Tax Client Information

Client Information Intake
Personal Information
Full Name*

First NameLast Name
Date of Birth (MM/DD/YYYY)*

MonthDayYear
Date
Social Security Number (SSN)Number*
Marital Status*

SingleMarried Filing JointlyMarried Filing SeparatelyHead of HouseholdQualifying Widower
Phone Number*
Please enter a valid phone number.
Email Address *
example@example.com
Residential Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please select a Tax Year:*
Spouse Information (if applicable)
Full Name

First NameLast Name
Date of Birth (MM/DD/YYYY)

MonthDayYear
Date
Social Security Number (SSN):
Phone Number
Please enter a valid phone number.
Email
example@example.com
Dependent Information(if applicable)
Dependent Information
Income Information
Sources of Income (check all that apply):

W-2 Wages1099 IncomeUnemployment BenefitsSocial SecurityInvestments/DividendsRental IncomeOther
Did you pay for any of the following? (check all that apply):

Childcare/Dependent CareEducation Expenses (e.g., tuition, student loan interest)Medical Expenses (not reimbursed by insurance)Charitable ContributionsMortgage Interest/Property TaxesIRA or Retirement Contributions
In order for your tax refund to be deposited into your bank account, please enter your direct deposit information
Bank Name
Routing Number
Account Number
Account Type

CheckingSavings Additional Information
Did you receive any IRS or state correspondence during the year?

YesNo
If you were referred, please enter referral name:
Would you like to bundle tax preparation with credit repair for an additional $1,000

YesNo
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Authorization
By signing below, I confirm that the information provided is accurate to the best of my knowledge. I authorize RoyalTax Prep to prepare my tax return based on the provided information.
Client Signature*
Date*

MonthDayYear
Date
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Client Information Intake

Personal Information

Spouse Information (if applicable)

Dependent Information(if applicable)

Authorization