2026 Intake Form
Intake Form
Name
*
First Name
Last Name
Spouse Name
First Name
Last Name
Email
example@example.com
Spouse Email
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Spouse Phone Number
-
Area Code
Phone Number
Which of the following applies to you?
*
Please Select
New Client
Existing Client
Tax Professional name
*
Shawitekia (Tia) Johnson
Shakela (Kela) Lott
Crystal Beharry
Sherita Sturgis
Nikki Crenshaw
Jessica Roberts
Tamara Hatcher
How did you hear about SMJ Tax Firm and Associates?
*
Facebook
TikTok
Instagram
Snapchat
Referral
Returning Client
Who referred you?
please type the name of the person that referred you.
What tax year are you filing?
*
Please Select
2025
2024
2023
2022
2021
What's your martial status as of December 31,2024
*
single
head of household
married filing jointly
married filing separately
qualifying widower
Taxpayer Social Security number
*
Spouse Social Security number
Taxpayer date of birth
*
-
Month
-
Day
Year
Date
Spouse date of birth
-
Month
-
Day
Year
Date
How many Dependents are you claiming?
*
Please Select
1
2
3
none
If dependent/dependents is not your child why are you claiming them? if it doesn't apply to you type N/A
*
Dependent #1 name
First Name
Last Name
Dependent #1 date of birth
-
Month
-
Day
Year
Date
Dependent # 1 Social Security Number
Dependent #1 Gender
Male
Female
What's the relationship between you and the dependent #1
Is child #1 a US Citizen, US National or US Resident?
Yes
No
Dependent #2 name
First Name
Last Name
Dependent #2 date of birth
-
Month
-
Day
Year
Date
Dependent # 2 Social Security Number
Dependent #2 Gender
Male
Female
What's the relationship between you and the dependent #2
Is child #2 a US Citizen, US National or US Resident?
Yes
No
Dependent #3 name
First Name
Last Name
Dependent #3 date of birth
-
Month
-
Day
Year
Date
Dependent # 3 Social Security Number
Dependent #3 Gender
Male
Female
What's the relationship between you and the dependent #3
Is child #3 a US Citizen, US National or US Resident?
Yes
No
Which of the following applies to you?
*
I paid daycare or a nanny to care for my child 13 years or younger while I worked or looked for work. I can get a statement with their EIN/SSN to provide this claim
I attended a college/ universities/ community college/ post-secondary school/ career school and paid eligble expenses that can be proven with a 1098T form.
I paid charity, tithes, or given donations to community organizations and/ or religious organizations.
I paid over $12,400 in expenses for itemization
I paid student loan interest and recieved a 1098E
I had eligible medical expenses
I sold and/ or purchased a home
I had a baby, or adopted a child
I am in the military and had to move
I am separted/ divorced paid or received alimony
none of the above
Are there any dependents in daycare?
yes
no
Upload a copy of your daycare form here
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Who was your healthcare provider?
*
Mediciad
Marketplace Insurance
Employer
Private Insurance
none
Have you ever been denied Earn Income Tax Credit?
*
Yes
No
Were you or any of your dependents in college during the year?
*
Yes
No
Do you owe student loans, taxes, or other government entities that may offset your return?
*
Yes
No
Did you trade or virtual currency?
*
Yes
No
Did you receive unemployment? If so upload you 1099G
*
Yes
No
Are you trying to purchase a home within the next two years?
*
Yes
No
Are you self-employed (1099NEC, 1099MISC)?
*
Yes
No
Did you operate in any goods or services during the tax year totaling $400 or more?
*
Yes
No
If yes, what's your business name and job title?
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date business started?
-
Month
-
Day
Year
Date
Do you have an EIN number? is provided it here or type NA
What documents do you have to support your business income/ expenses? such as bank statements, profit and loss statement, cash app, Zelle, Apple Pay, PayPal, chime etc. summary report
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If you don't currently have supporting documents, will you be able to produce then in case of audit?
*
Yes
No
If you don't have any expenses please explain why?
How much was your last year tax return?
blanks
*
How would you like to receive your tax refund? If you're not paying for services upfront additional fees will be added to your return.
