enter the person name who referred you.
Would you like to see if you PREQUALIFY for a SAME DAY ADVANCE UP TO $7,000 (ends 2/28/25)
Spouse Full Name

First NameLast Name
Spouse Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Spouse SSN
Date

MonthDayYear
Date
Spouse Email
example@example.com
Were you previously issued an identity protection pin (IP PIN) by the IRS? If YES, provide the number. (Your TAX RETURN will REJECT without this number)
Did your spouse work in 2024?
What is your occupation? (job title)
EmployedSelf EmployedRetiredActive Military, National Guard, ReservedCollege StudentUnemployedOther
Are there any offsets that LEGACY FINANCIAL needs to be mindful of for the taxpayer/spouse? These could include obligations like child support, IRS or state taxes, student loans, etc. If uncertain, please contact 1-800-304-3107 and provide the details as outlined below. Alternatively, you can indicate in the box if you would prefer LEGACY FINANCIAL to make the call on your behalf.*
If you have any offsets, please provide details along with the amount owed. If you don't have any offsets, please write N/A. (Please be honest about offsets, as LEGACY FINANCIAL will eventually discover any offsets when it's time for your return to be funded. If the offset takes your entire refund, you will receive an invoice for preparation fees. Failure to pay these fees will result in LEGACY FINANCIAL reporting the debt to collections, which will appear on your credit report, and legal action will be pursued to collect the debt.)*
Did you, your spouse, or any dependents attend college in 2024?
Did you or your spouse receive unemployment benefits in 2024?
Did you or your spouse withdraw money from 401k in 2024?
Did you make any charitable contributions in 2024?
Did you or your spouse receive government assistance in 2024? (i.e. SNAP(food stamps), Medicaid or Section 8 Housing assistance)?
Do you rent or own your current residence?
Do you plan to purchase a home within the next one or two years?
Did you or your spouse receive social security benefits in 2024?
Do you or your spouse own a rental property?
Can you provide a copy of your filed 2023 tax return?*
Credit RepairBusiness CreditLife Insurance (Quote Upon Filing)Budgeting & Savings ConsultationBusiness Formation ServicesTravel Agent (Looking to go on a cruise or planning a vacay)Childcare ServicesGraphic Design (Small Businesses looking for branding services, website designs, flyers, etc)Bookkeeping (Quote Upon Filing)Louisiana Realtor & MLOTexas Realtor & MLOLooking for an apartmentNeed a Car
Dependent Information

Relationship / Support / Residency

Children & Others if this does not apply put N/A on Dependent 1 Section and move on to the next question*

Rows	Full Name (First & Last Name)	Relationship	Date of Birth	Social Security Numbers	How many months has the dependent(s) lived with you?	Is the dependent(s) disabled? If YES, Do you receive SSI / disability income? Provide amount	Did you claim Dependent(s) on your 2022 Tax return?	Does the dependent have an ID Protection Pin? If Yes, provide number	Is the dependent adopted? if not your biological child	Provide reason why dependent(s) resides with you if not biological child
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5
Dependent 6
Dependent 7

School RecordsMedical RecordsBirth Certificate(s)Shot Record(s)Legal DocumentsN/A
SELF EMPLOYMENT / BUSINESS INCOME SECTION ONLY
SOLE PROPRIETORSHIPLLCS CORPC CORPPARTNERSHIPNON PROFITN/A
Business Name (if you don’t have one leave blank)
Please provide a detailed description of your business or the purpose of your business. If you are a 1099 contractor, include the type of work you perform (e.g., Uber, DoorDash, paid cash for work). If this does not apply to you, write N/A.*
YESNO
CASHBUSINESS BANK ACCOUNTPERSONAL BANK ACCOUNTTHIRD PARTY (CASHAPP, ZELLE, PAYPAL, ETC)
YESNO
I understand
REFUND OPTIONS
Would you like your tax refund direct deposited into your bank account? If so, please complete bank information below:*
Name of Bank*
Please upload a screenshot of your routing and account number *

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Please double check your account information for accuracy

