Client Intake Form

Please fill-up the information within the current year only.(2025)

Consent for Payment and ACH Authorization

 We value our relationship with our clients and strive to provide the highest level of service. Please note that our service is for tax preparation, not the guarantee of a tax refund. As the taxpayer, you may pay your tax preparation fees using cash, money order, credit card, electronic payment, or directly from your tax refund.

 If you opt to have the tax preparation fees deducted from your refund and your refund is intercepted or offset, you are still responsible for the full payment of the tax preparation fees. By signing your tax return, you agree to pay these fees regardless of whether your refund is issued or intercepted.

 In the event of an intercepted refund, an invoice for the outstanding fees will be issued. If payment is not received within 30 days, we reserve the right to initiate ACH processing or pursue collections if no bank account information is on file.

 Important Notice: The Department of Treasury’s Financial Management Services (FMS) can offset unpaid federal or government debts from your tax refund without prior notice. Offsets commonly apply to:

• Past-due child support

• Debts owed to federal or state agencies

• Unemployment overpayments

• Past-due federal student loans

 

ACH Authorization Form

 I authorize Whitley Tax & Financial Solutions to initiate electronic debits from my bank account to collect payment for tax preparation services. I agree to the following terms:

1. Payment Obligation

I acknowledge that payment for tax preparation services is due in full and is not contingent on the approval or disbursement of my tax refund.

2. Authorization for Billing

If my tax refund is not approved or disbursed within 30 days through a third-party bank product, I authorize Whitley Tax & Financial Solutions to electronically debit my account for the total tax preparation fees as agreed. This debit will occur after the 30-day period.

3. Accurate Bank Information

I confirm that the bank account information provided is accurate and current for the purpose of this electronic debit.

4. Revocation of Authorization

I understand that I may revoke this authorization at any time by providing written notice to Whitley Tax & Financial Solutions. However, revocation does not waive any fees already incurred.

5. Notice of Changes

Whitley Tax & Financial Solutions will notify me in writing of any changes to the payment amount or schedule at least 10 days before any debits are initiated.

 

By signing below, I confirm that I have read, understood, and agree to the terms outlined in this ACH Authorization Form.

 

You agree to provide all necessary information regarding income and deductible expenses for the preparation of your tax return. Should you receive additional information after we beginwork on your return, you agree to notify us immediately to ensure that all relevant details are accurately reflected.

You confirn that all reported expenses and deduction amounts are accurate and supported by the required written documentation. In certain instances, we may request additional documents for your supporting records. in the event of an audit by the IRS or state tax authority, you must be able to produce written documentaion for all items reported on your return. We are available to offer guidance on acceptable forms of supporting evidence.

Before signing, carefully review the return to ensure the information is correct. Fees must be paid before your tax return is delivered to you or filed on your behalf. If you terminate this engagement before completion, you agree to pay a fee for work completed. A retainer is required for the preparation of late returns.It is advisable to keep a copy of your tax return and any related tax documents. A fee may be assessed if you request a copy in the future.By signing below, you acknowledge reading, understanding, and accepting your obligations and responsibilities.For a joint return, both taxpayers must sign.

It is recommended to retain a copy of your tax return and any related documents for your records, as a fee may be incurred if you request a copy at a later date. 

By signing below, you confirm that you have read, understood, and agree to your responsibilities and obligations.