CLIENT INTAKE FORM (1)

Dear Taxpayer,

Thank you for the opportunity to work with you in preparing your income tax returns. To foster a complete understanding of our relationship, take a moment to review the following information.

We will prepare your income tax returns based solely on the information you furnish to us.

Upon completion of your tax returns we will return any original tax documents to you.

From time to time our office may retain scanned copies of your documents for our records, however you should retain all documents, cancelled checks and other data that form the basis of income and deductions and other tax return forms, schedules, elections and disclosures.
FIRST TIME CLIENTS

The details you provide are fundamental for precise tax preparation and maximum benefits.

RETURNING CLIENTS
To maintain the highest accuracy in our records, we request current information even if you've filed with us before. This ensures your tax return reflects your most recent circumstances.

Your form is only received when you: Click the SEND INTAKE FORM button below Receive the "CONFIRMED RECEIPT" email message.Without these steps, your information will not be transmitted to our system.

Need assistance? Contact admin@pfstaxconsultants.com

Submissions not following this format will be returned for proper completion.
What tax year do you need to file with this form submission?*
Client's Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Social Security Number*
Filing Status?*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Did you live at this address the entire tax year?*
Provide Spouse Information If You Are Filing Under Married Filing Jointly or Seperately
Spouse Name

First NameLast Name
Spouse Date of Birth

MonthDayYear
Date
Spouse Social Security Number
Were you and your spouse separated or living in separate households at any time during the previous year?*
How did you hear about Professional Financial Solutions?*
If referred, list the person's name
Did you file your taxes last year?*
Please provide your previous tax year AGI (adjusted gross income) if available.
Will you be making any major purchases in the next 3 years? (new home, investment properties, vehicle, etc.)*
Do you have dependents?*
Dependent#1 Name

First NameLast Name
Dependent # 1 Social Security Number
Dependent#1 Date of Birth

MonthDayYear
Dependent # 1 Relationship to you
Dependent #2 Name

First NameLast Name
Dependent # 2 Social Security Number
Dependent#2 Date of Birth

MonthDayYear
Dependent #2 Relationship to you
Dependent #3 Name

First NameLast Name
Dependent # 3 Social Security Number
Dependent #3 Date of Birth

MonthDayYear
Dependent #3 Relationship to you
Dependent #4 Name

First NameLast Name
Dependent # 4 Social Security Number
Dependent #4 Date of Birth

MonthDayYear
Dependent #4 Relationship to you
Please Upload a Copy of Your Dependent(s) Social Security Card(s)

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Please select all income or deduction types that apply.

W2Self-EmploymentUnemployment (1099-G)Social SecurityEarned Rental PropertyPensionHomeownerChildcare ExpensesRenterCash/Non-Cash GivingWork ExpensesEducator ExpensesWork Related TravelDriving Mileage ReportMedical ExpensesDental ExpensesPaid PropertyCollege Enrolled 2023Disabled Child or Adult DependentsMoving ExpensesLottery / Gambling Wins or LossesIRA ContributionsNotice 1444Independent Contractor {1099-NEC)
Please Upload All Files Here. (Education forms, Child Care Expenses, Self Employment Documents, 1098T forms, W2 forms, 1099 forms, etc.)

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Would you like to apply for a REFUND ADVANCE? If so, please select which advance you would like to apply for.*
Please select method of payment for your refund (if applicable)*
If you would like to receive your refund by direct deposit,
please provide the bank routing and account information below.
Please upload a copy of your Driver's License, ID or Passport. Note: We cannot accept expired identification.*

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Please upload a copy of your spouses Drivers License if married filing jointly or separately, ID or Passport. Note: We cannot accept expired identification.

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Bank Name (This account will be used to direct deposit your refund)
Bank Routing Number
Bank Account Number
Please enter your Identity Protection PIN for this current tax year. (You will always receive a new IP PIN each tax year)
I AgreeI Disagree
Signature

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CHILD AND DEPENDENT CARE
Please attach a signed letter with letterhead from the daycare, camp, nanny or babysitter with their name, address, and phone number, EIN or SSN including total amount paid for the current tax year

You can also have them sign the w10.

(If you do not have this please move to the next question)
File Upload

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Please provide your daycare, camp, nanny or babysitter's name.
Please provide your daycare, camp, nanny or babysitter's phone number.
Please provide your daycare, camp, nanny or babysitter's Address
Please provide your daycare, camp, nanny or babysitter's EIN or SSN.
CONSENT TO USE AND DISCLOSE OF TAX RETURN INFORMATION

You are the online buyer of Professional Financial Solutions mobile tax prep service. By checking the appropriate box and typing your name as an e-signature, you agree to these terms.

Federal law requires this consent form be provided to you (“you” refers to each taxpayer, if more than one). Unless authorized by law, we cannot use, without your consent, your tax return information for purposes other than the preparation and filing of your tax return.

You are not required to complete this form to engage our tax preparation services. If we obtain your signature on this form by conditioning our services on your consent, your
consent will not be valid. Your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year.

By signing below, you authorize us to use the information you provide to us during the preparation of your 2023-2024 tax return to determine whether to offer you an opportunity to apply for an Electronic Refund Product.
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