EES Tax Client Intake Form

Tax Client Intake Form

Please provide the following information to help us prepare your taxes. We will request documentation based on your details, such as dependents and income sources.
Full Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Employment Income
Self-Employment Income
Investment Income
Other Income
Mortgage Interest Paid
Charitable Donations
Education Expenses
Child Care Expenses
Filing Status
Number of Dependents
Drop Important Documents (ID, Driver’s license, etc.)

Cancelof
Consent to Prepare Taxes
Client Signature
Date Signed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: