Tax Preparation Client Intake Form 2025
Filing Status
Single
Head of Household
Married Filing Separate
Married Filing Joint
Qualifying Widower
Taxpayer Information
Name
*
First Name
Last Name
Age
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
SSN
*
Are you a full-time student?
*
Yes
No
Are you totally and permanently disabled?
*
Yes
No
Are you legally blind?
*
Yes
No
Please upload your drivers license/ID
*
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of
Please upload your W-2, 1099,SSA-1099
*
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of
Social Security Cards for Each Individual on Return
*
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of
Spouse Information
Name
First Name
Last Name
Age
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
SSN
Are they a full-time student?
Yes
No
Are they totally and permanently disabled?
Yes
No
Are they legally blind?
Yes
No
Are they your dependent?
Yes
No
Please upload your drivers license/ID for your spouse (if applicable)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload your W-2, 1099,SSA-1099 for your spouse (if applicable)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Dependents
Enter your dependents here
Name
SSN
Date of Birth
Relationship
1
2
3
4
5
6
Does you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it?
Yes/No
Employer
Spouse Ins
Exchange/ Marketplace
Direct with Insurer
Medicare
Medicaid
Taxpayer
Yes
No
Spouse
Yes
No
Dependent 1
Yes
No
Dependent 2
Yes
No
Dependent 3
Yes
No
Dependent 4
Yes
No
Dependent 5
Yes
No
Tax Related Questions
Employment Status
*
Employed
Unemployed
Self-employed
Are you contributing to 401k or other pre-tax account?
Yes
No
Do you or your dependents have tuition expenses?
*
Yes
No
If you received a 1098-T form for school, please upload here.
Browse Files
Drag and drop files here
Choose a file
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of
Do you have any expenses for child care?
*
Yes
No
Are you currently renting?
Yes
No
What is the monthly rental amount?
How long have you lived at the property?
# of months
Do you have your own home?
Yes
No
Do you have documents that shows you paid for property taxes?
Yes
No
Did you sell any stock?
Yes
No
Did you take money from your 401k?
Yes
No
Did you pay your vehicle tax?
Yes
No
Do you have mortgage interest?
Yes
No
Do you have real estate tax?
Yes
No
Did you receive a federal tax last year?
*
Yes
No
Expenses
Please fill-up the information within the current year only.
General Expenses
Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses
How Did You Hear About Us
*
Facebook
Instagram
Referral
Name of Referral Person
Additional comments
How do you want to receive your refund?
Direct Deposit
If You have an IPpin ENTER it here
Acknowledgment & Signature
I confirmed that all information I entered here is accurate and true.
I allow (company name) to capture my sensitive data like personal id, government id, social security number (SSN), and other information.
I have read the terms and conditions and privacy policy of (company name).
By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Date Signed
*
-
Month
-
Day
Year
Date
Taxpayer Signature
*
Date Signed
-
Month
-
Day
Year
Date
Spouse Signature
Print
Submit
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