• Tax Preparation Client Intake Form

    Tax Preparation Client Intake Form

  • Filing Status*
    • Taxpayer Information 
    • Date of Birth*
       - -
    • Format: (000) 000-0000.
    • Were you previously issued an Identity Protection PIN (IP PIN) by the IRS?*
    • Can another taxpayer claim you as a dependent on their tax return?*
    • Will you be filing a tax return with your spouse?*
    • Date of Birth
       - -
    • Format: (000) 000-0000.
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    • Did the taxpayer work last year?*
    • Do you have any dependents you will claim on your last year's tax return?*
    • Dependents 
    • Rows
    • Did you, your spouse, or any dependents attend college last year?*
    • Did you, your spouse or dependents receive health insurance through Marketplace last year and receive Form 1095-A?*
    • Do you have any expenses for child care?*
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    • Employment Status 
    • *
    • Rows
    • Tax Related Questions 
    • Are you currently renting?*
    • Do you have your own home?*
    • Do you have documents that shows you paid for property taxes?*
    • Did you sell any stock?*
    • Did you take money from your 401k or other retirement accounts?*
    • Do you need to report any crypto currency? (upload under income documents)*
    • Did you receive any 1099s for independent contract work? IE. Uber, Lyft, Door Dash etc. (upload under income documents)*
    • Did you pay for vehicle tax?*
    • Do you have mortgage interest?*
    • Do you have real estate tax?*
    • Did you receive a federal tax last year?*
    • Are you a victim of identity theft?*
    • Do you or your spouse owe debt to any Government Agency such as: IRS, Student Loans, Social Security, Child Support, etc?*
    • Did you or your spouse receive unemployment benefits last year?*
    • Did you make any charitable contributions last year? (Goodwill, Salvation Army, Church, etc.)?*
    • Did you or your spouse make payments on your student loans last year?*
    • Did you or your spouse pay any medical or dental expenses last year? (Does not include insurance premiums)*
    • Do you or your spouse own a rental property?*
    • Did you or your spouse have any gambling winnings last year?*
    • Did you or your spouse receive social security benefits last year?*
    • Would you like to apply for a SAME-DAY TAX ADVANCE UP TO $7,000?
    • Would you like to receive a text message when your refund is funded?*
    • Acknowledgment & Signature 

    • I confirmed that all information I entered here is accurate and true. I allow Express Tax & Financial Services to capture my sensitive data like personal id, government id, social security number (SSN), and other information. I also allow Express TAx & Financial Services to sign my return on my behalf.

      Terms & Conditions:

      CONSENT FOR USE OF TAX RETURN INFORMATION

      Federal law requires this consent form be provided to you. 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. However, federal law also prohibits us from revealing any personal or financial information to any third party.

      Therefore as a matter of fact, we will never reveal your financial or personal information in any way, to anyone, unless you specifically request we do so, and provide in writing to us the specific person or persons to whom you wish that disclose to be made, which is done on a wholly separate consent form from this.

      For the purposes of this consent form please note we are seeking consent only to satisfy requirements set forth by federal law so we may speak with you on the phone, send you email correspondences of any kind, send you mailings, newsletters, email reminders, holiday and occasional cards and greetings, and reminders of upcoming deadlines, etc. You are not required to complete this form. If we obtain your signature on this form by conditioning our service 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 a period of three years from the date you have signed the consent.

      The undersigned hereby consents to the use; by Express Tax & Financial Services, its owner, employees, and staff; of any and all tax return information pertaining to: Direct questions, inquiries or requests you make regarding your tax returns, situation, or issues. Requests you make for copies of your documents, figures, numbers, or information. Upon your direct request in order to connect you with another professional in another field or profession so you may gain further information on a certain topic not available or in the realm of expertise of this firm. Notification of important tax law changes. Notification of changes or information that will impact our engagement, such as a change of firm website address, email address, physical location, or other such contact, biographical or geographical information. Other reasonable business purposes including but not limited to: appointment reminders, holiday mailings, birthday greetings and other informational mailings.

      The tax information may not be disclosed or used by Express Tax & Financial Services, its owner, employees, or staff, for any purpose other than that which is permitted by this consent document. If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484 by email at complaints@tigta.treas.gov.

       

      TAX PREPARATION POLICY

      • We will prepare your tax return for current and or previous tax years
         and state tax returns based on information you provide. Services for preparation of your return do not include auditing or verification of information provided by you.
      • This engagement does not include any audit or examination of your books or records. In the event your return is audited, you will be responsible for verifying the items reported.
      • The tax return preparation fee does not include bookkeeping.
      • Fees charged for tax return preparation do not include audit representation or preparing materials to respond to correspondence from taxing authorities.
      • Preparation fees do cover limited assistance and consultation during the year.
      • The engagement to prepare your tax returns terminates upon delivery of your completed returns and original documents to you. Please store your supporting documents and copies of your tax returns in a secure place for at least seven years. You may be assessed a fee if you requesr a copy in the future.

      TAXPAYER RESPONSIBLITY & REQUIREMENTS

      • You agree to provide us all income and deductible expense information. If you receive additional information after we begin working on your return, you will contact us immediately to ensure your completed tax returns contain all relevant information.
      • You affirm that all expenses or other deduction amounts are accurate and that you have all required supporting written records. In some cases, we will ask to review your documentation.
      • You must be able to provide written records of all items included on your return if audited by either the IRS or state tax authority. We can provide guidance concerning what evidence is acceptable.
      • You must review the return carefully before signing to make sure the information is correct.
      • In the event that your refund is taken due to child support, student loans or wage garnishments your fee is still due. By signing your this disclosure you are agreeing to pay the preparation fees regardless if your refund was received or not. After 60 days from the date the refund was scheduled to arrive if no payment or payment arrangement is made, I will be forced to put your account into collections. 
      • If  no refund is due fees must be paid before your tax return is delivered to you or filed for you. If you terminate this engagement before completion, you agree to pay a fee for work completed. A retainer is required for preparation of late returns.

      I have read the terms and conditions and privacy policy of Express Tax & Financial Services. By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.

    • Date Signed*
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    • Appointment
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