• 2025 Client Intake Form

    2025 Client Intake Form

  • Did you File 2023-2024 Taxes?*
  • Did you successfully receive your 2024 Tax Refund?*
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  • Are you filing with an eligible Spouse ?*
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  • Do you or your spouse have an identity Protection Pin (IP PIN)?*
  • Are you filing a Dependent(s) ?*
  • Child’s Gender:
  • Child’s Gender:
  • Child’s Gender:

  • INCOME / EXPENSES

  • Do you have any Debt?*
  • Do you have Market Place?*
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  • Do you have a W-2?*
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  • Do you have a form for unemployment ( 1099-G) ?*
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  • Do you have a Social Security (SSA-1099) form?*
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  • Do you have a retirement/ pension (1099-R) form ?*
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  • Do you have an Education Credit (1098-T) form ?*
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  • Do you have an Interest Dividen (1099-INT/ 1099-DIV) form ?*
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  • Are you Self-Employed ? *
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  • Do you have a Non-employee Compensation Form?*
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  • Do you make Rental Property Income?*
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  • Do you have Charitable Contributions?*
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  • Do you have a form for Child Care Expenses?*
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  • Do you have Itemized deductions on previous return?*
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  • Do you have any Stock / Home Sales (1099-B/ 1099-S)?*
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  • Do you have any Gambling Winnings (W2G)?*
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  • Do you have any Cancellation of Debt (1099-A/ 1099-C)?*
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  • Do you have any Medical Expenses?*
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  • Did you purchase Health Insurance through healthcare.gov Marketplace (Obama Care)?*
  • If YES, Did you receive a 1095-A form from the Marketplace?
  • Do you have any Mortgage Interest?*
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  • Do you have any Real Estate Taxes?*
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  • How would you like to receive your Refund?*
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  •                                                             ADVANCE TERMS 

    The advance is not a guarantee.

    The bank approves or denies the advance based on their own criteria (they don't advise what they look at to make their decision).

    The bank makes decisions on the advance within 1-2 business days.

    The bank will email you and tell you whether or not you're approved. If you don't receive an email then the advance was denied.

    If the advance is approved, the bank will determine the amount you will receive and that amount can not be changed.

    If the advance is approved, and you have direct deposit, it will be deposited into your account within 1-3 business days.

    If the advance is approved, and you do NOT have direct deposit, a check can be printed / picked up in the office within 1-2 business days.

    The bank does charge a processing fee of about $100, that will be taken out of the refund once received, if the advance is approved.

     

  • Would you like to apply for Pre-Ack Advances?*
  • Would you like to apply for the In-Season Advances?*

  • PLEASE READ BELOW                          I CERTIFY I WOULD LIKE TO HAVE MY TAX RETURN PREPARED IN ACCORDANCE WITH THE INFORMATION I HAVE PROVIDED

  • If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without

    your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at

    1-800-366-4484, or by email at complaints@tigta.treas.gov.

  • I AGREE TO THE ABOVE TERMS & CONDITIONS!*

  • CONSENT FORMS

  • CONSENT TO DISCLOSURE OF TAX RETURN INFORMATION

  • Federal law requires this consent form to be provided to you. Unless authorized by law, we cannot disclose, without your consent, your tax return information to third parties for purposes other than the preparation and filing of your tax return. 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. Because our ability to disclose your tax return information to another institution affects the service that we provide to you, we may change the terms of service that we provide to you if you do not sign this form. 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. You have indicated that you are interested in obtaining a bank account, refund settlement product, card service, and/or related banking services. These products are made available through arrangements that we have with financial institutions and their partners. To apply for and obtain any of these products or services, we may forward your information to these companies and/or their affiliates. If you sign this form and check the box below, you authorize us to disclose your 2024 Tax Return for the designated purpose. I authorize Elegent Taxes and Credit LLC  to disclose my entire 2024 Tax Return and information collected during the preparation of my taxes to ensure that any refund settlement products, and related banking services that I obtain or apply for can be issued, processed, underwritten, and serviced. The foregoing activities and related services may be performed by one of the following companies and/or their affiliates:Santa Barber Inc

     

  • Date*
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