*
Check (availble in office only) * refund advantage product
Direct deposit
Debit card * refund advantage product
Banking Information
Are you requesting a cash advance?
Yes
NO
undecided, let's discuss the terms
If you're a new client upload the las two tax returns
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Primary Taxpayer signature
*
Spouse signature If applicable
Closure Agreement
*
Closure Agreement between Client and SMJ Tax Firm and Associates A voluntary closing agreement between client and SMJ Tax Firm and Associates is when a taxpayer inadvertently fails to meet the requirements and obligations of SMJ Tax Firm and Associates tax processing policy(s). If a taxpayer inadvertently fails to meet the requirements of their tax return; and does not receive a tax return regardless of the violations or deficiencies on their part. The taxpayer will be liable within 10 days from the date of being notified by SMJ Tax Firm and Associates to set up payment arrangements. If the taxpayer fails to set up payment arrangements the taxpayer will be legally obligated to pay all court costs, filing fees, and all other fees associated with the non-compliant activities.
Spouse Closure Agreement
Closure Agreement between Client and SMJ Tax Firm and Associates A voluntary closing agreement between client and SMJ Tax Firm and Associates is when a taxpayer inadvertently fails to meet the requirements and obligations of SMJ Tax Firm and Associates tax processing policy(s). If a taxpayer inadvertently fails to meet the requirements of their tax return; and does not receive a tax return regardless of the violations or deficiencies on their part. The taxpayer will be liable within 10 days from the date of being notified by SMJ Tax Firm and Associates to set up payment arrangements. If the taxpayer fails to set up payment arrangements the taxpayer will be legally obligated to pay all court costs, filing fees, and all other fees associated with the non-compliant activities.
Acknowledgement
*
I hereby authorize SMJ Tax Firm and Associates to electronically file my tax return on my behalf. I understand that e-filing is a secure and efficient method of submitting my tax documents to the relevant tax authorities. I acknowledge that my tax return will be prepared in accordance with the information provided by me and that I am responsible for the accuracy and completeness of this information. I further understand that e-filing requires my consent and acceptance of any applicable terms and conditions set forth by the Internal Revenue Service (IRS) or other relevant tax authorities. I authorize SMJ Tax Firm and Associates to act as my authorized representative for e-filing purposes, including but not limited to, signing and submitting my tax return electronically, receiving electronic acknowledgments, and providing any additional information to support my tax filing. I acknowledge that once my tax return is successfully e-filed, it is considered filed and no paper return with the same information will be submitted. I confirm that I have read and understood the e-filing process and authorize SMJ Tax Firm and Associates to proceed with electronic filing on my behalf.
Spouse Acknowledgement
I hereby authorize SMJ Tax Firm and Associates to electronically file my tax return on my behalf. I understand that e-filing is a secure and efficient method of submitting my tax documents to the relevant tax authorities. I acknowledge that my tax return will be prepared in accordance with the information provided by me and that I am responsible for the accuracy and completeness of this information. I further understand that e-filing requires my consent and acceptance of any applicable terms and conditions set forth by the Internal Revenue Service (IRS) or other relevant tax authorities. I authorize SMJ Tax Firm and Associates to act as my authorized representative for e-filing purposes, including but not limited to, signing and submitting my tax return electronically, receiving electronic acknowledgments, and providing any additional information to support my tax filing. I acknowledge that once my tax return is successfully e-filed, it is considered filed and no paper return with the same information will be submitted. I confirm that I have read and understood the e-filing process and authorize SMJ Tax Firm and Associates to proceed with electronic filing on my behalf.
Upload Driver License/ or State Issued ID
*
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Taxpayer/ spouse driver license
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Upload Social security cards
*
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Taxpayer/ spouse and dependents
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Upload W2, 1099, 1099G, 1098, 1098T
*
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Choose a file
W2, self- employment, unemployment, mortgage interest statement, tuition statement, or etc.
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of
Date
*
-
Month
-
Day
Year
Date
Take a Selfie
Spouse Take a selfie
This document is true and to the best of my knowledge,
*
This document is true and to the best of my knowledge,(spouse)
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