FIRST LOOK - BEFUND.Us - INTAKE TAX RETURN FORM

First Look - Business Tax Credit Form
Please have the following available BEFORE proceeding with the application:

1. Photo Identification (BOTH SELF, SPOUSE AND ALL DEPENDENTS)

2. Social Security Card (BOTH SELF, SPOUSE AND ALL DEPENDENTS)

3. Business EIN Letter

4. W2(s) and 1099(s): 2021, 2022, 2023, 2024 (If applicable)

5. Personal Tax Return: 2021, 2022, 2023, 2024 (If applicable)

6. Business Tax Return: 2021, 2022, 2023, 2024 (If applicable)

7. Bank Routing and Account Number

SECTION I: PERSONAL INFORMATION
Date

MonthDayYear
Date
Referral
How Did You Learn About BEFUND?
Client Name*

First NameLast Name
Spouse Name (If Applicable)

First NameLast Name
Date of Birth *

MonthDayYear
Date
Spouse Birth Date (If Applicable)
US Citizen?*
Spouse - U.S. Citizen? (If Applicable)
Social Security Number*
Spouse Social Security Number
Current Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Personal Email*
example@example.com
Phone Number*
Select all that applies:*

Legally blind?Disabled?None of the above

SECTION II: BUSINESS INFORMATION:
Legal Business Name*
Brief Description Of Your Business or (NAICS)*

25 words or lesss0/25
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Entity Type
Registered Domicile State
Employer Identification Number (EIN)
Business Start Date

MonthDayYear
Date
Business Email
example@example.com

SECTION III: FILING STATUS AND HOUSEHOLD INFORMATION
Filing Status*

Dependent Information

	Name	SSN	Date of Birth	Relationship
1
2
3
4
5

Do you owe federal taxes?*

YesNo
Yes, Federal Tax Amount?
Do you owe state taxes?*

YesNo
Yes, State Tax Amount?
What State?
Do you owe child support?*

YesNo
Do you owe Student Loans?*

YesNo
Yes, Student Loan Amount?*
Type 0 (zero) if you do not have a student loan.
Student Loan Status?*

Repayment (Currently Paying Monthly)Grace PeriodDefermentForbearanceDelinquentDefaultNo Student Loan
Did you receive any stimulus payments?*

20212022N/A
Did you receive any unemployment payments?*

2020202120222023No
Select your current tax situation for 2021:*

No Taxes FiledPersonal Taxes Filed, Business Taxes Not FiledBusiness Taxes Filed, Personal Taxes Not FiledBoth Personal and Business Taxes Filed
Select your current tax situation for 2022:*

No Taxes FiledPersonal Taxes Filed, Business Taxes Not FiledBusiness Taxes Filed, Personal Taxes Not FiledBoth Personal and Business Taxes Filed
Select your current tax situation for 2023:*

No Taxes FiledPersonal Taxes Filed, Business Taxes Not FiledBusiness Taxes Filed, Personal Taxes Not FiledBoth Personal and Business Taxes Filed
Select your current tax situation for 2024:*

No Taxes FiledPersonal Taxes Filed, Business Taxes Not FiledBusiness Taxes Filed, Personal Taxes Not FiledBoth Personal and Business Taxes Filed
SECTION IV: INCOME

Check all that apply
Income - Last Year, Did You (and/or Your Spouse) Receive:*

Wages or Salary? (Form W-2)Self-employment income? (Forms 1099-MISC, 1099-NEC, 1099-K, cash, digital assets, or other property or services)Scholarships? (Forms W-2,1098-T)Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099- INT, 1099-DIV)Tip Income?Refund of state/local income taxes? (Form 1099-G)Alimony income or separate maintenance payments?Cash/check/digital assets, or other property or services for any work performed not reported on Forms W-2 or 1099?Unemployment compensation? (Form 1099-G)Income (or loss) from the sale or exchange of stocks, bonds, digital assets, or real estate? (including your home) (Forms 1099-R, W-2)Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)Retirement income or payments from pensions, annuities, and/or IRA? (Form 1099-RSocial Security or Railroad Retirement Benefits? (Forms SSA-1099, RRB-1099) Income (or loss) from rental property?Other income? (gambling, lottery, prizes, awards, jury duty, digital assets, Sch K-1, royalties
SECTION V: LIFE EVENTS

