Tax Intake Form 2024

How did you hear about us?

If someone referred you, please type his or her name here.

Tax Period(s) or Tax Year(s) for preparation

If new client please attached prior year(s) tax return for review.

Form 1040 and supporting tax return schedules

Are you trying to buy a new home within the next 2 years?

Other

Tax Payers Name

First NameLast Name

Taxpayer's SSN

Example: xxx-xx-xxxx

Taxpayer's Date of Birth

Example: 01/01/2001

Taxpayer's Phone Number

Example: xxx-xxx-xxxx

Taxpayer's Email Address

example@example.com

Taxpayer's Job Title

Taxpayer Driver License Number

DL State

DL Issue Date

Date

DL Expiration Date

Date

Business owner(s) please provide copy of Drivers License(s) (New Beneficial Owner Information (BOI) Report Requirement)

Front of DL Only

Spouse Name

First NameLast Name

Spouse's SSN

Example: xxx-xx-xxxx

Spouse's Date of Birth

Example: 01/01/2001

Spouse's Phone Number

Example: xxx-xxx-xxxx

Spouse Job Title

Spouse's Email Address

Example: example@example.com

Spouse Driver License Number

DL State

DL Issue Date

Date

DL Expiration Date

Date

Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Did you and your spouse live apart during the year?

What is your marital status as of December

Did you pay over half the expenses of maintaining your residence for the entire year?

Did you support a child or family member for more than 6 months out of the year?

If yes, did you live together at any time after June 30, 2024?

Are you self employed?

Are you on any Government Assistance

Do you have a business?

What Type of Business?

Business Name

Business Tax ID

State Business was created

Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

What Type of Business?

If multiple businesses

Business Name

If multiple businesses

Business Tax ID

If multiple businesses

State Business was created

Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Provide IRS Business Tax ID Letter (s)

From SS-4 (EIN) Letter

For S Corporation, provide IRS S Corporation Election Letter (if applicable)

How many dependents are you claiming?

Dependent #1

First NameLast Name

Dependent #1 Date of Birth

01/01/2001

Dependent #1 SSN

What is Dependent #1's Relationship to you (son, daughter, etc.)?

How many months did Dependent #1 live with you in 2024? (If all year, enter 12)

Dependent #2

First NameLast Name

Dependent #2 Date of Birth

Example: 01/01/2001

Dependent #2 SSN

How many months did Dependent #2 live with you in 2024? (If all year, enter 12)

What is Dependent #2's Relationship to you (son, daughter, etc.)?

Dependent #3

First NameLast Name

Dependent #3's Date of Birth

01/01/2001

How many months did Dependent #3 live with you in 2024? (If all year, enter 12)

Dependent #3s SSN

Example: xxx-xx-xxxx

Dependent's #3 SSN

What is Dependent #3's Relationship to you (son, daughter, etc.)?

Dependent #4's First Name

First Name

Dependent #4's Last Name

Last Name

Dependent #4's Date of Birth

01/01/2001

Dependent #4's SSN

Example: xxx-xx-xxxx

What is Dependent #4's Relationship to you (son, daughter, etc.)?

How many months did Dependent #4 live with you in 2024? (If all year, enter 12)

Dependent #5's First Name

First Name

Dependent #5's Last Name

Last Name

Dependent #5's Date of Birth

01/01/2001

Dependent #5's SSN

Example: xxx-xx-xxxx

What is Dependent #5's Relationship to you (son, daughter, etc.)?

How many months did Dependent #5 live with you in 2024? (If all year, enter 12)

Are there any dependents in daycare? If yes, please upload the form you received from your daycare provider.

Upload a copy of your daycare form here (if applicable).

How would you like to receive your tax refund?

Name of Bank

Which type of account would you like your refund deposited into?

Other

Routing Number

Bank Account Number

Can someone else claim you as a dependent?

Did you have health insurance in 2024?

Did you have health insurance for the entire year?

Who was your insurance cover through in 2021?

Was your insurance through your employer?

Was your insurance through Medicaid?

Was your insurance through the Affordable Care Act (The Marketplace) aka Obamacare?

Did your dependents have health insurance for the entire year?

Was YOUR DEPENDENTS' insurance through your employer?

Who was your Dependents insured with in 2021?

Upload Taxpayer & Dependent(s)Insurance Documents (Form 1095 A/B/C)

Was YOUR DEPENDENTS' insurance through Medicaid?

Was YOUR DEPENDENTS' insurance through the Affordable Care Act (The Marketplace)?

Have you ever been denied the Earned Tax Credit (EITC)?

Were you or any of your dependents in college in 2024?

Do you have a 1098-T Form for either you or your dependents?

If you have a 1098-T form, upload it here.

Did you trade any Virtual/Crypto Currency

Did you engage in any stock or exchange activity?

If yes and received 1099B, upload it here.

Did you buy or sell real estate in 2024?

If yes bought real estate, upload Closing Disclosure/HUD-1; If yes sold real estate, upload Form 1099-S.

Did you receive Advance Child Tax Payments in 2021?

Did you receive notices from the IRS or State/ (ex. Advance Child Tax Credit Letter 6419, Economic Impact Payments, etc)

If yes, upload IRS or State Notice(s)/Letter(s)

Did you have a foreign account that exceeds over $10,000?

Did you make contributions for the 2024 tax year to an IRA account?

If yes, please provide details and the amount of contribution

Did you receive the 1st Economic Stimulus Payment?

How much did you receive from the 1st Economic Stimulus Payment? (up to $1200 per taxpayer and $500 per dependent)

Did you receive the 2nd Economic Stimulus Payment?

How much did you receive from the 2nd Economic Stimulus Payment? (up to $600 per taxpayer and per dependent)

Did you receive the 3rd Economic Stimulus Payment?

How much did you receive from the 3rd Economic Stimulus Payment? (up to $1400 per taxpayer and dependent)

Are you interested in AUDIT PROTECTION?

CLIENT NON PAYMENT/OFFSET CLAUSE At Troubled Tax Experts, we strive to assist all of our clients in their tax needs, however we understand that situations arise. If your refund is offset by the IRS, student loans, child support, etc., or your check is mailed, you are still obligated to pay our company the fees associated with filing your tax return. By signing this agreement you acknowledge that if payment is not made in full with in 30 days legal actions will be sought to resolve payment and informaiton gathered for preparation of tax returns can be used to collect unpaid fees.

Remedies for uncollected payments may include issuance of 1099C (Cancellation of Debt) which would include any legal fees incurred in connection with the uncollected payments.

Primary Taxpayer's Signature

Date

I am giving Troubled Tax Experts and associated affiliates permission to prepare all forms related to my tax return(s) and I have signed all necessary forms, and/or have provided permission, to file my income tax return electronically. I take full responsibility for the accuracy of this client intake form and understand that Troubled Tax Experts and associated affiliates hold no responsibility for any misrepresentation or false claims.

Taxpayer's Signature

Spouse's Signature (If no spouse, leave blank)

Date

Additional information for tax preparation

Provide W2(s), 1099(s), 1098(s)

Provide any other documents that you think may be relevant

Dependent(s) Birth Certificate(s)

Taxpayer's and Dependent(s ) Social Security Card(s)

Client Intake Questions