Returning Client Intake Form
Tax Filing Year:
*
Please Select
2024
2023
2022
2021
2020
2019
Filing Status
*
Please Select
Single
Head of Household
Married Filing Jointly
Married Filing Separately
Qualifying Surviving Spouse
Select Your Tax Preparer:
*
Please Select
Colleen Richardson
Brittany Stubblefield
Taxpayer Name
*
First Name
Last Name
Spouse Name
First Name
Last Name
Taxpayer Social Security Number
*
Spouse Social Security Number
Taxpayer Date of Birth
*
/
Month
/
Day
Year
Date
Spouse Date of Birth
/
Month
/
Day
Year
Date
Taxpayer State ID/Driver's License
*
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Spouse State ID/Driver's License
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Taxpayer Phone Number
*
Please enter a valid phone number.
Spouse Phone Number
Please enter a valid phone number.
Taxpayer Email
*
example@example.com
Taxpayer Email
example@example.com
Taxpayer Occupation
*
Spouse Occupation
Taxpayer Preferred Contact Method
*
Please Select
Phone
Email
SMS
Taxpayer Preferred Contact Method
Please Select
Phone
Email
SMS
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Residency Proof(lease, utility bill, etc.)
*
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Are you and/or your spouse active military?
*
Please Select
Taxpayer
Spouse
Both
None
Are you and/or your blind?
*
Please Select
Taxpayer
Spouse
Both
None
Are you and/or your spouse the dependent of another?
*
Please Select
Taxpayer
Spouse
Both
None
Do you and/or your spouse have an IP PIN? If so, please list the IP PIN in the corresponding section.
*
YES/NO
IP PIN
Taxpayer
YES
NO
Spouse
YES
NO
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DUE DILIGENCE
(IF QUESTIONS PERTAIN TO YOU/YOUR SPOUSE/DEPENDENTS AND ARE NOT ANSWERED, THIS CAN DELAY YOUR ESTIMATE AND TAX RETURN SUBMISSION)
DID YOU/YOU ALL
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YES
NO
Did you or your spouse collect Social Security or Retirement Income?
Did you or your spouse receive unemployment compensation last year?
Did you or your spouse have income other than your W-2(s)?
Did you, your spouse, and or your dependents have health insurance through Healthcare.gov or received a 1095-A form?
Did you, your spouse, or your dependent(s) get a student loan or make college tuition payments?
Did you or your spouse make a withdrawal from a 401K?
Did you or your spouse pay mortgage/property taxes/insurance?
DO YOU/YOU ALL
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YES
NO
Do you or your spouse owe delinquent Child Support?
DO you owe any delinquent Alimony?
Do you owe any delinquent Student Loans?
Do you any delinquent Back Taxes?
Do you owe the IRS?
HAVE YOU/YOU ALL
*
YES
RESPONSE
Have you already attempted to file your current tax return?
YES
NO
Have you ever had a rejection on a previous year tax return?
YES
NO
Have you ever been audited by the IRS? If so, what was the outcome?
YES
NO
Have you, your spouse, or dependent(s) ever claimed the American Opportunity Tax Credit? If so, for how many years?
YES
NO
Have you, your spouse, or dependent(s) ever been charged with a drug related felony? If so, who?
YES
NO
Have you ever been disallowed the Earned Income Tax Credit, the Child Tax Credit, and/or the Additional Child Tax Credit? If so, when and why?
YES
NO
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Adding New Dependent(s) Information
(IF QUESTIONS PERTAIN TO YOU/YOUR SPOUSE/DEPENDENTS AND ARE NOT ANSWERED, THIS CAN DELAY YOUR ESTIMATE AND TAX RETURN SUBMISSION)
Dependent(s) Information
Dependent First Name
Dependent Middle Name
Dependent Last Name & Suffix
Dependent Social Security Number
Dependent Date of Birth
Dependent Age
Lived w/you how many months?
Relationship
Disabled
IP PIN
Dependent 1
Dependent 2
Dependent 3
If adding a new dependent please upload Birth Certificate(s) and Social Security Card(s)
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Has the child(ren) lived with you for more than six months of the year?
