Ikonic Tax Client Intake Form

Client Intake Form

Please fill out the following form to provide your financial background and dependent details necessary for completing your tax return.
Who is your tax professional?
IF LEFT BLANK THE OWNER WILL PROCESS YOUR RETURN.
Full Name*

First NameLast NameSuffix
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
[object Object],[object Object],[object Object]
Spouse Full Name

First NameLast NameSuffix
Tax payer's IP PIN (Identity Protection Personal Identification Number)
Applicant Date of Birth*

MonthDayYear
Date
Social Security Number (SSN)*
Residential Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
SingleMarried Filing JointlyMarried Filing SeparatelyHead of HouseholdQualifying Widow(er)
IndividualJointBusinessAmended (this is the same price as a regular tax return depending on the type)Other
YesNo
YesNo
Dependent Information
Dependent 1 Full Name

First NameLast NameSuffix
Social Security Number (SSN)
Dependent 1 Date of Birth

MonthDayYear
Date
Dependent 1 Age
Dependent 1 Relationship to You
Dependent 1 IP PIN (Identity Protection Personal Identification Number)
Dependent 2 Full Name

First NameLast NameSuffix
Social Security Number (SSN) for Dependent 2
Dependent 2 Date of Birth

MonthDayYear
Date
Dependent 2 Age
Dependent 2 Relationship to You
Dependent 2 IP PIN (Identity Protection Personal Identification Number)
Dependent 3 Full Name

First NameLast NameSuffix
Social Security Number (SSN) for Dependent 3
Dependent 3 Date of Birth

MonthDayYear
Date
Dependent 3 Age
Dependent 3 Relationship to You
Dependent 3 IP PIN (Identity Protection Personal Identification Number)
YesNo
Dependent Caregiver Name for dependents ages up to 13
Caregiver Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Caregiver Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Dependent Care Expenses ($)
Banking Information

Direct deposit your tax return. Some banks qualify for 5-day advance deposits. If you do opt into paper check, there is a fee up to $25.00-$50.00.
Bank Name
Account Number
Routing Number
YesNo
Please note there is an advance application fee of $100 added to your fee.
BY YOU SIGNING THIS DOCUMENT YOU GIVE I'KONIC TAX RELIEFE PERMISSION TO FILE YOUR RETURN AND ALL DOCUMENTS PROVIDED IS CORRECT. YOU ALSO UNDERSTAND YOU NEED TO UPLOAD ALL DOCUMENTS NEEDED TO COMPLETE YOUR RETURN IF NOT THIS WILL DELEY YOUR PROCESS. YOU ARE ABLE TO UPLOAD ON OUR APP AS WELL, THERE IS A LINK TO DOWNLOAD IT ON THE WEBSITE. WE DO OFFER PICK UP AND DROP OFF SERVICE FOR AN ADDTIONAL FEE, PLEASE SPEAK TO YOUR TAX PROFESSIONAL.

**“Please note: If a tax return amendment becomes necessary due to missing, incorrect, or withheld information on your part, an upfront amendment fee will be required.”
Client Consent Signature*
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OFFSET LINE ACCESS & FORM 8821 AUTHORITY CONSENT
🔹 SECTION 1 — OFFSET LINE ACCESS CONSENT

This section authorizes I’KONIC TAX RELIEF to access and review information related to any federal or state refund offsets, including but not limited to:

Treasury Offset Program (TOP)
Child support arrears
Student loan debt
State tax liabilities
Unemployment overpayments
Federal agency debts

Authorization

I authorize I’KONIC TAX RELIEF to:

Contact the IRS, Bureau of Fiscal Service, and state agencies to verify offset activity
Obtain details regarding pending or completed refund offsets
Document and store offset information for tax preparation and compliance
Communicate findings to me via phone, email, text, or secure portal
I understand this consent does not authorize negotiation or settlement of debts.

🔹 SECTION 2 — IRS FORM 8821 AUTHORITY CONSENT

This section authorizes I’KONIC TAX RELIEF to prepare and submit IRS Form 8821 (Tax Information Authorization) on my behalf.

Form 8821 allows I’KONIC TAX RELIEF to receive IRS tax information for the purpose of:

Retrieving tax transcripts
Reviewing account balances
Checking refund status
Confirming identity verification issues
Reviewing notices or compliance flags
Confirming offset activity
Supporting accurate tax preparation

Authorization

I authorize I’KONIC TAX RELIEF to:

Prepare and submit IRS Form 8821
Receive tax transcripts, notices, and account information
Store and use this information for tax preparation and compliance
Communicate findings to me through approved communication channels
I understand:

Form 8821 does not grant power of attorney
I may revoke this authorization at any time in writing
This consent applies only to the tax years listed on the 8821 prepared for me

🔹 SECTION 3 — CLIENT ACKNOWLEDGMENT

By signing below, I acknowledge that:

I am voluntarily granting I’KONIC TAX RELIEF permission to access my offset and IRS tax information
I understand this combined consent is valid for the current tax year unless revoked
I’KONIC TAX RELIEF will maintain my information securely and confidentially
I may request a copy of this authorization at any time.
Client is required to sign*
Should be Empty:

Client Intake Form

Dependent Information

Banking Information

OFFSET LINE ACCESS & FORM 8821 AUTHORITY CONSENT