2025 New Tax Preparation Client Intake Form

Name

First NameLast Name
Date of Birth

MonthDayYear
Date
SSN
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What county do you live in? If applicable please enter school district name and code.
Occupation
Are you a full-time student?

Enter your dependents here

Does you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it?

Employment Status
Are you currently renting?
What is the monthly rental amount?
How long have you been renting this property?
# of months
Do you have your own home?
Do you have documents that shows you paid for property taxes?
Did you sell any stock?
Did you have a 401k or any form of a retirement plan that you contribute to on a regular basis?

What kind of debt do you have and list the amount.

Rows	Yes	No	Amount
Credit Card Debt
Student Loans
Mortgage
Car Loan
Other debt please name it and list the amount in the amount field.

General Expenses

What is the name of your bank for your refund?
Screenshot only of the routing and account number or write it on a piece of paper and take a picture to upload here.

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Are you looking for financial guidance or entrepreneurship?

- I confirmed that all information I entered here is accurate and true.
  
  I allow Hayes Tax Prep to capture my sensitive data like personal id, government id, social security number (SSN), and other information.
  
  I have read the terms and conditions and privacy policy of Hayes Tax Prep.
  
  By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Submit ID Here (if filing jointly add spouse ID) Please take clear picture of ID

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Date Signed

MonthDayYear
Date
Taxpayer Signature
Date Signed

MonthDayYear
Date
Spouse Signature
Should be Empty: