New Client Questionnaire

New Client Questionnaire
DATE

MonthDayYear
Date
Please complete each field to the best of your ability, before submitting back to your tax preparer.
TAXPAYER INFORMATION
Name

First NameLast Name
Middle
Date Birth

MonthDayYear
Date
Social Security Number
Age
Occupation
Email Address
Format: (000) 000-0000.
Email Address
Format: (000) 000-0000.
Email Address
example@example.com
Street Address
Apt
City
State
Zip Code
Did your address change this past year?

Did your marital status change this past year?
SPOUSE INFORMATION
Name

First NameLast Name
Middle
Social Security Number
Date of Birth

MonthDayYear
Date
Age
Occupation
Cell Phone Number
Format: (000) 000-0000.
DEPENDENTS - CHILDREN AND OTHERS
Number of months this person lived with you

Section 3 Did you provide more than half of the support? YesNo

Did you provide a home for or help support anyone else, not listed above? Were there any births, deaths, marriages, divorces, or adoptions that occurred in your immediate family this past year? If so, please list details in the "other information" section at the end of this document. Could you be claimed as a dependent on another person's tax return? If requested by the IRS, do you have documentation (receipts/records/etc to substantiate your eligibility for any applicable credits and/or head of household filing status?
INCOME INFORMATION
Did you receive any income from employment as an employee or independent contractor this past year? If yes, please attach Form W-2 and/or 1099-NEC. Did you receive any unemployment compensation this past year? If yes, please attach 1099-G. Did you receive any social security benefits this past year? If yes, please attach Form SSA-1099.
DUE DILIGENCE QUESTIONS
ALL TAX PAYERS:
1 Are you married
2 Have you ever been disallowed the EITCAOTCCTC If so when
3 Did you live in the United States and where
4 If you are a single parent wheres the other parents of your childchildren
5 What is the name of the other parents
6 Why is the other parent of the childchildren not claiming the child
7 Explain why the dependents have different last names than the taxpayer
8 If you are separateddivorced when did you last live in the same home
9 Do you have joint custody of your child
a. How long did the child live in your home during this tax year? b. How long did your child/children live in the other parent's home during this tax year? c. How much income did the other parent have during this tax year? d. Do you have a signed Form 8332?
a How long did the child live in your home during this tax year
10. Did anyone else live in the home that provides financial support for your child/dependent(s)?
a If yes who lives there and how much do they pay
11 Does the taxpayer have full custody of their dependents
12 Is this your biological dependents
13 How old were you when your oldest child was born that is listed on this return
a.If the taxpayer was under the age of 18, explain circumstances and who/how the child was cared for until the taxpayer was old enough to support and care for her own child
14 How many months did the dependents live in your home during the tax year
15 Can anyone else claim your dependents as a dependent on their tax return
16 Is your dependent married
17. If you live alone, who babysits while you work (for children 12 & younger)? Name: 18. Do you receive any other type of supplemental, non taxable income such as child support, welfare benefits, social security, etc?
17 If you live alone who babysits while you work for children 12 younger Name
a If so how much and what kind
19 If this is not your biological child what is your relationship to the dependent
20 Did the dependent live in your home for more than 6 months
21 Do you have custody
If so, through what court/agency?
JSS
DUE DILIGENCE QUESTIONS
ALL TAX PAYERS:
22 Who are the biological parents
23 Where do the biological parents live
24 What were the circumstances leading to the dependents being placed in your home
25. Do you receive any financial aid for this child such as WIC, Medicaid, SNAP, listed on your health insurance policy, etc? If yes, which ones? 26. Are you listed as the guardian for this dependent(s) on school records, medical records, daycare records, or place of worship records?
COLLEGE CREDITS
27 Which college did the student attend
28 Did student attend at least half time
Degree Seeking
29 Did this student receive a tuition statement from the school
Other BooksMaterials
30. Did this student work while attending school?
If so how much did they earn
31 How many tax years have you claimed the AOTC
Drug Related Felonies
PLEASE PROVIDE BURSAR STATEMENT OF ACCOUNT HISTORY AND COPY OF 1098T FORM FROM THE COLLEGE
DISABLED AT ANY AGE:
32 If your dependent is over the age of 18 and Disabled what is the nature of the disability
33 Has this dependent been declared disabled by a physician
If so, can you provide documentation?
34 Does dependent receive social securitydisability benefits
If so, how much do they receive?
35 Are you listed as the Social Security Representative Payee for this dependent
36. Is this the dependent(s) expected to recover in the next year? 37. If this is not your biological child, why is this child living with you and not another family member?
37 If this is not your biological child why is this child living with you and not another family member
38 Where are the biological parents of your disabled dependents
39. Who cares for the disabled dependent while the taxpayer works?
CAN YOU THE TAXPAYER PROVIDE SCHOOLMEDICALDAYCAREPLACE OF WORSHIPBIRTH CERTIFICATES UPON REQUEST FROM THE GOVERNMENT
DUE DILIGENCE QUESTIONS
Income $ Others that lived in your home that is not reported on this tax return? Is this person biologically related to your dependent(s)? Preparer Notes as to why the above named relative is not claiming the child on the above named relative's tax return
Others that lived in your home that is not reported on this tax return
to what relationship
Head of Household: Single parent paying more than 1/2 cost of keeping up a home
Monthly Income Wages child support other income
(Wages, child support, other income)

