• Client Intake Form

    Please complete the intake form to the best of your ability. If a question or section doesn't apply to you, kindly skip that section. Completion of this form is REQUIRED to ensure you are filing your personal and/or business income & expenses correctly. This form is also required to help make sure you are in full compliance with the IRS. Please call 1-800-320-5171 if you need assistance with completing this form.
  • Are you a new or returning tax client?*
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  • Do you have ALL of your tax documents? Keep in mind we will NOT begin working on your file until all documents have been received by our office.
  • Are you Interested in a Refund Advance of Up to $9,500 upon bank approval?
  • Are you submitting documents for your 2024 Tax Return?
  • FILING STATUS (Filing status will be ultimately determined by information given and tax preparers discretion)
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  • Primary Taxpayer Date of Birth*
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  • **PHOTO ID/PASSPORT CANNOT BE EXPIRED**

  • Was your main home in the US for more than 6 months?*
  • Format: (000) 000-0000.
  • Are you required by the IRS to use an Identity PIN? If Yes, Enter PIN
  • Were you married as of December 31st?
  • Can anyone claim you or your spouse as dependent?
  • Are you claiming any dependents this year?
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  • INCOME

  • Did you receive a W-2, 1099-MISC, 1099-INT, 1099-DIV, 1099-B, 1099-G, or 1099-S?
  • Did you receive unemployment compensation this year?
  • Are you retired? Did you receive any retirement income? Examples: 1099-R, 1099-SA, 1099-RRB, etc?
  • Did you make an early withdrawal from your 401K/​IRA?
  • Did you receive any gambling winnings, lottery winnings, prizes, or other awards?
  • Did you have a home foreclosure, credit card or other debt forgiven/​cancelled? Examples: 1099-A, 1099-C
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  • HEALTH INSURANCE

  • Did you, your spouse, or a dependent have insurance under the Affordable Care Act (Market Place Health insurance) in 2024? *If so, select Yes – you MUST report Form 1095-A for the IRS to accept your return. If you did not have an Affordable Care Act insurance plan, select No.

  • SELF-EMPLOYMENT

    If you received a 1099-MISC OR 1099-NEC form OR conducted any kind of side businesses and got paid CASH, you are self employed.
  • Do you own a business/​self employed?

  • CREDITS

  • Did you or anyone in your household attend a college or university this year?
  • Did you purchase a plug-in EV or fuel cell electric vehicle (FCV) 2023 or after?Did you or anyone in your household attend a college or university this year?

  • **All-electric, plug-in hybrid, and fuel cell electric vehicles purchased new in 2023 or after may be eligible for a federal income tax credit of up to $7,500.

  • ADJUSTMENTS TO INCOME

  • Did you make any IRA contributions, withdrawals or rollovers?
  • Did you contribute to a Health Savings Account this year?
  • Did you make any student loan payments?
  • Did you receive the first time Home Buyers Credit in 2008?

  • ITEMIZED DEDUCTIONS

  • Did you pay any medical expenses?
  • Did you buy a car for personal use this year?
  • Did you buy or sell a home this year?
  • Did you make any mortgage payments this year?
  • Did you make any charitable contributions?
  • Did you pay tithes and offering?
  • If due a refund, would you prefer direct deposit?
  • If due a refund, would you prefer a check?
  • I confirm and agree I double checked all information for any errors.
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  • Sign Here

    Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

  • Consent to Use of Tax Return Information

  • Federal law requires this consent form be provided to you. Unless authorized by law, we cannot use your tax return information for purposes other than the preparation and filing of your tax return without your consent.

    You are not required to complete this form to engage in our tax return preparation services. If we obtain your signature on this form by conditioning our tax preparation services on your consent, your consent will not be valid. 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.

    If you do not consent, you may still have your tax return prepared and electronically filed by us for a fee.

    For your convenience, we have entered into an arrangement with third parties to provide qualifying taxpayers with the opportunity to apply for an Electronic Refund Disbursement Service and/or Loan product. To determine whether these products may be available to you, we will need to use your tax return information in order to calculate the amount of your anticipated refund.

    If you would like us to use your tax return information to determine whether these products may be available to you while we are preparing your return, please sign and date this consent to the use of your tax return information.

    By signing below, you authorize us to use the information you provide to us during the preparation of your 2024 tax return to determine whether to present you with the opportunity to apply for these products and services.

  • Date*
     - -

  • If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by e-mail at complaints@tigta.treas.gov

  • Sworn Statement of Residency

  • Name of Parent(s) or Guardian(s):

  • Dates the dependent(s) lived with you in Calendar Year:

  • Address that your dependent(s) lived at with you in Calendar Year:

  • List All Dependents That Lived With You From Your Tax Return:

  • I am certifying that the dependents listed above that I am claiming on my tax return has lived with me at the address above for more than 6 months in the United States.

  • If I was audited by the IRS for EITC, Head of Household, or Child Tax Credit; I would be able to provide document(s) below to prove residency of my dependents:

  • Select one:

  • I hereby affirm under penalty of perjury that the facts set forth in this statement are true:

  • Should be Empty: