Tax Return Intake Form
Please complete to the best of your knowledge. We'll get the financial amounts and other information during the phone interview. Let's get started! Fields with * required.
Please select
*
I'm a returning TAX RETURN client
I'm a new TAX RETURN client
If a new TAX RETURN client, who referred you so we can bless them with our referral fee?
NEW TAX RETURN CLIENTS ONLY: Take Photo of your driver license or ID clearly showing the ID number, ISSUE date and EXPIRATION date. (required for electronic filing)
What tax year is this return for?
*
Did you file last year?
*
No
Yes
Don't know or can't remember
If yes, what is the Adjusted Gross Income (AGI) on that return? (required to electronically file this return).
If none, put NONE and skip the photo.
If unsure, take a clear picture of the BOTTOM of the first two pages of last year's return.
What other tax years do you need to file?
*
Complete a separate Intake form for each year.
Taxpayer Information
Name
*
First Name
Last Name
Filing Status
*
Single
Head of Household
Married Filing Separate
Married Filing Joint
Qualifying Widower
Not sure
Social Security Number
*
Date of Birth
*
Age
*
Phone Number
*
Email
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
FOR EXISTING TAX CLIENTS ONLY: Is this address the same as last year or new?
Same
New
Occupation (what is or was your line of work even if you're not working now?)
*
Totally or permanently disabled?
*
Yes
No
Legally blind?
*
Yes
No
Full-time student?
*
Yes
No
Spouse/Significant Other Information (if none, skip and go to next section)
Name
First Name
Last Name
Social Security Number
Date of Birth
Age
Phone Number
Email
Address (if different than above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation (even if not working)
Full-time student?
Yes
No
Totally or permanently disabled?
Yes
No
Legally blind?
Yes
No
Dependents
Are you claiming any dependants?
*
No
Yes (put details below)
Dependants
Any dependant a student?
Please Select
No
Yes
Any Dependant blind or disabled?
Please Select
No
Yes
Can any dependant be claimed by someone else?
Please Select
No
Yes
Do you have any expenses for child care?
Yes
No
Please provide childcare provider info to claim child tax credit
Need Provider's name, address, EIN or SSN
Tax Related Questions
Current Employment Status
*
Employed
Unemployed
Self-employed
Retired
Did you contribute to a 401k or other pre-tax account?
*
Yes
No
Do you or any dependants have tuition expenses?
*
Yes
No
Do you own your home?
*
Yes
No
Did you pay real estate taxes?
*
Yes
No
Did you pay mortgage interest?
*
Yes
No
Did you make any energy improvements to your home?
*
No
Windows
Doors
Furnace
Hot water tank
Other
Did you sell any stock or cryptocurrency?
*
Yes
No
Did you take money from your 401K?
*
Yes
No
Did you start a business?
*
Yes
No
If yes, what is the business name?
Are you a victim of identity theft?
*
Yes
No
Expenses
Check all that apply
*
NONE
Over the Counter Medications
Hospital
Prescriptions
Medical
Insurance Premiums
Dental
Union Dues
Optical
Tax Preparation
Other
Did you make any donations?
*
Cash or Check (church, charity, etc)
Non-Cash (Goodwill, etc) Will need address
DOCUMENTS
Upload ALL your tax documents such as W2s, 1095s, 1098s, 1099s, donation receipts etc OR email to jenwilliamsintl@gmail.com OR Fax to (480) 525-7738
Browse Files
Drag and drop files here
Choose a file
Cancel
of
OR take photos. Must clearly show the ENTIRE document to ensure accuracy.
Schedule Phone Interview
What time zone are you in?
*
Please Select
Eastern
Central
Mountain
Pacific
Hawaiian
The above questions are not all the information needed for your return. Please schedule a phone appointment in YOUR time zone for a tax return interview (approx 45 minutes). We will contact you to confirm.
*
Select REFUND preference
If getting a refund, how do you want it?
*
Direct Deposit
Mail a check
Other (explain during phone interview)
If direct deposit, what are your routing and account numbers?
Is it a Checking or Savings account?
Questions or Comments?
Please let us know
Invoice, Acceptance & Signature
Tax returns are $150 each. Please choose your preferred payment method. An invoice with that choice will be emailed to you. Full payment is required before tax return is prepared.
*
Please Select
Cash App
Zelle
Other
If other, inform during phone interview
Taxpayer Signature
*
Date Signed
*
-
Month
-
Day
Year
Spouse/Significant Other Signature
Date Signed
-
Month
-
Day
Year
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