Mortgage interest expense Utility Charges Upkeep and Repairs Property Insurance Food Consumed on the premises Other Household expenses

Do not count money received under public assistance/welfare/foodstamps in the amount you paid. But include costs paid with public assistance in the total cost

Taxpayer has provided all answers to the above questions to be true and correct to the best of the taxpayer's knowledge. Taxpayer has been informed that claiming a dependent for EITC/CTC?AOTC/HOH or other can result in an audit, fines and penalties if information provided to preparer is incorrect

Preparer signature Date inquiries were made Answers were provided by taxpayer on the above date unless otherwise noted here:
Preparer signature

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Date inquiries were made

MonthDayYear
Date
Answers were provided by taxpayer on the above date unless otherwise noted here

MonthDayYear
Date
HS PROFIT PRO SOLUTIONS
DUE DILIGENCE QUESTIONS
SELF EMPLOYMENT DUE DILIGENCE
Description of business Type of work service rendered product sold business location hours of operation
EIN
What kind of records do you keep? Check mark below

Customer receipt book Paid Expenses Receipts Computer Records Ledgers Advertising

Business Stationary Car Travel log Car/Truck Expense

Client Statements Insurance Other's
Business Phone Business Website
Format: (000) 000-0000.
Business Address How do you advertise?
Business Address
How do you advertise
Do you have a license? Is a license required for your occupation?
Do you have a license
Is a license required for your occupation
Did you file state andor local sales tax returns for the tax year
How Did you calculate your income? How Did you calculate your expenses?
How Did you calculate your income
How Did you calculate your expenses
If you do not have any business expenses, explain why
PREPARER NOTES:
Taxpayer Signature (Business Owner/Subcontractor)
HPS PROFIT PRO SOLUTIONS
SCHEDULE C WORKSHEET
for Self Employed Businesses and/or Independent Contractors IRS requires we have on file your own information to support all Schedule C's

Business Name (if any) Is this your first year in business?YesNo Did you make payments requiring a Form 1099?YesNo YesNo

Federal ID # (if any) If YES' did you file required Form 1099?

Total Gross Business Income (not necessarily amount shown on 1099's)

Beginning Inventory Merchandise Purchased for Resale Cost of labor (Do not include $'s paid to yourself) Materials & Supplies Other Direct Sales Costs Ending Inventory

Advertising Commissions and Fees Contract Labor (1099's Issued, if app) Insurance (other than health) Health Insurance (for you) Health Insurance (for your employees) Mortgage Interest (If paid for Business) Other Interest Paid Professional Fees Office Expenses Rent on Business Property Equipment Rentals % used for business Telephone

Repairs and Maintenance Supplies (not included above) Real Estate Taxes (If paid for business)$ Other Taxes (Payroll) Travel (do not include meals) Meals and Entertainment Utilities Wages (W-2's Issued) Bank and CC Charges Tools Uniforms YES or NO logo License / Dues Other

(Do not include mileage to and from home unless your office is in your home)

Question MUST be answered >> Do you have "evidence" to support your mileage? and this if applicable >> If yes, is the "evidence" written?YesNo "Evidence" includes mileage logs, appointment records, calendars, etc. plus IRS could ask for odometer readings from oil changes, repair invoices, purchase and sale documents.

Did you purchase any major pieces of equipment?YesNo IF YES List: Equipment Equipment Do you have an Office in Your Home?YesNoIF YES Complete questions below Real Estate Taxes $ Sq. Ft of Office Sq. Ft of Home HO Insurance $ Mortgage Interest / Rent Paid $Utilities(Lights and Gas) $

I certify that I have listed all income, all expenses, and I have documentation to back up the figures entered on this worksheet. For tax year
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