Client Intake Form

Client Intake Form

Please provide your information to help us get started.
Tax Payer Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Social Security Number
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Email Address
example@example.com
Taxpayer Valid Driver's License or ID
State
Issue Date

MonthDayYear
Date
Expiration Date

MonthDayYear
Date
Taxpayer Filing Status
Occupation
Preferred Method of Contact

Other
Were you penalized by IRS last year?
Do you have an IP PIN?
IP PIN Number
Spouse Name

First NameLast Name
Spouse Social Security Number
Spouse Date of Birth

MonthDayYear
Date
Tax Payer Bank Institution Name
Bank Account Number
Bank Routing Number
Dependent 1 Full Name

First NameLast Name
Dependent 1 Date of Birth

MonthDayYear
Date
Dependent 1 Social Security Number
Dependent 1 Relationship
Dependent 2 Full Name

First NameLast Name
Dependent 2 Date of Birth

MonthDayYear
Date
Dependent 2 Social Security Number
Dependent 2 Relationship
Dependent 3 Full Name

First NameLast Name
Dependent 3 Date of Birth

MonthDayYear
Date
Dependent 3 Social Security Number
Dependent 3 Relationship
Tax Payer Signature

Consent and Disclosure Statement for Sunflower Taxes: By submitting this form, you acknowledge and agree that Sunflower Taxes may collect, use, and disclose your personal information for tax preparation and related services in accordance with applicable laws and regulations. Your information will be handled with confidentiality and used solely for the purposes stated herein. Please read our full privacy policy for more details.
Privacy Policy for Sunflower Taxes: At Sunflower Taxes, we are committed to protecting your privacy and ensuring the security of your personal information. This privacy policy explains how we collect, use, disclose, and safeguard your information when you use our services. 1. Information Collection: We collect personal information that you provide to us directly, such as your name, contact details, Social Security number, financial information, and tax-related documents. 2. Use of Information: Your information is used solely for the purpose of preparing and filing your taxes, communicating with you regarding your tax matters, and complying with legal requirements. 3. Information Sharing: We do not sell or rent your personal information to third parties. We may share your information with trusted service providers who assist us in tax preparation and related services, under strict confidentiality agreements. 4. Data Security: We implement appropriate technical and organizational measures to protect your data from unauthorized access, disclosure, alteration, or destruction. 5. Your Rights: You have the right to access, correct, or request deletion of your personal information held by us, subject to legal and regulatory requirements. 6. Changes to This Policy: We may update this privacy policy from time to time. We encourage you to review it periodically. If you have any questions or concerns about our privacy practices, please contact us at privacy@sunflowertaxes.com.
Agreement Statement for Schedule C or Schedule H: I hereby affirm that all information provided in this form is true, accurate, and complete to the best of my knowledge. I understand that falsifying any information may result in penalties or legal consequences.
Thank you for choosing Sunflower Taxes, we are here to provide you with honesty and accurate filing
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Tax Prepare Name
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