Sharlena Taylor Services Client Intake Form
Language
  • English (US)
  • Español

  • Were you referred?                  If yes, please type referral name (First and Last Name)

  • Date of Birth
     - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Is the address provided the same used as last years tax return?*
  • Drivers License Issue Date
     - -
  • Drivers License Expiration Date
     - -
  • What is your filing status?
  • Income Type (Choose All that Apply)
  • Are you purchasing a home in the next 2 years?*
  • Did you purchase healthcare from the marketplace (Healthcare.gov)? Received a 1095-A?
  • Do you owe any of the below items?*
  • Would you like to purchase credit repair services?*

  • Self-Employed Income

    Job #1 (If NONE hit "NEXT/SKIP" at bottom right)
  • Do you need to add another SELF-EMPLOYED job?

  • Self-Employed Income

    Job #2
  • Do you need to add another SELF-EMPLOYED job?

  • Self-Employed Income

    Job #3

  • Household Income (i.e housekeepers, babysitters/nanny,gardners etc.)

    Job #1 (Employee Not a Independent Contractor) (If none hit "NEXT/SKIP" at bottom right)
  • Format: (000) 000-0000.
  • Do you need to add another HOUSE HOLD job?

  • Household Income (i.e housekeepers, babysitters/nanny,gardners etc.)

    Job #2 (Employee Not a Independent Contractor)
  • Format: (000) 000-0000.
  • Do you need to add another HOUSE HOLD job?

  • Household Income (i.e housekeepers, babysitters/nanny,gardners etc.)

    Job #3 (Employee Not a Independent Contractor)
  • Format: (000) 000-0000.

  • Education

    Include Expenses for a Child Dependent as well. (If none hit "SKIP" at bottom right)
  • Did you attend school for more than half of year?
  • Do you have a 1098-T Form?

  • Dependents

    Dependent #1 (If none hit "SKIP" at bottom right)
  • Date of Birth
     - -
  • Disabled?
  • Did you provide 50% or more support for Dependent #1?
  • Did Dependent #1 live with you for more than half of the year?
  • Is anyone else claiming or allowed to claim Dependents #1 ?
  • Do you need to add another Dependent?

  • Dependents

    Dependent #2
  • Date of Birth
     - -
  • Disabled?
  • Did you provide 50% or more support for Dependent #2?
  • Did Dependent #2 live with you for more than half of the year?
  • Is anyone else claiming or allowed to claim Dependents #2 ?
  • Do you need to add another Dependent?

  • Dependents

    Dependent #3
  • Date of Birth
     - -
  • Disabled?
  • Did you provide 50% or more support for Dependent #3?
  • Did Dependent #3 live with you for more than half of the year?
  • Is anyone else claiming or allowed to claim Dependents #3 ?
  • Do you need to add another Dependent?

  • Dependents

    Dependent #4
  • Date of Birth
     - -
  • Disabled?
  • Did you provide 50% or more support for Dependent #4?
  • Did Dependent #4 live with you for more than half of the year?
  • Is anyone else claiming or allowed to claim Dependents #4 ?

  • Loan Advance

  • Are you applying for a loan advance?*
  • Refund Disbursement Option (Choose One)*
  • Rows

  • Documentation Upload

    Use this section to upload ID Cards, W-2's, Social Security Cards, Birth Certificates, Pay Stubs, etc. (CAN UPLOAD MULTIPLE FILES)
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  • Signature Page

    Acknowledgement Clause

  • By signing below I,   *   *   agree to give Sharlena Taylor LLC the authority to use my information provided for tax preparation purposes ONLY. All information submitted by me "the taxpayer" is true and accurate to the best of my knowledge.
    I understand that I am financially responsible for any outstanding balance due to any false information given. If there is a balance due, you must pay the tax preparation fee upfront. If for any reason you owe an entity and they take the entire refund, you are STILL responsible to pay the tax preparation fee for services rendered.

    *For any reason an amendment has to be filed with no fault of the tax preparer, an upfront fee of $150.00 is required! Please view your tax return, which is emailed to you. Any copy after the first copy is a fee of $10.00.

    ALL FEES (bank and service fees) are found in the return and are non-refundable nor negotiable! NO EXCEPTIONS TO THIS!!

    Please utilize www.irs.gov for all federal refund tracking. Please utilize your state Department of Revenue site for any State Refund tracking. Do NOT add the amounts together. Federal taxes are federal, and state taxes are state when tracking your status. Please allow 8 weeks to surpass from the date of submission before calling the IRS, if you have any tracking questions. 
    IRS Contact 800-829-1040

    Please click this link to check your federal refund status. You will need your filing status, social security number, and the total amount of the refund before fees
    https://sa.www4.irs.gov/irfof/lang/en/irfofgetstatus.jsp 

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