JACQUELINE BLAKE TAX PROFESSIONAL

Tax Preparation Client Intake Form

Please fill out the form carefully. Any Questions or concerns Email info@anjtotalservicesltd.com TEXT/CALL (888) 835-4571
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please select the service(s) you're interested in?

Name

First NameLast Name
Age
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
Are you a full-time student?
Are you totally and permanently disabled?
Are you legally blind?
Can this individual be claimed as a dependent by someone else?

Enter your dependents here

Rows	Name	Date of Birth	Relationship
1
2
3
4
5
6

Did you, your spouse, and your dependents have health insurance coverage for all 12 months of the tax year? If yes, who provided the coverage?

Rows	Name	SSN	Date of Birth	Relationship
Taxpayer
Spouse
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5

Employment Status
Did you earn income from gig work, freelancing, contracting, or self-employment this year?

Please provide information for the current tax year only.

General Expenses

Rows	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

Total Expenses
Additional comments
Please review the list below and ensure you upload all documents that apply to your situation. Providing complete documentation helps us prepare your return quickly and accurately.

Common documents include:

• W-2 forms from all employers
• 1099 forms (1099-NEC, 1099-MISC, 1099-K, etc.)
• Government-issued photo ID
• Social Security cards for dependents (if applicable)
• Prior year tax return
• Self-employment income records (if applicable)
• Childcare provider information (if claiming childcare credit)
• Education forms such as Form 1098-T

If additional documentation is required, our office will contact you.
👉 Missing Documents? We Can Help

If you are missing W-2s, 1099s, or other tax documents, we can retrieve your IRS Wage & Income transcripts on your behalf for an additional service fee.
👉 Have you already gathered all your tax documents?
👉 Do you need help retrieving your tax documents (W-2, 1099, IRS transcripts)?
👉 Document Recovery & IRS Verification Service
Authorization Consent
Service Fee Agreement
👉 After submitting this form, you will receive a secure payment link to complete your service request. Transcript retrieval will begin once payment is received.
👉 By selecting this service, you acknowledge that transcript data may not include state income details and additional documentation may still be required.
Upload W-2 Forms

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Upload Government-Issued Photo ID and Dependent Social Security Cards (if applicable)

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Upload 1099 Forms

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Upload Prior Year Tax Return

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Upload Other Supporting Documents

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Will you upload additional documents later?
ANJ Total Services will prepare your tax return based solely on the information and documents you provide. You are responsible for providing accurate and complete information and reviewing your tax return before filing.
If tax preparation work has begun and the client fails to respond or provide required documentation within 30 days, the return may be considered abandoned and an abandonment preparation fee may apply.
I confirm that all information and documentation provided to ANJ Total Services is accurate to the best of my knowledge.
I authorize ANJ Total Services to charge my payment method for outstanding preparation fees if services have been completed and payment has not been received.
Tax preparation services provided by ANJ Total Services do not include representation before the IRS or state tax agencies unless a separate agreement is established.

I certify that the information provided in this intake form and all supporting documents submitted to ANJ Total Services are accurate and complete to the best of my knowledge.

General information only: This form is not legal or tax advice and should be reviewed by a licensed professional for federal and state requirements. Do not provide full Social Security numbers or payment account numbers in this form unless specifically requested and lawfully permitted.

I acknowledge that ANJ Total Services will prepare my tax return based on the information provided. I understand that I am responsible for reviewing my completed tax return before authorizing filing.

By signing below, I confirm that I have read, understood, and agree to all client agreements and disclosures included in this intake form.
Date Signed

MonthDayYear
Date
Taxpayer Signature
Date Signed

MonthDayYear
Date
Spouse Signature

Should be Empty:

Tax Preparation Client Intake Form

👉 Missing Documents? We Can Help