Tax Intake Form
Your information is kept confidential and secure. Please complete all sections that apply to you.
Name
*
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Social Security Number
*
Your SSN will only be used for tax filing purposes and is never shared.
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Preferred Contact Method
*
Text
Email
Call
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Filing Status
Single
Married Filing Joint
Married Filing Separate
Head of Household
Qualifying Widower
Dependents
Dependents
*
Income Information Setup
Please select all income sources that apply to you.
W-2 (Employment Income)
1099 (Independent Contractor, Investments, etc.)
Schedule C (Self-Employed Business
Rental Income (Schedule E)
Retirement / Social Security (1099-R, SSA-1099)
Unemployment Income (1099-G)
Other (Alimony, Gambling, etc.)
Upload your income documents (W-2, 1099s, etc.) here
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Other income details we should know about?
Deductions & Credits
Select all deductions or credits that apply to you.
Mortgage Interest (Form 1098)
Medical Expenses (out-of-pocket)
Child Care Expenses (include provider info)
Education Expenses (Form 1098-T)
Charitable Contributions
Retirement Contributions (IRA/401k)
Business Expenses (if self-employed)
Other
Upload related forms or receipts here
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Please provide any additional information about your deductions or credits.
Additional Services Setup
Would you like us to help with any of these additional services?
Bookkeeping Clean-Up (starting at $1,000)
Additional Tax Forms / Schedules ($250 each)
Tax Planning & Strategy Session ($250)
Business Consulting / Advisory ($250 per session)
Financial Coaching / Money Management Plan ($250 setup)
Upload any additional documents that may be relevant to your tax return (last year’s return, receipts, bank statements, etc.)
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Signature/Consent
Signature
Continue
Continue
Should be Empty: