Income Tax Intake Form

Income Tax Intake Form

Please fill out all that apply
Taxpayer Name

First NameLast Name
Taxpayer SSN
Taxpayer Date of Birth

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Are you a US Citizen or Green Card holder?
What is your filing status?
Occupation
Spouse Name

First NameLast Name
Spouse Date of Birth

MonthDayYear
Date
Spouse SSN
Please ensure we have the full names and dates of birth for all children and dependents with SSN if applicable.
Dependent #1

First NameLast Name
Dependent #1 DOB

MonthDayYear
Date
Dependent #1 SSN
Dependent #2

First NameLast Name
Dependent #2 DOB

MonthDayYear
Date
Dependent #2 SSN
Dependent #3

First NameLast Name
Dependent #3 DOB

MonthDayYear
Date
Dependent #3 SSN
Dependent #4

First NameLast Name
Dependent #4 DOB

MonthDayYear
Date
Dependent #4 SSN
Amount of property tax or rent paid in the year and the name of the landlord/municipality
Comments or Other Important Tax Information:
Do you have Marketplace Insurance?

YesNoUnsure
Did the IRS provide you with a IP Pin?

YesNoUnsure
How would you like to receive your refund?
Name of Bank/Institution
Please also attach a copy or screenshot of your account/routing number
Please upload the required documents to file your tax return. These include W-2s, 1099s, or other income statements; a valid driver’s license or state-issued ID; a Social Security card; the previous year’s tax return (if applicable); and any receipts or records supporting deductions and tax credits. If you are claiming dependents, provide their Social Security cards and any relevant childcare or school records. For business owners, include income and expense records, profit and loss statements, 1099-NECs issued, and any other relevant business documents.

Ensure files are clear and legible. Accepted formats include PDF, JPEG, and PNG. If you have any questions about required documents, feel free to contact us. Thank you!
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