Premium Client Intake Form

Premium Client Intake Form
Chose your Tax Strategist*
Filing Status

SingleHead of HouseholdMarried Filing SeparateMarried Filing JointQualifying Widower

Enter your dependents here

Do you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it?

Expenses
Upload any Business Expense Sheets related to your tax return. You can also use the General expenses section below to add any additional expenses.

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Please fill-in the information with information from current tax year only.

Example: If todays date is in 2025, then we are filing your 2024 taxes and will need information regarding 2024 expenses.

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

Acknowledgment & Signature
- I confirmed that all information I entered here is accurate and true.
- I allow The Thrive Firm to capture my sensitive data like personal id, government id, and other information.
- I have read the terms and conditions and privacy policy of The Thrive Firm.
- By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Date Signed*

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Taxpayer Signature*

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Date Signed

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Spouse Signature

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