Tax Preparation Client Intake Form
Taxpayer Information
Name
*
First Name
Last Name
SIN Number
*
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
Filing Status
*
Single
Head of Household
Married Filing Separate
Married Filing Joint
Qualifying Widower
Check if any of the situation apply to you
Full-time student
Permanently disabled
Legally blind
Spouse Information
Name
*
First Name
Last Name
SIN
*
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Email
*
example@example.com
Occupation
*
Income
*
Check if any of the situation apply to your spouse
Full-time student
Permanently disabled
Legally blind
Fully dependent on you
Dependents
Enter your dependents here
Name
Date of Birth
Relationship
1
2
3
4
5
6
Tax Related Questions
Employment Income
Self-Employment Income
Rental Income
EI and other benefits
Foreign Income
Investment Income
Capital gain/loss
Other Income
Expenses
Please fill-up the information within the current year only.
General Expenses
Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses
Total Expenses
Additional comments
Acknowledgment & Signature
I confirmed that all information I entered here is accurate and true.
I allow ABC Financial to capture my sensitive data like personal id, government id, and other information.
I have read the terms and conditions and privacy policy of ABC Financial.
By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Date Signed
-
Month
-
Day
Year
Date
Taxpayer Signature
Date Signed
-
Month
-
Day
Year
Date
Spouse Signature
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