Tax Preparation Verification and Due Diligence Intake Form
Please fill out this form accurately to help us prepare your tax return effectively.
Full Name
*
First Name
Middle Name
Last Name
Social Security Number
*
.
Format: (000) 000-0000.
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Residential Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Date of Birth
*
-
Month
-
Day
Year
Date
Spouse Full Name
First Name
Middle Name
Last Name
Spouse Date of Birth
-
Month
-
Day
Year
Date
Filing Status
*
Single
Married Filing Jointly
Married Filing Separately
Head of Household
Qualifying Widow(er)
Dependents
*
Yes, I have dependents
No dependents
Dependent 1 Full Name
First Name
Middle Name
Last Name
Dependent 2 Full Name
First Name
Middle Name
Last Name
Dependent 3 Full Name
First Name
Middle Name
Last Name
Who’s Your Preparer?
*
Aris
Farren
Have you received any income from sources such as self-employment, rental, investments, or foreign income?
*
Yes
No
Did you have any health insurance coverage during the year?
*
Yes
No
Did you make any large financial transactions or investments?
*
Yes
No
Any Crypto
*
Yes
No
Would you like to apply for cash advance? (Up to 24 hours approval)
*
Yes
No
If yes, which advance are you interested in?
*
Small advances $500-$2000
Larger advances $2000 -$9500 (Fee Attached)
Taxpayer/Spouse/Dependent Document Uploads
Tax Payer
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Spouse Id
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Tax Payer Social Security card
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Spouses Social Security card
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Any birth, death, marriage, divorce or adoption certificates
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Dependent #1 SSC And proof Dependency
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Dependent #2 SSC & Proof of dependency
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Dependent #3 SSC & Proof of dependency
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Dependent #4 SSC and proof of dependency
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Dependent #5 SSC and proof of dependency
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Proof of child care
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Additional documents
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Income verification documents
Income docs (W2 or 1099)
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Unemployment Compensation (1099G)
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Interest Income 1099-INT and/or 1099-DIV
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Social Security Benefit (Form SSA-1099)
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Stocks/Investments (1099-B)
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Gamblings or Losses (Including Lottery, Bingo & Raffles) (W2-G)
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Retirement information
Payments/Distributions from a retirement plan (401k, IRA 1099-R)
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Health information
Health insurance from from the healthcare.gov marketplace (Form 1095-A)
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Health savings account (HSA) or other medical savings account (Form 1099-SA & Form 5498-SA)
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Unreimbursed incurred medical expenses
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Housing information
Form 1098- Mortgage interest and 2020 property tax statement
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Closing disclosure and 1099-S
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Rental property income (Income and expenses)
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Foreclosure documents (1099-A or 1099-C)
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Energy efficient improvements made
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Did you rent in 2025?
Yes
No
If yes, how much was your monthly rent?
What is your landlord/apartment/ name & Address ?
Child and dependent care
Annual child care statement
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Education
Any tuition, fees or book expenses that were required to attend college, university or vocational school (1098-T and Expenses)
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Scholarships or grants for higher education
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Distribution from a 529 plan or education savings plan (Form 1099-Q)
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Contributions to a 529 plan or education savings plan
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Student loan interest (Form 1098-E)
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Itemized Deductions
Charitable contributions (Receipts or acknowledgments from charity, cancelled check or other proof)
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Business Information (1099-NEC, 1099-MISC or own a small business)
Business vehicle mileage documentation
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Miscellaneous
Any additional support documentation not listed above
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Consent to use of tax return information
Federal law requires this consent form be provided to you (“you” refers to each taxpayer, if more than one). Unless authorized by law, we cannot use your tax return information for purposes other than the preparation and filing of your tax return without your consent.You are not required to complete this form to engage our tax return preparation services. If we obtain your signature on this form by conditioning our tax return preparation services on your consent, your consent will not be valid. Your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature. For your convenience, we have entered into an arrangement with Santa Barbara Tax Products Group, LLC, a division of Green Dot Corporation, a Delaware corporation (“Processor”), using banking services of Green Dot Bank, to provide qualifying taxpayers with the opportunity to apply for refund processing services offered by and through Processor. To determine whether these services may be available to you, we will need to use your tax return information by analyzing it and calculating the amount of your anticipated refund. If you would like us to use your tax return information to determine whether these services maybe available to you while we are preparing your return, please sign and date this consent to the use of your tax return information.By signing below, you (including each of you if there is more than one taxpayer) authorize us to use the information you provide to us during the preparation of your 2024 tax return to determine whether to present you with the opportunity to apply for refund processing services through Processor.
Name
First Name
Last Name
Signature
Date
-
Month
-
Day
Year
Date
Spouse
First Name
Last Name
Signature
Date
-
Month
-
Day
Year
Date
Consent to disclosure of tax return information
Federal law requires this consent form be provided to you (“you” refers to each taxpayer, if more than one). Unless authorized by law, we cannot disclose your tax return information to third parties for purposes other than the preparation and filing of your tax return without your consent. If you consent to the disclosure of your tax return information, Federal law may not protect your tax return information from further use or distribution.You are not required to complete this form to engage our tax return preparation services. If we obtain your signature on this form by conditioning our tax return preparation services on your consent, your consent will not be valid. If you agree to the disclosure of your tax return information, your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature.You have indicated that you are interested in applying for a Refund Transfer (“RT”) product from Santa Barbara Tax Products Group, LLC, a division of Green Dot Corporation, a Delaware corporation (“Processor”) using banking services of Green Dot Bank (“Bank”). In order to have your refund processed by and through Processor, we must disclose all of your 2024 tax return information to Processor and Bank.If you would like us to disclose your 2024 tax return information to Processor and Bank for this purpose, please sign and date your consent to the disclosure of your tax return information.By signing below, you (including each of you if there is more than one taxpayer) authorize us to disclose to Processor and Bank all of your 2024 tax return information so that Processor can evaluate and process your application and Bank can provide banking services for the RT product. You understand that if you are not willing to authorize us to share your tax information with Processor and Bank, you will not be able to obtain an RT product from Processor, but you can stillchoose to pay us directly to have your tax return prepared and filed.
Name
First Name
Last Name
Signature
Spouse
First Name
Last Name
Spouse Signature
Date
-
Month
-
Day
Year
Date
By signing below, I agree to all policy terms, disclosures, and agreements made by Financial Alignment Tax Service LLC
*
Signature to verify the accuracy of the provided information
*
End
SERVICING ALL 50 STATES!!!
24681 Northwestern Highway, Southfield, MI 48075 phone number 702-720-9312 Ari / 313-482-7162 Farren
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