Please Select
YES
NO
If you are a single parent claiming dependent, please provide why other parent is claiming child(ren).
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School Information
(IF QUESTIONS PERTAIN TO YOU/YOUR SPOUSE/DEPENDENTS AND ARE NOT ANSWERED, THIS CAN DELAY YOUR ESTIMATE AND TAX RETURN SUBMISSION)
Did anyone filing or being claimed on this tax return attend college? If so, please complete the sections listed pertaining to them.
Attendee First Name
Attendee Middle Name
Attendee Last Name
School Name
Part/Full Time Student
Attendee 1
Part Time Student
Full Time Student
Attendee 2
Part Time Student
Full Time Student
Attendee 3
Part Time Student
Full Time Student
Attendee 4
Part Time Student
Full Time Student
College Expenses
Dependent Name/Amount
Expenses
Tuition
Room & Board
Books
Supplies(on-campus)
Supplies(off-campus)
Other Expenses
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Uploads
Please upload all the previously mentioned documents, statements, etc that pertain to everyone in your household. (IF QUESTIONS PERTAIN TO YOU/YOUR SPOUSE/DEPENDENTS AND ARE NOT ANSWERED, THIS CAN DELAY YOUR ESTIMATE AND TAX RETURN SUBMISSION)
Upload 1098-T(s) school form for anyone on this return who attended college
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Taxpayer, spouse and/or dependent(s) Income Documents
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Taxpayer and/or spouse Self Employment Documents(Income/Expenses)if applicable
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If you, your spouse, and/or your dependents received insurance through the Marketplace, please upload your updated 1095A if applicable
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Childcare Statements
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Submit
Please upload any additional document(s) that should be filed with your tax return.
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Please list any additional or updated information that needs to be communicated to your tax preparer or input N/A.
*
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PAYMENT METHOD
Would you like to apply/add any of the below features?
*
YES
NO
Tax Refund Advance(up to $7,000) Approval is not guaranteed. Fees do apply and will be deducted from refund.
Audit Protection($52.00 added fee)
Identity Theft Protection($39.95 added fee)
Refund Payment Method(Bank Transfer: Timeframes are estimates from the date the return is accepted electronically by the IRS, you will receive your funds less filing fees)If you are opting in for a Tax Advance Loan, one of the RT options has to be chosen)
*
This Option
RT-Refund Transfer: Check(7-21 days)(BANK TRANSFER fees deducted from refund)(check will be printed by Tax Office)(BANK PRODUCT)
RT-Refund Transfer: Prepaid Debit Card(7-21 days)(BANK TRANSFER fees deducted from refund)(tax preparer will provide the card to you)(BANK PRODUCT)
RT-Refund Transfer: Direct Deposit(7-21 days)(BANK TRANSFER fees deducted from refund)(BANK PRODUCT)
E-file: Direct Deposit(10-21 days)(FEES PAID AT TIME OF SERVICES)
E-File: Check(3-4 weeks)(FEES PAID AT TIME OF SERVICES)(check will be printed by Tax Office)
Mailed Paper Return(6-8 weeks)(FEES PAID AT TIME OF SERVICES
If you chose Direct Deposit please list your information below(this information is needed for your refund to be deposited electronically or for your balance owed to be paid:
Bank Name
Bank Routing Number
Bank Routing Number Confirmation
Bank Account Number
Bank Account Number Confirmation
Service Quality
Upload a screenshot of your banking information to be used for confirmation
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By Typing Your Name and Dating this document you agree that everything entered on this form and your tax return is true and correct to the best of your knowledge.
-I have confirmed that all information I entered here and on my tax return and this form is accurate and true. I allow Above and Distinguished Services & FS LLC to capture my sensitive data like personal ID, government ID, Social Security Card and Numbers, and other information. By typing your name(s) below, and dating this document you acknowledge that you have read, understood, and agree to your responsibilities and our responsibilities in doing this tax return.
Taxpayer Name
*
First Name
Last Name
Spouse Name
First Name
Last Name
Today's Date
*
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Month
/
Day
Year
Date
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