Tax Preparation Client Intake Form
600 Westridge Pkwy, Ste 714, PMB 1015, McDonough, GA 30253
Filing Status
*
Single
Head of Household
Married Filing Separate
Married Filing Joint
Qualifying Widower
Taxpayer SSN#
*
Copy of SSN Card
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If you are a new Client we require a copy of your previous year Federal Tax Return:
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Taxpayer Information
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
Please Select
Male
Female
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Current Home Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
Are you a full-time student?
Yes
No
Are you totally and permanently disabled?
Yes
No
Are you legally blind?
Yes
No
Spouse Information
Spouse SSN#
Copy of Spouse SSN#
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Name
First Name
Last Name
Age
Date of Birth
-
Month
-
Day
Year
Date
Gender
Please Select
Male
Female
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Current Home Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
Where they a full-time student?
*
Yes
No
Are they totally and permanently disabled?
Yes
No
Are they legally blind?
Yes
No
Are they your dependent?
Yes
No
Dependents
Enter your dependents here
Rows
Name
Date of Birth
Relationship
SSN#
Have lived with you more than 7 months?
1
2
3
4
5
6
Does you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it?
Rows
Yes/No
Employer
Spouse Ins
Exchange/ Marketplace
Direct with Insurer
Medicare
Medicaid
Taxpayer
Yes
No
Spouse
Yes
No
Dependent 1
Yes
No
Dependent 2
Yes
No
Dependent 3
Yes
No
Dependent 4
Yes
No
Dependent 5
Yes
No
Tax Related Questions
Employment Status
*
Employed
Unemployed
Self-employed
Are you contributing to 401k or other pre-tax account?
Yes
No
Does your dependents have tuition expenses?
Yes
No
Do you have any expenses for child care?
Yes
No
Do you have energy star rated improvements to your home?
Windows
Doors
Furnace
Other
Are you currently renting?
Yes
No
What is the monthly rental amount?
How long have you lived at the property for at least 7 months?
# of months
Do you have your own home?
*
Yes
No
Do you have documents that shows you paid for property taxes?
Yes
No
Other
Did you take money from your 401k?
Yes
No
Do you have mortgage interest?
Yes
No
Did you receive a federal tax last year?
Yes
No
Are you a victim of identity theft or do you require an IP PIN?
*
Yes
No
Expenses
Please fill-up the information within the current year only.
General Business Expenses
Rows
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
Total Expenses
Additional comments
Upload State Issued ID or Drivers License:
*
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Acknowledgment & Signature
I confirmed that all information I entered here is accurate and true.
I allow
Meek Life Financials, LLC dba Meek Life Global
to capture my sensitive data like personal id, government id, and other information.
I have read the terms and conditions and privacy policy of
Meek Life Financials, LLC dba Meek Life Global
.
By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Date Signed
*
-
Month
-
Day
Year
Date
Taxpayer Signature
*
Date Signed
-
Month
-
Day
Year
Date
Spouse Signature
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