Legacy Financial Solutions: Tax Preparation Client Intake Form

Proof of Residency
Are you a resident of this state for tax purposes?

Other
Has your residency status changed in the current tax year?

Other
Do you maintain a residence at any other address?

Other
Important Note: This sworn statement is for tax preparation purposes only and will be used to determine your eligibility for certain tax credits, deductions, and residency-based requirements (e.g., state taxes, in-state tuition credits, etc.). Instructions for Client: • Please ensure that all sections are completed accurately. • If you have any questions or need assistance, don’t hesitate to ask your tax preparer. • A false statement or omission could lead to errors in your tax return, and you may be held responsible for any discrepancies or penalties. Declaration:I affirm that I do not maintain a residence at any other location for tax purposes, and the information provided above is true and accurate to the best of my knowledge.

Dependent Information
Dependents
Have you ever had the Child Tax, American Opportunity, Earned Income or any other credit(s) disallowed or reduced in a previous year?
Additional Information (Please provide any additional relevant information needed in relation to dependents including relationship and IPPIN if required.)
I swear under penalty of perjury that the children listed above, for whom I am claiming if any the Child Tax Credit or Other Dependent Credit, are under the age of 17 and/or meet the IRS criteria for dependents, live with me for more than half the year, and I meet all other eligibility requirements for the credit. I also acknowledge that I may be asked to provide proof of the children’s eligibility, including but not limited to school records, living arrangements, and other relevant documentation, if requested by the IRS.
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Important Documents

Upload the following forms: Driver License, Social Security Cards, W-2s, 1099s (income, freelance, etc.), 1098 (mortgage interest), 1098-E (student loan), Form 8863 (education credits), Form 2441 (childcare), and bank details for direct deposit.We prioritize the security of your personal information. We use SSL encryption and secure payment processing to protect your data. Rest assured; your privacy is always safeguarded. If you have any concerns, we're here to help.
File Upload

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I declare under penalty of perjury that all documents uploaded for the purposes of my tax return preparation, including but not limited to income statements, deductions, credits, and supporting documentation, are true, correct, and complete to the best of my knowledge.I affirm that the uploaded documents accurately reflect my financial and personal information for the relevant tax year, and I understand that any false or incomplete information may result in penalties, fines, or legal consequences.
Date

MonthDayYear
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What is your preferred method of contact?
When is the best time to contact you?

Referral(s)

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Where did you hear of Legacy Financial Solutions?

Other
Name of the person who referred you:

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Referral
Name

First NameLast Name
Phone Number
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Email
example@example.com
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
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Tax Preparation Client Intake Form