2025 Tax Intake Form

Tax Client Intake Form

(804) 571-7225
Please Select*
Referred By:
Do you have a NEW address?

YesNo
Upload Your Current ID

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Upload Your W2s, 1099s, and other Tax Documents

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Upload Any Supporting Documents, including Letters from IRS

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Filing Status

SingleHead of HouseholdMarried Filing SeparateMarried Filing JointQualifying Widower1120 C Corp or S CorpNon-ProfitOther
Dependent(s)?

Taxpayer Information
Name

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
SSN
EIN
If you need an Federal Tax ID number for your business or non-profit ENTER ALL 11-11111s
Are you a full-time student?

YesNo
Are you totally and permanently disabled?

YesNo
Are you legally blind?

YesNo
Is this individual dependent of other?

YesNo

	Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses

Acknowledgment & Signature
I confirmed that all information I entered here is accurate and true. I allow ParaLobby LLC and affilliates/partners to to capture my sensitive data like personal id, government id, social security number (SSN), and other information for tax and business development and mangement services. I have read the terms and conditions and privacy policy of ParaLobby, and agree allow representation as my registered agent and I understand that I must sign a Power of Attorney form in order for any tax resolution assistance.

By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.

Sample Power of Attorney Form: https://www.irs.gov/pub/irs-pdf/f8821.pdf
Date Signed

MonthDayYear
Date
Taxpayer Signature

Clear
Spouse Signature

Clear
Should be Empty:

Tax Client Intake Form