Tax Client Intake Form

Tax Intake Form

Your information is kept confidential and secure. Please complete all sections that apply to you.
Who is your preparer?*
Were you referred by someone?*
please type first and last name
Personal Info
Name*

First NameLast Name
Date of Birth*

MonthDayYear
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.Format: (000) 000-0000.
Email*
example@example.com
Preferred Contact Method*

TextEmailCall
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Filing Status*

SingleMarried Filing JointMarried Filing SeparateHead of HouseholdQualifying Widower
Please upload all proper identification documentation*

ID, SSC, Passport
Cancelof
- Dependents
- Please upload all proper identification documentation
  
  Birth Certificate, SSC
  Cancelof
- Please select all income sources that apply to you.*
  
  W-2 (Employment Income)1099 (Independent Contractor, Investments, etc.)Schedule C (Self-Employed BusinessRental 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*
  
  Cancelof
- Other income details we should know about?*
- 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 ContributionsRetirement Contributions (IRA/401k)Business Expenses (if self-employed)Other
- Upload related forms or receipts here*
  
  Cancelof
- Please provide any additional information about your deductions or credits.
- Would you like us to help with any of these additional services?
  
  Bookkeeping Clean-Up (starting at $1,000)Additional Tax Forms / Schedules ($100 each)Tax Planning & Strategy Session ($250/month)Business Consulting / Advisory ($250 per session)Financial Coaching / Money Management Plan ($250 setup)
- All services and prices listed above are only subject to change if agreed upon by Jose Martinez Founder/Owner
- Upload any additional documents that may be relevant to your tax return (last year’s return, receipts, bank statements, etc.)*
  
  Cancelof
- Signature*
- Should be Empty:

Tax Intake Form

Personal Info