MMM Taxpayer Filing Intake Form

ENGAGEMENT LETTER-This form is to confirm and specify the terms of our engagement with you and to clarify the nature and extent of the services we will provide. In order to ensure an understanding of our mutual responsibilities, we ask all clients for whom returns are prepared to confirm the following arrangements. By providing us with your signature, you are accepting the terms and conditions specified on this form.We will prepare your TAX YEAR(S) federal, state and local income tax returns from information which you will furnish to us. We will not audit or otherwise verify the data you submit, although it may be necessary to ask you for clarification of some of the information. We will furnish you with questionnaires and worksheets to guide you in gathering the necessary information. We reserve the right to assess additional bookkeeping charges. It is your responsibility to provide all the information required for the preparation of complete and accurate returns. You should retain all the documents, cancelled checks and other data that form the basis of income, expenses, credits and deductions. These may be necessary to prove the accuracy and completeness of the returns to a taxing authority. You have the final responsibility for the income tax returns and, therefore, you should review them carefully before you sign them. Our work in connection with the preparation of your income tax returns does not include any procedures designed to discover defalcations and/or irregularities, should any exist. We will render such bookkeeping assistance as determined to be necessary for preparation of the income tax returns. The law provides various penalties that may be imposed when taxpayers understate their tax liability. If you would like information on the amount or the circumstances of these penalties, please view the IRS website. Your returns may be selected for review by the taxing authorities. Any proposed adjustments by the examining agent are subject to certain rights of appeal. You are in full agreement with our tax company completing your tax return, and making sure that your return is filed with all of the available deductions given your filing circumstances. Since your tax return is unique to your circumstances, we CANNOT GUARANTEE the outcome of what happens after your return is sent to the IRS. If your return is used to fulfill an offset, this DOES NOT RELIEVE YOU OF YOUR OBLIGATION TO PAY for services provided. If the above sets forth your understanding, please sign this form in the space indicated. This form will apply for all tax returns prepared for you by our tax preparers. I understand that this information is being provided to the IRS and State Revenue. I have been advised by my tax preparer that any false and misleading information that I provide for income tax filing purposes is against the law and are subject to penalties. I understand that this tax firm is only liable for any Error and Omission on their part and will be responsible for any interest and penalties and not tax due. ARBITRATION If a dispute arises out of or relates to this contract or engagement letter, or the obligations of the parties therein, and if the dispute cannot be settled through negotiation, the parties agree first to try in good faith to settle the dispute by mediation administered by the American Arbitration Association under its commercial Mediation Rules before resorting to arbitration, litigation, or some other dispute resolution procedure. Signature:

Primary Taxpayer FULL Name

First NameLast Name

Taxpayer's SSN

Taxpayer's Birthdate

Date

Primary Taxpayer's Occupation

Taxpayer Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Taxpayer Email Address

example@example.com

CURRENT Street Address

Apartment Number (type n/a, if non applicable)

City

State

Zip/Postal Code

Filing Status?

If you are filing HEAD OF HOUSEHOLD, you must fill out my head of household questionaire to ensure you are eligible to file this as your filing status for tax season 2025.

Use the link immediately below. Everyone filing this status MUST fill out that questionaire no exceptions.

Head of Household Questionnaire Link

Were you legally married on the last day of the year?

Spouse FULL name type n/a, if non applicable)

First NameLast Name

Spouse Occupation (type n/a, if non applicable)

Spouses birthdate

Date

Spouse Social Security Number (type n/a, if non applicable)

Spouse phone number (if applicable)

Format: (000) 000-0000.

Spouse Email Address (if applicable)

example@example.com

Do you and your spouse reside at same residence address?

Can you or your spouse be claimed as a dependent on another persons tax return?

Did you, your spouse or anyone else on this return receive unemployment for the tax year you are filing?

Has the IRS ever banned you or your spouse from receiving tax credits? Such as earned income credit, child tax credit, head of household, or college credits?

Do you owe any delinquent:

Whether on vacation, working or living, were you in a state where a natural disaster occured in the last 2 years?

Last year did you purchase an electric vehicle?

Did you make any charitable donations?

Did you pay tithes?

Do you have any gambling loss to report?

Do you have proof of a bad debt that someone owes you but you were unable to collect on?

Did you sell any stocks?

Are you a teacher/educator?

Did you have any job related out of pocket moving expenses?

Did you operate/own a farm?

Do you currently own or rent at your residence?

Did you make any environmental upgrades to your residence? Such as solar panels, windows, indoors etc.

YOU MUST PROVIDE YOUR TAX PREPARER WITH A COPY OF YOUR SOLAR PANEL CONTRACT OR RECEIPTS/BANK STATEMENT FOR UPGRADES.

Are you claiming a Dependent(s) for 2025 Tax Season?

Did you pay for dependent/child/day/after-school expenses for a child under the age of 13 at any time in 2025 only? (Payment could be rendered to an individual or a Child Care Facility)

IF YOU ARE CLAIMING A DEPENDENT, PLEASE UTILIZE THE LINK BELOW TO FILL OUT THE DEPENDENT DUE DILIGENCE QUESTIONAIRE FORM

Dependent Due Diligence Form Link

THIS IS REQUIRED FOR ANY TAXPAYER CLAIMING A DEPENDENT

THIS WILL HELP DETERMINE IF YOU ARE ELIGIBLE TO RECEIVE CREDITS SUCH AS CTC, EITC, CHILD CARE DEPENENT CREDIT AND OTHER DEPENDENT CREDITS FOR THE DEPENDENT YOU ARE ATTEMPTING TO CLAIM.

Did you, your spouse or any other dependents receive an IP PIN (Identity Protection Pin Letter from the IRS this year?

Your tax preparer will request a copy of screenshot of your IP PIN (Identity Protection Pin Letter from the IRS this year. We do not accept applications without proof of the IPPIN, if you were issued one.

Your tax preparer must have all VALID state or federal identification or driver license card for ANYONE 18 years old and older on this tax return. For your convenience you may include ALL cards in ONE photo. You can also upload to secure portal.

UPLOAD YOUR UNEXPIRED ID, PASSPORT OR MILITARY ID

ONE OF THE THREE MUST BE UPLOADED.

Your tax preparer must have all SOCIAL SECURITY CARDS for EVERYONE listed on this tax return. For your convenience you may include ALL social security cards in ONE photo. You can also upload to secure portal.

UPLOAD YOUR SOCIAL SECURITY CARD OR BIRTH CERTIFICATE (FOR YOURSELF, SPOUSE (IF APPLICABLE) AND ALL DEPENDENTS)

ONE OR THE OTHER MUST BE UPLOADED

Your tax preparer must have all W2'S and 1099's for EVERYONE listed on this tax return. You can also upload the document to our secure portal.

UPLOAD YOUR W-2(S), 1099(S) any ANY other income you need to file (FOR YOURSELF, SPOUSE (IF APPLICABLE) AND ALL DEPENDENTS)

Examples of other income: Disability, Uber/Lyft statement, Lottery Winnings (Form WG,) etc

Did you do overtime at your place of employment during 2025?

If YES to the above question, for the NO TAX ON OVERTIME, please upload your LAST 2025 paystub to ensure maximum refund results.

Did you or anyone on this return attend college or trade school for the tax year you are filing?

Your tax preparer must have all 1098T, Receipts from College receipts for EVERYONE listed on this tax return.

Please upload your 1098T Form directly from your College/ University

If you paid for tuition, books, fees, upload ANY proof of payment toward the expenses you paid OUT OF POCKET for the year 2025 ONLY

Example: Books, Tuition, Classes, Enrollment fees etc

Is ANYONE on this return disabled or blind?

Did you purchase health insurance through healthcare.gov marketplace (aka Obamacare)? Did you receive form 1095-A?

If YES, to the previous question upload your 1095-A form.

NOTE: the return submission will be REJECTED if this info is not entered. Retrieve this form from healthcare.gov

Are you required to repay all of the advance premium tax credit received? In most cases, the answer is NO. ONLY answer YES if you were NOT considered lawfully present in the U.S. or you meet the Health Coverage Tax Credit criteria

INCOME FOR INDEPENDENT CONTRACTORS OR BUSINESS OWNERS

Are you self employed? Do you have a business? (Any additional income you receive through the exchange of goods or services is a business, even if you work from home, and do not have an employer identification number)

Your tax preparer must have proof of your business. A Business Card/Flyer or Screenshot your Business Social Media Page/Post, google listing, text thread between you and a client.

Did you accept payments from your clients through a 3rd party such as CASH APP, VENMO, PAYPAL, SHOPIFY, STRIPE, SQUARE etc for the year 2025 only? Check ALL that apply.

If yes to the above question, please upload your 1099k they should have provided you to report that income.

IF YOU ARE AN INDEPENDENT CONTRACTOR AND/OR BUSINESS OWNER PLEASE USE THE LINK BELOW TO ANSWER FURTHER QUESTIONS TO ENSURE THE BEST RESULTS

Schedule C Questionnaire Link

How would you like your refund to be deposited?

Bank Name?

Bank Account Number?

Bank Account Number Confirmation (DO NOT USE copy/paste. Please double check for accuracy)

Bank ROUTING Number? (please double check for accuracy)

Before you fill out your banking details please make sure you have the correct routing and account number aligned with your banking institution. Check it TWICE after entering.

Once I submit your taxes to the IRS, I cannot change any banking details. I CAN’T switch accounts, correct any accidental numbers entered or anything once I have submitted the return. No exception because there is nothing I can do once it has been sent to the IRS.

What additional questions can we answer for you?

We love to give credit when its due! Please give us the name of the person who referred you.

How did you hear about my services?

The BEST compliment you can give us is a referral! Get paid $25 per accepted referral 🥳. Have anyone you'd like to refer? Please enter their name and phone number below.

Please verify that you are human

I, hereby, state that all the information above is true, valid, to the best of my knowledge and that I am allowing Mindful Money Moves to prepare my taxes based on that fact. I accept full responsibility of the answers and statements mentioned above. Any and all disputes regarding my interview shall be forwarded to me with the information found on my tax returns forms. I understand that I am financially responsible for any outstanding balance due to any false information given.

* For any reason an amendment has to be filed with no fault of the tax preparer, an upfront fee of $150.00 is required!

Please view your tax return, which is emailed to you (it is sent prior to submission). Any copy after the first copy is a fee of $20.00. ALL PREPARATION FEES ARE DUE PRIOR TO SUBMISSION.

Please utilize www.irs.gov for all federal refund tracking. Please utilize your state
Department of Revenue site for any State Refund tracking. Do NOT add the amounts together. Federal taxes are federal, and state taxes are state when tracking your status. Please allow 8 weeks to surpass from the date of submission before calling the IRS, if you have any tracking questions.

For any direct assistance please email morgan@mindfulmoneymoves.com or IRS Contact 800-829-1040

Signing below, is you understanding and agreeing to all of the above.

Signature

Date form being completed

Date

Mindful Money Moves Tax Filing Intake