Client Intake Form
Thank you for choosing us to get started on your taxes! This form is designed to collect the necessary information to prepare your tax return accurately and efficiently. The information you provide is strictly confidential and will be used solely for tax preparation and related services. Your Privacy Matters: I understand the sensitivity of the information you are sharing. I am committed to maintaining your privacy and protecting your personal and financial data through secure handling practices, encryption (where applicable), and strict confidentiality protocols. Due Diligence Statement: As part of my professional responsibility and in accordance with IRS regulations and industry standards, I collect this information to ensure compliance, accuracy, and to safeguard both your interests and mine. Please complete all sections to the best of your ability. If you have any questions while filling out this form, don’t hesitate to reach out.
Full Name
First N.ame
Last Name
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Date of Birth
-
Month
-
Day
Year
Date
Mailing address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Upload your ID
*
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Choose a file
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Upload your social security card (no copy)
*
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Filing Status
Please Select
Head of Household
Single
Married Filing Jointly
Married Filing Separate
Type of Income
W-2
W-2 & Side Business
Student
Stay at Home Mom
Other
Are you a full time student?
Yes
No
Upload Income related documents (W-2, 1099, OR 1098)
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Who is your tax preparer
Were you referred to by someone?
Yes
No
If so, who were you referred by?
Do you have any dependents? If yes complete next page
Yes
No
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Dependent information
Skip if you do not have any dependents
Dependent #1 Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Relationship
If the dependent is not your biological child, do you have permission to claim them & why isn’t the biological parent claiming them?
Yes, I also have proof/reasoning
Yes but no proof/reasoning
No I do not have permission
Other
Do you have any childcare expenses? (If so upload any related documents)
Yes
No
Additional Dependents
Upload Birth Certificate or last years return
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Upload Social Security Card or last years return
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Back
Next
Spouse Information
Skip if you do not have a spouse
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
-
Month
-
Day
Year
Social Security Number
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Next
Authorization and consent
I confirm that all information I entered here is accurate and true to the best of my knowledgeI allow you to capture my sensitive data like personal ID, government ID, Social Security Number (SSN), and other information.I have read the terms and conditions and privacy policy.By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Signature
*
Date
-
Month
-
Day
Year
Date
Continue
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