Tax Checks Client Intake Form

Tax Client Information Form

Get the Maximum Refund Amount TAXCHECKSATLLLC.COM
Tax Preparers Name
Your Name

First NameLast Name
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth
SSN
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Occupation
Are you a Full Time Student?
Do you receive SSI?
Do you owe the IRS ?
Do You owe Child Support?
Filing Status
Do you have dependents?
Dependent #1 Name (or Spouse Information)

First NameLast Name
Dependent #1 Date of Birth (or Spouse Information)
Dependent #1 SSN (or Spouse Information)
Dependent #2 Name

First NameLast Name
Dependent #2 Date of Birth
Dependent #2 SSN
Dependent #3 Name
Dependent #3 Date of Birth
Dependent #3 SSN
Do you own a business?
If so please provide EIN and business name
Did you, your spouse or your dependents have Health Insurance with Marketplace?
Do you have a 6 digit Pin provided by the IRS? If so please provide ( copy and paste link below in your browser to retrieve your pin )
https://www.irs.gov/identity-theft-fraud-scams/get-an-identity-protection-pin
https://www.irs.gov/identity-theft-fraud-scams/get-an-identity-protection-pin
Self Employment Income Amount

Self Employment Write Off Sheet

Upload Driver License (Required), Birth Certificate (Required) for all Dependents, Social Security Card, W2, 1099 ,1095-A (if applicable) , and any form that needs to be filed with the IRS

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How do you want to receive your refund?
For Direct Deposit : Bank Name
Routing Number
Account Number
* By clicking submit you agree for TAX CHECKS ATL LLC to file your Tax Return with the IRS.

( Please note a Tax Quote will be emailed to you before your tax return is filed with the IRS, Please respond to that email.)
Referred By
Do want to apply for Cash Advance
Should be Empty:

Tax Client Information Form