Client Intake and Disclosure Form
CLIENT STATUS
RETURNING
NEW CLIENT
WHO WOULD YOU LIKE TO PREPARE YOUR RETURN
CHRISTIE MOSLEY
DESTINEE STEADMAN
ASHLEY DARK
AKERA CHRISTIAN
ANY PREPARER
NAME AND PHONE NUMBER OF THE PERSON WHO REFERRED YOU TO US.
WHAT YEARS ARE YOU FILING?
2025
2024
2023
Other
FILING STATUS
*
SINGLE
HEAD OF HOUSEHOLD
MARRIED FILING JOINT
MARRIED FILING SEPERATE
QUALIFING WIDOWER
Name
*
First Name
Last Name
TAXPAYER SOCIAL SECURITY NUMBER
*
DATE OF BIRTH
*
-
Month
-
Day
Year
Date
DATE OF DEATH
-
Month
-
Day
Year
Date
EMPLOYMENT STATUS
*
Please Select
SELF-EMPLOYED
UNEMPLOYED
EMPLOYED
DISABLED
RETIRED
TAXPAYER OCCUPATION
*
TAXPAYER IPPIN
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
TAXPAYER EMAIL
*
example@example.com
PRIMARY PHONE
*
Please enter a valid phone number.
Format: (000) 000-0000.
SPOUSE NAME
First Name
Last Name
SPOUSE SOCIAL
SPOUSE DATE OF BIRTH
-
Month
-
Day
Year
Date
SPOUSE DATE OF DEATH
-
Month
-
Day
Year
Date
EMPLOYMENT STATUS
Please Select
SELF-EMPLOYED
UNEMPLOYED
EMPLOYED
DISABLED
RETIRED
SPOUSE OCCUPATION
SPOUSE PHONE
Please enter a valid phone number.
Format: (000) 000-0000.
SPOUSE EMAIL
example@example.com
SPOUSE IPPIN
Did you live in any other state during 2025?
Yes
No
Did you make money in any other state in 2025?
Yes
No
BANK NAME
CHECKING/SAVINGS
Please Select
CHECKING
SAVINGS
ROUTING #
ACCOUNT #
DO YOU HAVE DEPENDENTS TO CLAIM?
*
YES
NO
DEPENDENT INFORMATION *do not include yourself or your spouse. please include everyone who lived in your home and anyone outside of your home who you provided 50% or more of support*
Rows
NAME
SOCIAL SECURITY
D.O.B
RELATIONSHIP
MONTHS LIVED WITH YOU
IPPIN IF THEY HAVE ONE
DEPENDENT 1
DEPENDENT 2
DEPENDENT 3
DEPENDENT 4
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OTHER INFORMATION, SELECT THOSE IN WHICH THE ANSWER IS "YES"
DID ANYONE ON THIS RETURN HAVE HEALTHCARE THROUGH THE HEALTHCARE MARKET PLACE? IF SO 1095 A MUST BE PROVIDED.
DID ANYONE ON THIS RETURN ATTEND COLLEGE CLASSES?
DID ANYONE ON THIS RETURN RECIEVE UNEMPLOYMENT BENEFITS?
DOES ANYONE ON THIS RETURN HAVE AN ID.ME ACCOUNT?
DOES ANYONE ON THIS RETURN HAVE AN IPPIN? IF YES, IP PIN MUST BE PROVIDED.
TAX QUESTIONS, SELECT THOSE IN WHICH THE ANSWER IS "YES"
DID YOU FILE A FEDERAL RETURN LAST YEAR?
DID YOU FILE A STATE RETURN LAST YEAR?
DID YOU RECIEVE A FEDERAL REFUND LAST YEAR?
DID YOU RECIEVE A STATE REFUND LAST YEAR?
WAS LAST YEARS REFUND TAKEN FOR PAST DUE OBLIGATIONS OR DEBTS?
DO YOU OWE ANY OF THE FOLLOWING? SELECT THOSE IN WHICH THE ANSWER IS "YES"
CHILD SUPPORT
FEDERAL TAXES
ALIMONY
STATE TAXES
STUDENT LOANS
HAVE YOU BEEN AUDITED OR DENIED A REFUND OR CREDIT IN A PREVIOUS YEAR?
YES
NO
UNSURE
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TIME TO UPLOAD YOUR DOCUMENTS
SOCIAL SECURITY CARDS
*
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DRIVERS LICENSE
*
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INCOME INFORMATION (W2S, 1099S, ETC.)
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BIRTH CERTIFICATE OF DEPENDENT
*
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OTHER DOCUMENTS (MORTGAGE, COLLEGE FORMS, PROPERTY SALES, ETC.)
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UPLOAD A SELFIE (UNFILTERED & IDENTIFIABLE) FOR IDENTITY VERIFICATION
*
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CLIENT ACKNOWLEDGEMENT STATEMENT
I THE TAXPAYER,
*
Consent to Prepare & File Return, I authorize Sweet Magnolia Tax Co. LLC and its tax professionals to prepare my federal and state income tax return(s) for the above tax year based on information I have provided. I affirm that the information I have submitted is true, accurate, and complete to the best of my knowledge.
Consent to E-File, I authorize Sweet Magnolia Tax Co. LLC to file my return electronically with the IRS and applicable state agencies. I understand I must review and sign IRS Form 8879 before e-filing can occur.
Client Responsibilities ,I understand that I am responsible for the accuracy and completeness of all information provided to Sweet Magnolia Tax Co. LLC. If my return is audited or questioned, I understand I must provide supporting documents to prove any credits claimed on my return.
I understand that my refund may be delayed, reduced, or withheld by IRS or state agencies for various reasons beyond the control of Sweet Magnolia Tax Co. LLC .
I understand that if my refund is taken, I personally have an obligation to pay Sweet Magnolia Tax Co. LLC. for their time and service within 90 days of notification that my refund was taken by the IRS and that an invoice will be sent to me through my preferred method of communication.
Acknowledgment. By signing below, I acknowledge that I have read and understand the contents of this form, and consent to the above authorizations
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