Client Intake Form

DETROIT TAXES INTAKE FORM

Filing Status

Tax Year Requested

Taxpayer Name

First NameLast Name

Taxpayer SSN

Numbers only

Taxpayer Occupation

Taxpayer Date of Birth

Date

Taxpayer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Taxpayer Phone Number

Format: (000) 000-0000.

Taxpayer Email

example@example.com

Do you own or rent your residence?

Spouse Name

First NameLast Name

Spouse SSN

Spouse Date of Birth

Date

Spouse Occupation

Spouse Phone Number

Format: (000) 000-0000.

Spouse Email Address

example@example.com

Spouse Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

DEPENDENT INFORMATION

Rows	FULL DEPENDENT NAME	DATE OF BIRTH	# OF MONTHS DEPENDENT RESIDE WITH TAXPAYER	SSN	Relationship To You (son, daughter, etc.)
DEPENDENT 1
DEPENDENT 2
DEPENDENT 3
DEPENDENT 4
DEPENDENT 5

Do you have a "Special Needs" child?

Enter the aggregate amount of advance child tax credit payments you (and your spouse if filing jointly) received:

CHILD CARE (DAYCARE) PAYMENT AMOUNT FOR THE CALENDAR YEAR

DID YOU RECEIVED HEALTH COVERAGE (INSURANCE) THROUGH YOUR STATE MARKETPLACE OR HEALTHCARE.GOV? IF SO, PLEASE UPLOAD YOUR FORM 1095A

Please upload 1095A below:

Wages and Salaries (Attach W-2's)

Interest Income (Attach 1099's) (List and identify as non-taxable Interest Income)

Unemployment Compensation Received (FORM 1099G) PLEASE UPLOAD FORM BELOW:

Please upload W-2's, and/or 1099 forms below:

Were you, your spouse, or any dependent registered in college? Do you have a form 1098T?

Please upload 1098-T below:

Check If you would like your tax refund (if any) deposited directly into your bank

Bank Name

Account Number

Confirm Account Number

THESE NUMBERS DON'T MATCH. PLEASE TRY AGAIN

Routing Number

Confirm Routing Number

THESE NUMBERS DON'T MATCH. PLEASE TRY AGAIN

Please upload a copy of your ID (i.e. Driver's License, Passport, or State ID:

Please upload any additional tax documents below, such as proof of mortgage interest payments, out-of-pocket medical expenses, rent payments, church tithes, losses or theft from a federally declared disaster area, and/or any proof of business losses:

Does anyone listed on the Tax Return have an Identity Pin? If so, please list the name and Identity Pin below:

If you were referred by someone, enter their name below:

Client Consent and Engagement Terms

By submitting this form, I confirm that all information provided is accurate and complete to the best of my knowledge. I understand that submitting this form serves as a formal agreement to retain Detroit Taxes LLC for tax preparation services.

I acknowledge and agree to the following:

A $75 Engagement Fee is due if I choose not to move forward with filing my tax return(s) through Detroit Taxes LLC after services have been initiated (including consultation, document review, or preparation of returns).

I am fully responsible for all tax preparation fees, even if my refund is delayed, reduced, or offset by the IRS or any other government agency due to prior debts or liabilities.

I authorize Detroit Taxes LLC and its banking partners to facilitate any refund transfer products I select, and understand that applicable fees may be deducted from my refund.

I understand that Detroit Taxes LLC does not guarantee any specific refund amount. Final results are determined by the IRS and/or state tax authorities.
I am responsible for providing all necessary documentation (e.g., W-2s, 1099s, receipts) to support my return. Incomplete or missing documents may cause delays or inaccuracies.

Detroit Taxes LLC may withdraw services if sufficient documentation is not provided, if communication becomes unreasonable or unprofessional, or if unethical requests are made.

Detroit Taxes LLC is committed to protecting my personal information. All data submitted will be stored securely and used solely for the preparation and filing of my tax return, in accordance with federal privacy laws.

By submitting this form, I authorize Detroit Taxes LLC to begin preparing my tax return(s) and agree to all terms outlined above.

I have read and agree to the Client Consent and Engagement Terms above.

Type a question

Taxpayer Information

CHILD/DEPENDENT CARE EXPENSES

HEALTH INSURANCE COVERAGE: