CLIENT INTAKE FORM TAX SEASON 2025

Name

First NameLast Name

Spouse Name (If Filling Jointly)

First NameLast Name

Social Security #

Spouse Social Security #

Date Of Birth

MonthDayYear

Spouse Date Of Birth

MonthDayYear

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Email

Spouse Email

Phone #

Area CodePhone Number

Spouse Phone #

Area CodePhone Number

Occupation

Spouse Occupation

Dependent Name

Dependent Social

Dependent DOB

MonthDayYear

Relationship

Months Lived In Home

Dependent Name

Dependent Social

Dependent DOB

MonthDayYear

Relationship

Months Lived In Home

Dependent Name

Dependent Social

Dependent DOB

MonthDayYear

Relationship

Months Lived In Home

Dependent Name

Dependent Social

Dependent DOB

MonthDayYear

Relationship

Months Lived In Home

Filing Status

Did you receive a refund last year ?

Select Your Tax Preparer

Direct Deposit- Bank Routing #

Direct Deposit- Bank Account #

Referred By

Did you file with us last year?

Refund Advance Option (Optional)

ID/Drivers License

Social Security Cards

Tax Documents (W2,1099,Unemployment,ect)

Other Documents

Signature

Acknowledgment & Client Agreement - By signing below, I confirm that all information provided in this intake form is true, accurate, and complete to the best of my knowledge. I understand that providing false, incomplete, or misleading information may delay the processing of my tax return or affect its accuracy. I acknowledge that I am responsible for submitting all required documents and promptly informing Clear Choice Tax Preparation of any updates or changes to my personal, income, or dependent information. I understand that Clear Choice Tax Preparation will prepare my tax return based solely on the information and documentation I provide. I authorize Clear Choice Tax Preparation to use this information for the purpose of preparing and filing my federal and/or state tax return. By signing below, I agree to all terms stated above.

Date

MonthDayYear