Tax Quote Intake Form
Fill out the for,
Customer Details:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
example@example.com
How did you hear about us?
*
Please Select
Newspaper
Internet
Magazine
Other
Please Specify
*
Are you a full time student?
*
Please Select
Yes
No
Occupation
*
Please Select
W2 Employee
Self Employed
Unemployed
How much income did you make in 2024?
*
Number of Dependents
*
Please Select
0
1
2
3
4
5
6
7
8
Are you legally married?
*
Please Select
Yes
No
If Yes fill out the spouse section below. If no skip Spouse section
Spouse Name
First Name
Last Name
Spouse Email
example@example.com
Spouse Phone Number
Please enter a valid phone number.
Spouse Occupation
Are they a full time student?
*
Please Select
Yes
No
Do any of your dependent's have tuition expenses and received a 1098T?
*
Please Select
Yes
No
Do you have expenses for child care?
*
Please Select
Yes
No
Did you, your spouse, or a dependent have insurance under the Affordable Care Act ( Market Place Health Insurance) in 2024?
*
Please Select
Yes
No
How would you like to receive your refund?
*
Please Select
Direct Deposit
Check
Prepaid Card
Would you like to apply for a refund advance?
*
Please Select
Yes
No
Submit
Should be Empty: