INTAKE FORM
Name
First Name
Last Name
New or returning client
New
Returning
Which preparer is filing your tax return?
Please Select
Tiarra Lambert
Which Tax Year Are You Filing For?
If you are filing multiple years, you must complete a separate form for each year.
Filing Status?
Single
Head Of Household
Married Filing Jointly
Married Filing Separately
Number of dependents?
Will this be an amended (corrected) return?
Yes
No
Are you interested in a tax advance loan?
Yes
No
Were you previously issued an Identity Protection Pin(IP PIN) by the IRS?
Yes
No
If You Have A IP PIN List It Below
Do you have insurance through the Affordable Care Act (The Marketplace), current employer, or state?
Yes
No
General information Taxpayer's
Name
First Name
Last Name
Social Security Number
Taxpayer's Date of Birth
-
Month
-
Day
Year
Date
Taxpayer's Job Title
Taxpayer's Phone Number
Please enter a valid phone number.
Taxpayer’s Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your marital status as of December 31st?
Single
Married
Divorced
Separated
Surviving Spouse
Taxpayer's Driver's License/ State ID Upload A Clear Shot On A Flat Surface
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Taxpayer's Social Security Card Upload A Clear Shot On A Flat Surface
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Can someone else claim you as a dependent?
Yes
No
If so, what is the Name of person that can claim you?
What is your relationship to that person? (I.e. Mother, Father, etc.)
Do you owe the IRS, Child Support or in default with student loans?
Yes
No
Are you self-employed?
Yes
No
Do you have gambling winnings for the year?
Yes
No
Where are your winnings from?
How much did you win?
Upload W2-G
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Did you make any charitable contributions during the year?
Yes
No
Who did you make charitable contributions to?
Did you withdraw from your 401K during the year ?
Yes
No
How much did you withdraw?
How much Federal taxes were withheld?
Dependent information
Are you claiming any dependents on your tax return?
Yes
No
How many dependents are you claiming?
Dependent 1 Date of birth
-
Month
-
Day
Year
Date
Dependent 1 social security number
Dependent 1 name
Dependent 1 Social Security
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What is your relationship to the dependent 1 ? (Son, Nephew,Cousin, etc.)
Dependent 2 Date of birth
-
Month
-
Day
Year
Date
Dependent 2 social security number
Dependent 2 Name
Dependent 2 Social Security
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What is your relationship to the dependent 2 ? (Son, Nephew,Cousin, etc.)
Dependent 3 Date of birth
-
Month
-
Day
Year
Date
Dependent 3 Social security number
Dependent 3 Name
Dependent 3 Social Security
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What is your relationship to the dependent 3 ? (Son, Nephew,Cousin, etc.)
Spouse information
YOUR SPOUSES INFORMATION, IF married filing jointly
Spouses Name
First Name
Last Name
Date Of Birth
-
Month
-
Day
Year
Date
Social Security Number
Occupation
Phone Number
Please enter a valid phone number.
Email
example@example.com
Spouse's Driver's License or State Id Upload ID
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Does your SPOUSE have an IP PIN (issued from IRS yearly)
Upload Spouse W2 statements Upload A Clear Shot On A Flat Surface
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Do your spouse have insurance through the Affordable Care Act (The Marketplace), current employer, or state?
Yes
No
Income
Upload W2 statements Upload A Clear Shot On A Flat Surface
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Upload 1099 NEC Upload A Clear Shot On A Flat Surface
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Did you receive unemployment during the year?
Yes
No
Upload other Misc. Income Documents such as 1099 INT, 1099DIV, 1099 NEC. Upload A Clear Shot On A Flat Surface
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Have you received any Government Assistance Programs such as Food stamps, TANF,Medicaid, or Medicare in during the year?
Yes
No
Which program(s) did you receive?
Do you have a 1098 Mortgage Interest Statement?
Yes
No
Do you have 1095A, 1095B, or 1095C form?
Yes
No
PLEASE UPLOAD YOUR 1095 Form IF APPLICABLE Upload A Clear Shot On A Flat Surface
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Did anyone in your household including yourself attend college for the selected tax year?
Yes
No
What was the Name of the person(s) who attended college, followed by the name of the college they attended?
Form 1098-T (School Credit) Upload A Clear Shot On A Flat Surface
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Self Employed
What is the name of your business?
Enter EIN- Employer Identification Number
Legal Address of Business
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your business email address?
example@example.com
What is your business phone number?
Please enter a valid phone number.
What is your Business Entity
Sole Proprietorship Partnership
LLC S Corp
LLC Multi Member
C Corp
S Corp
Nonprofit
How much money did you make from your business?
What Was Your Gross Income For the year?
Detailed Summary of Expenses Upload A Clear Shot On A Flat Surface
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How long have you owned your business?
What services do you perform?
What types of items do you need to operate?
Do you travel for business?
How do you track of mileage?
Please upload documentation of Business License and Registration if Applicable
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Did you receive payments from a 3rd Party Network such as Cash App, PayPal, or Venmo?
Yes
No
How much did you receive in payments from a 3rd Party Network? (If over $20,000please upload your 1099 K form.
Upload your 1099 K document.Upload A Clear Shot On A Flat Surface
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Do you maintain separate banking accounts for personal and business transactions?
How do you differentiate between personal and business transactions and monetary assets?
Please upload supporting business documents. (ex P&L, 1099 NEC, Summary of Income, Spread sheet with expenses). Upload A Clear Shot On A Flat Surface
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Would you like to apply for an advance loan? (subject to bank approval)
Yes
No
Would you like to apply for a refund transfer? (Get paid up to 5 days faster) (This option is not available if you would like a check)
Yes
No
Acknowledgment
If your refund is offset by the IRS, student loans, child support or your check ismailed, you are still obligated to pay our company the fees associated withfiling your tax return. By signing this agreement, you acknowledge that ifpayment is not made in full within 30 days legal actions will be sought toresolve payment.
How would you like your refund disbursed if receiving on?
Direct deposit
Check By mail
Prepaid Debit card
If direct deposit, please list the Name of Bank, Routing Number, and Bank Account Number
Taxpayer signature
Date
-
Month
-
Day
Year
Date
Make sure you have uploaded current and valid documents. If we find that you are missing documents or documents are not valid, we will place your return on hold and WILL NOT EFILE until we receive the proper documents.
Phone Number
Please enter a valid phone number.
Continue
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