Virtual Tax Client Intake Form

Tax Client Intake Form

Fill out the form below to submit your tax information. If you have any questions prior to completing this form, do not hesitate to contact us - fileme@dillonfinance.com - www.dillonfinance.com - Thank you and have a great day!
How did you hear about us or who referred you?
First Name*
Middle Name
Last Name*
Suffix
Jr, Sr, II, III
Social Security Number*
Date of Birth*

MonthDayYear
Date
Occupation*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Driver's License #*
State Driver's License Was Issued*
Date Driver's License Was Issued *
MM/DD/YYYY
Driver's License Expiration Date*
MM/DD/YYYY
Photo of Social Sec. Card & Driver's License *

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Identification Cancelof
What is your filing status?*
Are you filing an eligible spouse on your tax return?*

YesNo

Dependents

Should only be listed if you take care of the dependent over half of the year
Image of Dependent's S.S.Card*

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1. Dependent Information

GenderFirst NameMiddle NameLast NameSuffix
Date Of Birth*

MonthDayYear
Date
Social Security Number*
Do you want to enter another dependent?*

YesNo, all dependents are entered
2. Dependent Information

GenderFirst NameMiddle NameLast NameSuffix
Date Of Birth*

MonthDayYear
Date
Social Security Number*
Do you want to enter another dependent?*

YesNo, all dependents are entered
3. Dependent Information

GenderFirst NameMiddle NameLast NameSuffix
Date Of Birth*

MonthDayYear
Date
Social Security Number*
Do you want to enter another dependent?*

YesNo, all dependents are entered
4. Dependent Information

GenderFirst NameMiddle NameLast NameSuffix
Date Of Birth*

MonthDayYear
Date
Social Security Number*
Did you pay any child care expenses throughout the year ?

YesNo

Child and Dependent Daycare Expenses

If the provider is a person, enter the care provider's SSN
Child Name Amount Paid*

First NameAmount Paid
Provider Phone Number*

Area CodePhone Number
Provider*

NameTax ID #/ SSN
Provider Address*

Street Address

Street Address Line 2

CityState

Zip Code
Do you want to enter another child care provider?*

YesNo
Child Name Amount Paid*

First NameAmount Paid
Provider*

NameTax ID #/ SSN
Provider Phone Number*

Area CodePhone Number
Provider Address*

Street Address

Street Address Line 2

CityState

Zip Code

Upload photos of your W-2,1099,and ALL documents

Attach an image of all documents that can be used to assist your tax preparer with the preparation of your tax return.
Upload*

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Enter any additional information or comments that you would like the include for your tax preparer
If you did not file your tax return with us last year, we recommend that you upload a copy of your previous year's tax return

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Optional but STRONGLY recommended Cancelof
Do you owe from previous years?

YesNoI have not filed previous years
Please select the following years you are trying to file

2024202320222021
Do you have a business that you would like to be included on your return?*

YesNo

Business Owners Data Sheet

Schedule C
Name of Business*
Employer ID Number
EIN
What is the legal structure of your business?*
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Amount of business taxes paid throughout the year?
$
Business Income

All income receive during the fiscal year
Total Income
$
Business Expenses

Complete to the best of your ability. In each field enter the approximate amount you spent in each category.
Advertising
Social media, Flyers, Business Cards, etc
Contract Labor
An person or company paid to assist you
Insurance
(Other than health)
Interest
Mortgage, Loans, Credit Cards, etc.
Legal & Professional Services
Training, Conferences, Mentors, Lawyers, etc
Office Expenses
Software, postage, email, internet, and any operating expenses
Rent and Lease
Vehicles, Machinery, Equipment, Electronics, Accessories, etc.
Repairs and Maintenance
Supplies
Objects used to operate your business
Taxes and Licenses
Travel, Meals, and Entertainment
Airfare, Uber, Taxi, Lyft, Business Dining, Business Entertainment, and etc.
Utilities
Other Expenses
Is there any other information, questions, or concerns that you want to include to your tax preparer pertaining to your business?
Attach any photos or documents that you want us to have on file.

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E-Signature*

Clear
By filling out this form, you are giving us permission to prepare your tax return and you are confirming that ALL information entered is accurate. If you have any questions do not hesitate to call our office at 1-(407)-868-2445 or email fileme@dillonfinance.com
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Tax Client Intake Form