2025 Ready Client Intake Form

Hometown Tax Service

Client Intake Form
Thank you for completing the Hometown Tax Service Client 25-26 Intake Form.

Please take your time and review ALL information before submitting.
Accurate information is required for your return to be filed correctly and to avoid delays.

⚠ If any required documents are missing or any information is incorrect, your return WILL be delayed.
⚠ Do not submit this form until you have ALL supporting documents.

This intake form takes approximately 20–30 minutes to complete.

If you uploaded documents to our mobile app previously, you MUST upload them again here.

DEPENDENT DOCUMENTATION REQUIREMENTS
If you are claiming any dependents, you MUST upload:

Social Security Cards
Birth Certificates
AND documents proving they live with you, such as:

School records
Medical records
Medicaid letters
Doctor bills
Social services letters
Lease/utility bills showing child’s name & address
These documents MUST show the child’s name and your address.

⚠ PLEASE READ THIS CAREFULLY BEFORE SUBMITTING.
Failure to follow these instructions may result in your intake being rejected or delayed.
What tax year is this submission for? If you need more than one year filed, it should be submitted as a separate submission for each year.*
How did you hear about us?

FacebookInstagramReferralReturning Client
Choose a preparer

Tiffany GravesJoycelyn FittsFelisha GrantAngela LeeNext Available
Who referred you?
The person's name must be submitted in order to receive the $50 referral incentive. (Referral must file and be due a refund over $150.)
Will this be an amended (corrected) return?

YesNoOther
If yes, upload your previously filed return (1040)

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Upload documents that caused the amendment

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Upload IRS notice (if any)

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Date of the interview?

MonthDayYear
Date
Interview setting?

In PersonVirtual/ Video or FacetimeOther

Dependents
Dependent 1
First Name
Last Name
SSN
Date of Birth

MonthDayYear
DOB
Is The dependent a citizen of the USA?
Was this dependent a full time student?
Relationship
Number of months the person have lived in your home in 2024
Dependent #1 Supporting Documentation. Birth Certificate, Social Security cards, school or medical records, insurance documents.

Example: Birth Certificate, Shot Record, School Record, Lease Showing Child As Resident
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Dependent 2
First Name
Last Name
SSN
Date of Birth

MonthDayYear
DOB
Is The dependent a citizen of the USA?
Was this dependent a full time student?
Relationship
Number of months the person have lived in your home in 2024
Dependent #2 Supporting Documentation. Birth Certificate, Social Security cards, school or medical records, insurance documents.

Example: Birth Certificate, Shot Record, School Record, Lease Showing Child As Resident
Cancelof
Dependent 3
First Name
Last Name
SSN
Date of Birth

MonthDayYear
DOB
Is The dependent a citizen of the USA?
Was this dependent a full time student?
Relationship
Number of months the person have lived in your home in 2024
Dependent #3 Supporting Documentation. Birth Certificate, Social Security cards, school or medical records, insurance documents.

Example: Birth Certificate, Shot Record, School Record, Lease Showing Child As Resident
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Did you provide a home or help support anyone not listed as your dependent?

YesNo
Did you pay any childcare expenses?

YesNo
Did your dependent(s) attend college and have tuition expenses?

YesNo
If yes, where and how much.
IF YOU ARE CLAIMING A DEPENDENT, PLEASE ANSWER THE QUESTIONS BELOW THAT PERTAINS TO YOUR DEPENDENT RELATIONSHIP. PER THE IRS REQUEST, WE MUST PROVE THAT NOBODY ELSE IS ELIGIBLE TO CLAIM YOUR DEPENDENT BUT YOURSELF.
If claiming son/daughter, where is the other parent of the dependent/dependents? Is the other parent providing any financial support?
If claiming a sister, brother, niece, nephew, aunt, or uncle, why are the parents not claiming the dependent/dependents?

Refund Disbursement
Are you interested in the SAME DAY Advance up to $1,000 with no interest?

YesNo
Are you interested in the SAME DAY Advance up to $7,000 with interest?

YesNo
Refund Disbursement Method
If you selected direct deposit, please provide your account details below. Please be sure you are the account Holder
Bank Name
Financial Institute
Is this a checking or a savings?

CheckingSavings
Account Number
Verify Account Number
Routing Number
Verify Routing Number
Do you have any other income than your W-2(s)?

YesNo
If yes, please upload your tax document(s)(W-2,1099,1098-T, etc.)

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ID Verification
Full legal name as shown on ID, Include middle initial or full name also.
Date of Birth:

MonthDayYear
Date
Upload a copy front and back of your valid government issued ID or DL.

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I certify this ID belongs to me*

I agree
Taxpayer's Social Security Card.

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Dependent Social Security Card(s)

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Anything you'd like us to know when preparing your return?

Acknowledgment & Signature
STOP

Did you finishing uploading all of your supporting documents?

IF YOU DID NOT UPLOAD ALL NECCESSARY DOCUMENTS YOUR INTAKE FORM WILL BE DEEMED NULL AND VOID.
I acknowledge that all information provided to Hometown Tax Service is true, complete and accurate to the best of my knowledge.

I understand that I am required to have any supporting documentation to validate the information provided.

Furthermore, I understand that knowingly providing false information on my tax return and reporting it to the IRS, that I am taking part in a potentially criminal penalty situation and is punishable by law including but not limited to; facing court dates, restitution and possible imprisonment.

I waive Hometown Tax Services and the preparer of any error due to incorrect information provided by me. By signing below, I authorize Hometown Tax Service to prepare all forms related to my tax return. To apply for a secure RAC's and RAL's on my behalf, sign all neccessary forms and file my taxes electronically. I take full responsibilty for the accuracy of this form and the information I have provided.
Date Signed*

MonthDayYear
Date
Taxpayer Signature*

Clear
Date Signed

MonthDayYear
Date
Spouse Signature

Clear
Upload a selfie. (Optional)

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Should be Empty:

Hometown Tax Service

Household & Marital Information (For Filing Status Determination)

Dependent 1

Dependent 2

Dependent 3

ID Verification