Tax Preparation Client Intake Form
Tax Year
2025
2024
2023
2022
Please fill-up the information within the current year only.
Filing Status
Single
Head of Household
Married Filing Separate
Married Filing Joint
Qualifying Widower
Taxpayer Information
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Spouse Information (if applicable)
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Do you own this home?
Yes
No
Is this individual dependent of other?
Yes
No
Are you married?
Yes
No
Dependents
Do you have dependents
Yes
No
Enter your dependents here
Rows
Name
SSN
Date of Birth
Relationship
1
2
3
4
5
6
Tax Related Questions
Did you have Health Insurance
Yes, through the Marketplace (Affordable Care Act)
Yes, through my job
Yes, Medicaid
No
Employment Status
Employed
Unemployed
Self-employed
Occupation
Upload Documents
Browse Files
Ex: ID, SSN, Dependent's Birth Certificate, W2, 1099, 1098T, Account and Routing Number etc
Cancel
of
Referred By:
Remember: You get $50 for every referral! Thank you in advance!
Would you like your refund to be direct deposit?
Yes
No
Bank Name
Account Number
Routing Number
Does your family need life insurance?
Yes
No
Are you interested in repairing your credit?
Yes
No
Additional comments
Submit
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