CLIENT INTAKE FORM

Please fill out this form to help us prepare your taxes accurately and efficiently.
Taxpayer's SSN
Social Security Number
Filing Status
Full Legal Name

First NameLast Name
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Date of Birth

MonthDayYear
Date
Occupation
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Did the IRS issue you an IP Pin for this tax year?
If yes, please enter your 6-digit IP Pin:
Did you or anyone in your household have Marketplace (Healthcare.gov) insurance for the tax year?
Have you ever had an audit or tax issue in the past?
Primary ID Type
Upload Front of Government ID

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Upload Selfie/Live Photo

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Upload Tax Documents (PDF, JPG, PNG)

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Number of W-2s
Unemployment Income
1099/Cash Income
Business Income
Spouse's Full Name

First NameLast Name
Spouse's Taxpayer Identification Number (TIN)
Spouse's Date of Birth

MonthDayYear
Date
Spouse's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Spouse's Email Address
example@example.com
Primary ID Type
Upload Front of Government ID

Cancelof
Upload Selfie/Live Photo

Cancelof
Upload Tax Documents (PDF, JPG, PNG)

Cancelof
Number of W-2s
Unemployment Income
1099/Cash Income
Business Income
Dependents Information
Child/Dependent Care Details
Education Credit Details
What refund deposit method do you prefer?
Bank Name
Bank Routing Number
Account Number
Account Type
Are you interested in applying for a Tax Cash Advance once your return is prepared?
If yes, what advance amount are you interested in?
Do you understand that approval is based on your refund amount and bank product eligibility?
Taxpayer Signature
Date

MonthDayYear
Date
Who is your preferred tax preparer?
Who referred you?
Consent to Use Information
Acknowledgment of Privacy Statement
Should be Empty: