Income Tax Data Form

Tax Preparation Client Intake Form

Jay's Professional Tax Service
Preparer ID:
Tax Year:
Select Your Tax Professional
Please choose which forms you want to file:
Primary Filer's Information
Name

First NameLast Name
Date of Birth
Social Security Number
Driver's License #
Driver License Expiration Date

MonthDayYear
Date
Driver License Issue Date

MonthDayYear
Date
Occupation
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Filing Status
Subject to change based on filing status qualification
Email
example@example.com
Are you a full-time student?
Are you totally and permanently disabled?
Are you legally blind?
Did You receive Health Insurance via Market Place?
Can someone else claim you as a dependent?
Spouse Information

** Section REQUIRED if filing MFJ (Married Filing Jointly)
Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Social Security Number
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Occupation
Are you a full-time student?
Are they totally and permanently disabled?
Are they legally blind?
Did You receive Health Insurance via Market Place?
Can someone else claim you as a dependent?
Source of Income. Check the Income Items Which Pertain to You.
Source of Expenses. Check the Expenses Which Pertain to You
Other
Dependent's Information
If you have any dependents please list how many?
Name of Dependent # 1

First NameLast Name
Date of Birth

MonthDayYear
Date
Social Security Number
Relationship
Name of Dependent # 2

First NameLast Name
Date of Birth

MonthDayYear
Date
Social Security Number
Relationship
Name of Dependent # 3

First NameLast Name
Date of Birth

MonthDayYear
Date
Social Security Number
Relationship
Child Care Information(Credit)
Did you pay any childcare in 2025?
Provider Name

First NameLast Name
Provider Phone Number
Format: (000) 000-0000.
Provider EIN Number
Provider Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child Name

First NameLast Name
Child Care Amount Spent
Please upload additional files: Dependent documents (if applicable) Dependents verification documents are required to claim dependent listed on return.

Birth Certificate, Medical Card, School Records, Lease, Utility Bill ECT...
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Document Upload
Please upload the following files: (IDENTITY DOCUMENTS - Driver License, State ID, Social Security Cards, Passport Etc....).

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Please upload the following files: (INCOME DOCUMENTS Check Stub, Expense Report, W-2 Form, 1099 or any other income documents (if applicable).

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Please upload the following files: Social Security Cards (Tax payer, dependents, and spouse)

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Please upload any additional files.

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Any Additional Information:
Banking Information (Routing Number / Account Number)
Tax Filing Products
Paper Filing (Fee Paid Upfront)
Would You Like To Apply For Refund Advance Loan (Not Available after Feb.)
Bank Products
Acknowledgment & Signature
I give JAY’S PROFESSIONAL TAX SERVICE permission to view and use all information submitted for filing Purposes. I agree to submit any additional required/requested information needed to move forward by completing other required documents. If in any case I am unable to do so or I have emailed additional documents required to file, my signature on this form will be considered valid to file 2025 tax return.
I give Financial permission to electronically deduct their final tax fee(s) from my IRS refund (Initial Below)
I understand, that Jay's Professional Tax Service Financial Advisor will contact you regarding the filing of your return and concerning the details you have indicated above?
I confirmed that all information I entered here is accurate and true.
I allow Jay's Professional Tax Service to capture my sensitive data like personal id, government id, and other information.
I have read the terms and conditions and privacy policy of Jay's Professional Tax Service. By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Client Signature
Date

MonthDayYear
Date
Spouse Signature
Date

MonthDayYear
Date
Should be Empty:

Tax Preparation Client Intake Form

Primary Filer's Information

Spouse Information

Source of Income. Check the Income Items Which Pertain to You.

Source of Expenses. Check the Expenses Which Pertain to You

Dependent's Information

Child Care Information(Credit)

Document Upload

Tax Filing Products

Acknowledgment & Signature