Check all that apply
Do you have a Health Savings Account? (Form 5498-SA, 1099-SA, W-2 with code W in Box 12)Do you have credit card, student loan or mortgage debt; cancelled or forgiven by a lender or have a home foreclosure? (Form 1099-C, 1099-A)Have you adopted a child?Do have a payment plan for owed taxes for past years?
ADDITIONAL INFORMATION AND QUESTIONS RELATED TO THE PREPARATION OF YOUR RETURN
Did you or anyone on the return have insurance through the Healthcare Marketplace? (If so, please provide a 1095-A or let us know if you need assistance retrieving it) *
Did you live in an area that was declared a Federal disaster area? *
Banking Information:
Bankholder Name

First NameLast Name
Bank Name
EX: Chase, Bank of America, Wells Fargo, etc.
Routing Number
Account Number
Account Type:*

CheckingSavingsNo Account
Account Type:*

BusinessPersonalNo Account
Supplemental Information:
ID (Front and Back) - AND - SSN Card *

Cancelof
ID Spouse (Front and Back) - AND - SSN Card

Cancelof
SSN Card(s) (Dependents)

Cancelof
2024, 2023, 2022, 2021 - W2(s) and 1099(s)

Cancelof
2024-2021 - 1099- K -Paypal- CashApp- Venmo- Stripe- Square- Shopify, etc

If you have received payments of $600 or more.
Cancelof
Business State Articles - Statement of Organization - Fictitious Name - DBA

Cancelof
EIN Letter

Cancelof
Personal Tax Returns

IF APPLICABLE, PLEASE INCLUDE: 2021, 2022, AND 2023 PERSONAL TAX RETURNS.
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Business Tax Returns

IF APPLICABLE, PLEASE INCLUDE: 2021, 2022, AND 2023 BUSINESS TAX RETURNS.
Cancelof
Additional Documents

Cancelof
PRIVACY ACT AND PAPERWORK REDUCTION ACT NOTICE
The Privacy Act of 1974 requires that when we ask for information we tell you our legal right to ask for the information, why we are asking for it, and how it will be used. We must also tell you what could happen if we do not receive it, and whether your response is voluntary, required to obtain a benefit, or mandatory. Our legal right to ask for information is 5 U.S.C. 301. We are asking for this information to assist us in contacting you relative to your interest and/or participation in the IRS volunteer income tax preparation and outreach programs. The information you provide may be furnished to others who coordinate activities and staffing at volunteer return preparation sites or outreach activities. The information may also be used to establish effective controls, send correspondence and recognize volunteers. Your response is voluntary. However, if you do not provide the requested information, the IRS may not be able to use your assistance in these programs. The Paperwork Reduction Act requires that the IRS display an OMB control number on all public information requests. The OMB Control Number for this study is 1545-1964. Also, if you have any comments regarding the time estimates associated with this study or suggestion on making this process simpler, please write to the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, Washington, DC 20224
Acknowledgment & Signature
I/We confirmed that all information that I/we have entered here is true and accurate.
I/We allow BEFUND and Best Tax Alliance to capture my sensitive data such as DL/ID, social security number, and other information.
I/We have read the terms and conditions and privacy policy of BEFUND.
By signing below, I acknowledge that I have read the acknowledgments and understand my responsibilities in providing true and accurate information to file my tax return.
Signature*

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Date
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First Look - Business Tax Credit Form

SECTION I: PERSONAL INFORMATION

SECTION II: BUSINESS INFORMATION:

SECTION III: FILING STATUS AND HOUSEHOLD INFORMATION

SECTION IV: INCOME

SECTION V: LIFE EVENTS

ADDITIONAL INFORMATION AND QUESTIONS RELATED TO THE PREPARATION OF YOUR RETURN

Banking Information:

Supplemental Information:

PRIVACY ACT AND PAPERWORK REDUCTION ACT NOTICE

Acknowledgment & Signature