2026 Client Intake Form
Name
*
Prefix
First Name
Middle Name
Last Name
Suffix
Are you a new or returning tax client?
*
New
Returning
Are you looking to buy a home this year?
*
Yes
No
Do you have ALL of your tax documents? Keep in mind we will NOT begin working on your file until all documents have been received by our office.
*
Yes
No
Are you Interested in a Refund Advance Up to $7500?
*
Yes
No
Filing Status
*
Single
Married filing jointly
Head of Household
Married filing separately
Primary Taxpayer Full Name
*
Prefix
First Name
Middle Name
Last Name
Suffix
Primary Taxpayer Date of Birth
*
-
Month
-
Day
Year
Date
Primary Taxpayer Social Security Number
*
Please upload Social Security Card
*
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Please upload ID
*
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Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you lived at this address?
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
What is your occupation?
*
Are you required by the IRS to use an Identity PIN? If Yes, Enter PIN
*
Were you married as of December 31, 2025?
Can anyone claim you or your spouse as dependent?
*
Are you claiming any dependents this year?
*
Income
Please put all Income for 2025
Did you receive a W-2, 1099-MISC, 1099-INT, 1099-DIV, 1099-B, 1099-G, or 1099-S or Self employed? Check all that apply.
*
W-2
1099
Self Employed
Other
Please upload W-2 or 1099 or Self Employed documents
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of
Please upload W-2 or 1099 or Self Employed documents
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload W-2 or 1099 or Self Employed documents
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload W-2 or 1099 or Self Employed documents
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Did you receive unemployment compensation this year?
*
Yes
No
Please upload unemployment document
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Are you retired? Did you receive any retirement income? Examples: 1099-R, 1099-SA, 1099-RRB, etc?
*
Yes
No
Please upload form
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Did you make an early withdrawal from your 401K/IRA?
*
Yes
No
Please upload form
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Did you receive any gambling winnings, lottery winnings, prizes, or other awards?
*
Yes
No
Please upload form
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Did you have a home foreclosure, credit card or other debt forgiven/cancelled? Examples: 1099-A, 1099-C
*
Yes
No
Health Insurance
Did you, your spouse, or a dependent have insurance under the Affordable Care Act (Market Place Health insurance) in 2024? *If so, select Yes – you MUST report Form 1095-A for the IRS to accept your return. If you did not have an Affordable Care Act insurance plan, select No.
*
Yes
No
Please upload 1095-A
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If you received a 1099-MISC OR 1099-NEC form OR conducted any kind of side businesses and got paid CASH, you are self employed.*Do you own a business/self employed?
*
Yes
No
Please upload Profit and Loss Statement
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Credits
Did you or anyone in your household attend a college or university this year?
*
Yes
No
If yes please upload form 1098-T
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Did you purchase a plug-in EV or fuel cell electric vehicle (FCV) 2023 or after? All-electric, plug-in hybrid, and fuel cell electric vehicles purchased new in 2023 or after may be eligible for a federal income tax credit of up to $7,500.
*
Yes
No
If yes please upload form
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Adjustments to Income
Did you make any IRA contributions, withdrawals or rollovers?
*
Yes
No
Did you contribute to a Health Savings Account this year?
*
Yes
No
Did you make any student loan payments?
*
Yes
No
Itemized Deductions
Did you pay any medical expenses? If so how much?
*
Did you buy a car for personal use this year? If so what is year make and model
*
Did you buy or sell a home this year?
*
Yes
No
If yes please upload form
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Did you make any mortgage payments this year?
*
Yes
No
Did you make any charitable contributions?
*
Yes
No
Did you pay tithe and offering? If so how much?
*
I confirm and agree I double checked all information for any errors
*
Yes
No
If you have any questions that were not addressed via this questionnaire, please list them here.
To your knowledge, do you currently owe the IRS?
*
Yes
No
I’m unsure
1. Dependent Name
Prefix
First Name
Middle Name
Last Name
Suffix
Relationship
Dependent Social
Dependent Date of Birth
Dependent Social Security Card
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Dependent Immunization Form
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2. Dependent Name
Prefix
First Name
Middle Name
Last Name
Suffix
Relationship
Dependent Date of Birth
Dependent Social Security Number
Dependent Social Security Card
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Dependent Immunization Form
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3. Dependent Name
Prefix
First Name
Middle Name
Last Name
Suffix
Relationship
Dependent Date of Birth
Dependent Social Security Number
Dependent Social Security Card
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of
Dependent Immunization Form
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4. Dependent Name
Prefix
First Name
Middle Name
Last Name
Suffix
Relationship
Dependent Date of Birth
Dependent Social Security Number
Dependent Social Security Card
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Dependent Immunization Form
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BANK NAME
*
DIRECT DEPOSIT ACCOUNT NUMBER
*
DIRECT DEPOSIT ROUTING NUMBER
*
MOTHERS MAIDEN NAME
*
I give Premier Taxes permission to prepare all forms related to my tax return and I have signed all necessary forms to file my income tax return electronically. I take full responsibility for the accuracy of this client intake form and I understand that Premier Taxes holds no responsibility for any misrepresentation or false claims.
*
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
*
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