Tax Preparation Client Intake Form

Tax Preparation Client Intake Form

SEVEN FINANCIAL SERVICE
Please schedule an appointment for us to call you after you've completed the form.
Filing Status
Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
Are you a full-time student?
Date

YearMonthDay
Date
Are you totally and permanently disabled?
Are you legally blind?
Name

First NameLast Name
Age
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
Are you a full-time student?
Are they totally and permanently disabled?
Are they legally blind?
Are they your dependent?

Enter your dependents here

Does you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it?

Employment Status
Are you contributing to 401k or other pre-tax account?
Is this your first time opening a pre-tax account?
Please select what state return are you requesting?
Does your dependents have tuition expenses?
Do you have any expenses for child care?
Do you have energy star rated improvements to your home?

Other
Are you currently renting?
What is the monthly rental amount?
How long have you lived at the property?
# of months
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 401?
Did you pay your 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?
Please fill-up the information within the current year only. Also before moving forward make sure you submit your social security for you and your dependants! DONT FORGET THE QUOTE IS FREE!!!
Please upload S.S CARD, GOV I.D, W2 ,1099

General Expenses

Rows	Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses

AMMENDMENTS

2021,2022,2023

$250.00 Quantity

CREDIT REPAIR

1 Full Year of Credit Repair service with booking keeping

$550.00 Quantity

Total

Credit Card

Cash App Pay

How did you hear about us?…. Please mention who referred you as well.
Account & Routing number
Type a question
- I confirmed that all information I entered here is accurate and true.
- I allow ABC Financial to capture my sensitive data like personal id, government id, and other information.
- I have read the terms and conditions and privacy policy of ABC Financial.
- By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Date Signed

MonthDayYear
Date
Taxpayer Signature
Date Signed

MonthDayYear
Date
Spouse Signature
Please verify that you are human
This is a fill in the blanks field. Please add appropriate blank fields and text.
http://keepertax.go2cloud.org/SH3Q
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