*LEGACY FINANCIAL* is not responsible for IRS delays due to inaccurate information*
UPLOAD IRS REQUIRED DOCUMENTS
Taxpayer / Spouse Income Documents
Taxpayer / Spouse W2, 1099, etc) *

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Self Employed 1099 NEC / 1099 K / 1099 MISC

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Taxpayer / Spouse verification
Upload Taxpayer / Spouse Identification (Valid Photo ID or Passport)*

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Upload Taxpayer / Spouse Social Security Card

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Head of Household: (Utility bill, lease, rent statement, separation agreement)

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Single: (Mail with current address or any type of bill with address)

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Married Filing Jointly / Separate: (Marriage Certificate)

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Qualified Widower: (Death Certificate)

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Taxpayer Dependent Verification:
Upload Dependent(s) Social Security Card(s)

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Taxpayer Dependent Relationship Verification:
Upload Dependent(s) Birth Certificate(s)

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Taxpayer Dependent Residency Verification:
Upload Dependent(s) School, Medical, or Shot Records

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Taxpayer Previous Tax Year Return Here. Also, If you need to file back taxes upload here.
Upload Here

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Additional Documents. (Please upload if available)
Child and Dependent Care Expense (Daycare Receipt)

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Education Expense ( College 1098T form)

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If you or your spouse or dependents receive health insurance through the Marketplace in 2024 please upload 1095-A. If unsure call 1-800-318-259 6 and say I am trying to file my taxes. I need someone to read my 1095-A form to me and include my policy number. Be sure to ask for and write down the following lines for each month (January–December) 33A, 33B, and 33C.

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1099 G if received unemployment benefits in 2024

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1099-r IRA (Individual Retirement), Dividend Income, Partnership Trust, Estate Income, Pension / Annuity Income

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Medical / Dental Expense

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1098-INT Mortgage Interest Form

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Upload ALL supporting documents for your business (i.e. Business Structure (LLC, DBA, Sole Proprietor,etc.) Bank Statements, Receipts, log sheets. etc

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Upload Form W-2G from gambling winnings for all person(s) who have any gambling winnings in 2024.

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Any Additional Documents (Previous Year Tax Return, IRS Letters, Etc.)

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DUE DILIGENCE QUESTIONNAIRE
The child(ren) for whom the tax credit(s) will be requested lived with me / us for the year, except for temporary absences *
I / We certify that the child(ren) for whom the tax credit(s) will be requested can be claimed as my / our dependent(s), as per the information provided at the end of this questionnaire. *
I am the custodial parent of the child(ren) for whom the tax credit(s) will be requested, and I released the dependency deduction to my former spouse for 2024 by signing Form 8832 (release / Revocation of Claim to Exemption for Child by Custodial Parent) *
I am not the custodial parent of the child(ren) but I have been given a signed Form 8832 by my former spouse, the custodial parent, allowing me to claim the child(ren) as the dependent(s) on my 2024 tax returns (you must give me the Form 8832)*
I / we, or my child(ren) have documentation to substantiate the credit(s) being claimed, such as Form 1098-T, bills, statements, and receipts for college tuition, fees, and book and material costs (you are responsible for keeping this documentation and providing it to the IRS if you are audited or questioned)*
Was a Child Tax Credit, Additional Child Tax Credit, or American Opportunity Credit claimed by you disallowed or reduced by the IRS on a past tax return?*
I claim I am unmarried or separated, support a qualifying person as your dependent, and pay more than half the cost of maintaining your household*
I, hereby swear and affirm under penalties of perjury the following:
To the best of my knowledge the information enclosed in this client tax questionnaire is correct and includes all income, deductions, and other information necessary for the preparation of this year's income tax returns for which I have adequate records
- I earned the following income during the tax year ending December 31, 2024.
- I acknowledge that My Tax Preparer have informed me that I am required to report all income I received during the tax year from all sources.
- I acknowledge that My Tax Preparer have informed me that it is unlawful to overstate my income to receive a large refund.
- I acknowledge that My Tax Preparer, have explained to me in detail the rules regarding Earned Income Tax Credits and the reporting of self-employment income and based on my understanding of those rules I qualify for the Earned Income Tax Credit
- I understand that I will be signing my income tax return under penalties of perjury and all items included on the return are true and correct.
- I acknowledge that My Tax Preparer have advised me of my duty to keep complete and accurate records supporting the source and amount of my income and the legitimacy of any deduction or credit I claim on my tax return.
- Furthermore, I understand that knowingly providing false information on my tax return and reporting it to the IRS, that I am taking part in a potentially criminal penalty situation and is punishable by law including but not limited to: facing court dates, restitution, and possible imprisonment. I waive LEGACY FINANCIAL and the preparer of any error due to incorrect information provided by me.
Taxpayer Signature*

