Tax Preparation Client Intake Form

Tax Preparation Client Intake Form
Required Documentation for Tax Preparation

To ensure the accurate and timely preparation of your tax return, please provide the following documentation:

Identity Verification

1.Social Security Cards or ITIN letters for all individuals listed on your tax return.
2.Valid, unexpired photo identification (e.g., Driver’s License or State ID) for you, your spouse, and any adult dependents included on your tax return.
Dependent Verification

3.Birth certificates for all minor dependents claimed on your tax return.
Income Documentation

4.All income-related documents, including but not limited to W-2s, 1099s,bank statements and other applicable forms.

Additional Instructions

Please complete all pages of the provided forms in their entirety.

Ensure that all information provided is accurate and complete, as you are ultimately responsible for the details included in your tax return.
If you have any questions or require assistance, please consult your tax return preparer.
What tax year are you filing ?
Who is your tax preparer ?
Who Referred You ??

First NameLast Name
SingleHead of HouseholdMarried Filing SeparateMarried Filing JointQualifying Widower
Name*

First NameMiddle NameLast Name
Taxpayer Date of Birth

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

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
COUNTY YOU LIVE IN
SCHOOL DISTRICT YOU LIVED IN
YesNo

Enter your dependents here and answer yes or no .

Rows	Name	Date of Birth	Relationship	How many months did the person lived with you	Is a US Citizen ?	Full time student (College or Trade school)	Disabled ?	Did you provided more than 50% if this person support last year ?	Did you pay more than half the cost of maintaining a home for this person
2
3
4
5
6

YesNo
American Opportunity Tax Credit (AOTC)If you were a student, please answer the following: Have you already claimed the American Opportunity Tax Credit (AOTC) four times or has a parent or guardian claimed the AOTC for you while you were their dependent ?
Does anyone listed on your tax return have an IP PIN? Provide the 6-digit IP PIN (you will not be able to file without the pin.
6 Digit IP PIN
Never MarriedMarriedDivorcedLegally Separated
YesNoYes but we lived in separate household for the last 6 months of the year
YesNo
YesNo
Date of final divorce decree (if applicable)

MonthDayYear
Date
Date of separate maintenance decree (if applicable)

MonthDayYear
Date
Year of spouse's death (if widowed)

MonthDayYear
Date
YesNo
YesNo

Name

First NameLast Name
Date of Birth

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

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
YesNo
YesNo
YesNo
YesNo

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

Rows	Yes/No	Employer	Spouse Ins	Exchange/ Marketplace	Direct with Insurer	Medicare	Medicaid
Taxpayer
Spouse
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5

Please fill-up the information within the current year only.

General Expenses and Questions

Rows	Yes or N/A	Amount
Medical Expenses ,Dental or insurance paid ?
Taxes (state, Real Estate, Personal Property, Sale)
Charitable Contributions
College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)
Home Mortgage Interest (form 1098)
Child or dependent care expenses such as daycare, summer camp, latchkey?
For supplies used as an eligible educator such as a teacher, teacher’s aide, counselor, etc.?)
Expenses related to self-employment income or any other income you received
Student loan interest? (Form 1098-E)
Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12?
Have credit card, student loan or mortgage debt cancelled/forgiven by a lender or have a home foreclosure? (Forms 1099-C, 1099-A)
Receive the First Time Homebuyers Credit ?

Total Expenses
Direct DepositPaper Check
Bank Name
Routing Number
Account Number
Checking or Savings Account
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
Amount of FIP received per social services annual summary (usually found on annual summary mailed to you)
YESNONOT APPLICABLE
YESNO
If yes, how much child support did you receive per month or for the year (this is not taxable income)?
YESNO
If you received rent assistance, how many months did you receive assistance?
YESNO
If yes, how much and what type?
YESNO
YESNO
YESNO
I UNDERSTAND
YESNO
YESNO
YESNO
If you could go anywhere in the world where would it be ? Pick two places United States or Out the Country ! We will send you a vacation voucher . Thanks for the support !
Privacy Act and Paperwork Reduction Act Notice

Federal Disclosure
Federal law requires this consent form be provided to you. Unless authorized by law, we cannot disclose your tax return information to third parties for purposes other than the preparation and filing of your tax return without your consent. If you consent to the disclosure of your tax return information, Federal law may not protect your tax return information from further use or distribution. You are not required to complete this form to engage our tax return preparation services. If we obtain your signature on this form by conditioning our tax return preparation services on your consent, your consent will not be valid. If you agree to the disclosure of your tax return information, 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 from the date of signature.
Additional comments
- I confirmed that all information I entered here is accurate and true.
- I allow Tax Guru For You Consulting Services to capture my sensitive data like personal id, government id, and other information.
- I have read the terms and conditions and privacy policy of Tax Guru For You Consulting Services
- By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Taxpayer Signature

Clear
Spouse Signature

Clear
Date Signed

MonthDayYear
Date
Date Signed

MonthDayYear
Date
Should be Empty:

Tax Preparation Client Intake Form

Privacy Act and Paperwork Reduction Act Notice