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Spouse Signature (If Applicable)

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Date*

MonthDayYear
Date
Engagement Letter
Our Responsibilities:

Legacy Financial will prepare your tax return based on the information you provide. While we may ask for clarification, we do not audit or verify your data. We will ensure you receive all credits and deductions you are legally entitled to.

Your Responsibilities:

You are responsible for:

• Providing complete and accurate information in a timely manner.

• Retaining supporting documents for income and deductions.

• Reviewing and approving your tax return before signing.

• Avoiding fraudulent activities.

This agreement outlines the terms and conditions for tax preparation services provided by Legacy Financial. By engaging our services, you acknowledge and agree to the following terms:

Fees and Payment
I get paid when you get paid! Tax preparation fees are due when your tax return is funded.

Amendments, prior year filings, & non-funded returns require upfront payment.

Tax Preparation Fees

Individual Returns:

Married Filing Jointly (MFJ): Starts at $450 (includes up to 2 W-2s; $25 per additional W-2).

Married Filing Separately (MFS): Starts at $500 (due to additional complexities in filing separately).

Simple Tax Returns (Single, HOH, Qualifying Widow): Start at $450 (includes up to 2 W-2s; $25 per additional W-2).

Self-Employment & Business Returns:

Self-Employment (Schedule C): Starts at $650 (includes one business).If I need to reconstruct income & expenses, additional pricing starts at $100, depending on complexity.

1099-NEC:If it's tied to your business, it's included in the $650 self-employment fee. If it's separate from your business, there is an additional $30 charge.

Additional Fees:

Additional fees apply for extra forms/services. You'll always receive pricing details upfront.

Audit Protection: Available for $89.95 (not included in prep fees).

Rush Fee: An additional $50-$100 may apply for last-minute filings (within 48 hours of the deadline).

Bank Processing Fee: If you opt for refund transfer (deducting my fees from your refund), third-party bank fees may apply.

Amendment Pricing

For returns I originally filed:
My error/omission: FREE
Client error/omission: $99

For returns I DID NOT file (With Return in Hand):
Simple add-on (W-2, 1099, etc.): $99
810 code for fraud/misuse: $500 until April 15th (pricing negotiable after that).

Without Prior Return in Hand:
Simple W-2 add-on, 1099, etc.: $199
810 code for fraud/misuse: $500 until April 15th (pricing negotiable after that).

Unfunded Returns (If You Owe Taxes)
If you owe, your prep fee will be 50% of the original fee.(Example: If your prep fee is $450, and you owe, your new prep fee is $225.)

If you choose not to file for ANY REASON AFTER I’ve entered your information, there is a minimum prep fee of $150 that must be paid UPFRONT.

ACH Authorization:

I authorize Legacy Financial to debit my bank account for payment of tax preparation services. If my tax refund is not funded and/or I decide not to proceed with Legacy Financial I understand that I have within 30 days to make payment for services rendered. I agree to pay the full amount directly.

By signing below, you acknowledge that you have read, understood, and agree to the terms outlined above.

Thank you for choosing Legacy Financial. We look forward to serving you.
Spouse Signature (If Applicable)

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Taxpayer Signature*

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Date

MonthDayYear
Date
Should be Empty:

Legacy Financial Tax Client Intake Form 2024

TAXPAYER / SPOUSE PERSONAL INFORMATION

Dependent Information

SELF EMPLOYMENT / BUSINESS INCOME SECTION ONLY

REFUND OPTIONS

UPLOAD IRS REQUIRED DOCUMENTS

DUE DILIGENCE QUESTIONNAIRE

Engagement Letter