Bootcamp Clone of Personal Tax Client Intake Form

Personal Tax Client Intake Form
As a Personal Income Tax Client, we need to collect the following information from you in order to begin to prepare your income tax return. Please do not submit until you have everything completed.

Important: The taxpayer must submit their own information as there are places where they must digitally sign.
Are you the taxpayer?
Please have the taxpayer submit as there are places that they must digitally sign during this process.
Are you a...

Returning tax clientNew tax client
New clients who we do not know personally are required to confirm ID, via government issued photo ID. Please have this available to submit if we do not know you personally.
Do you have any of the following to report? Please select those that apply.*

Self-Employment / Business IncomeSelf-Employment / Commission IncomeRental IncomeMedical ExpensesNone of the above
Which tax year is this form for? We will require a form for each tax year you are submitting.*

Personal Information
Legal Name *
Date of Birth*

MonthDayYear
SSN*
Gender*
Has your name changed with Social Security in this tax year?

Contact Information
Current Address*
Preferred Contact Phone Number*
Please enter a valid phone number.
Current Email Address*
example@example.com

Spouse/Partner Information
What is your current marital status?*
Spouse/Partner Legal Name*
Spouse/Partner Date of Birth*

MonthDayYear
Spouse/Partner SSN*
Is Spouse / Partner information being submitted to us?*
If not, what is your Spouse / Partners net income (line 150)*
Has your marital status changed during the tax year?*
What did your marital status change to?*
What is the effective date of this change?*

MonthDayYear
Date
Spouse/Partner Legal Name*
Spouse/Partner Date of Birth*

MonthDayYear
Spouse/Partner SSN*
Is Spouse / Partner information being submitted to us?*
If not, what is your Spouse / Partners net income (line 150)*
Child/Dependant Information
Do you have any children/dependants?*
How many children/dependants do you have to claim?*
Child/Dependent # 1*
Child/Dependent # 2*
Child/Dependent # 3*
Child/Dependent # 4*
Child/Dependent # 5*
Child/Dependant # 6*
Child/Dependant # 7*
Child/Dependant # 8*

Residency & Filing
United States Citizen?*
Residency Status*
Did you sell a home during the tax year(s) we are preparing for you?*
Was this home your primary residence for the full time you owned it?*
Did you rent any part of the home out during any of the years you owned it.*
Details of property sold...*
Did you own Foreign Property (real property, investments)?*
Are you disabled?*

Income
Tax Checklist - Income

Please ensure to gather to upload all income information including but not limited to...Once we receive your intake form you will be sent a link to our client poral.
- All W2's
- Investment income – 1099's
- Pensions -including Social Security Benefits
- Employment Insurance Benefit
- Unemployement
- Self-Employment / Business Activities - Worksheet required
- Self-Employment / Commission Activities - Worksheet required
- Rental Income - Worksheet required
What is the amount you made in tips during this tax year.*

Deductions
Tax Checklist - Deductions

Please ensure to gather to upload all supporting documents including but not limited to...
- Childcare – with supporting documents and SSN/EIN of the caregiver
- Adoption costs
- Tuition – 1098T
- Rent / Property Tax -
- Professional Fees
- Medical Expenses -
- Charitable Donations
- Interest on Student Loans
- Property Tax Statements
- Personal Property Tax Statements
- Saftey Deposit Box Fees
- Tax Preparation Fees
Are you submitting any of the above mentioned deduction receipts*

Document Uploads

Scan ALL your tax receipts, documents & receipts and then upload them below. Multiple files can be uploaded at once. You may take photos to upload, however you will need to ensure the photo is clear for viewing.
Document Upload - Please upload ALL tax documents using the window below.

Cancelof
Do you see all documents you uploaded in a list below the Browse Files window above? If not, please wait a moment or upload again.*
Do you have any additional notes or comments regarding your income taxes for us?*
Do you want your return processed with priority speed (3 business days) for $25 per return? Otherwise your return will be prepared within a 1-2 week turnaround time. *
Do you want Protection Plus insurance added to your return? Personal Tax Protection is 25.00 and Business Tax Protection is 125.00*
I declare that all information provided in this submission is complete and accurate. *
Signature*

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Date*

MonthDayYear
Date

Authorizing a representative

When you authorize another individual you are letting that person represent you for income tax matters at the level of authorization you specify, for the tax year or years you indicate. Income tax matters include issues related to information on your tax return. Example. You may wish us to speak to your spouse / partner or parent / child in your absence.
Do you wish for us to provide tax information such as your refund / balance owing amounts to another person? Example, you may wish for us to speak to your spouse / partner or your parent / child in the event that you are not available.*
Do you wish for us to provide tax information such as your refund / balance owing amounts to another person? Example, you may wish for us to speak to your spouse / partner or your parent / child in the event that you are not available. If you have already authorized someone via this form, you are not required to submit for the same person again.*
Have you previously authorized us to provide tax information such as your refund / balance owing amounts to another person whom you want the authorization revoked for?*
Please provide the name of the person for whom you wish to revoke authorization.
You agree that we may disclose information to your representative such as:

•       provide information, W2's and General Income;

•       information about your registered retirement savings plan, Home Buyers' Plan, tax-free savings account and Lifelong Learning Plan;

•       your accounting information, including balances, payment on filing, and installments or transfers;

•       your marital status (but not information related to your spouse or common-law partner)

•       adjustments to – income; – deductions; – non-refundable tax credits; and

•       change of address;

•       direct deposit information

Your representative may NOT

·        change your marital status

·        Access any information on your file from the moment we find out there is a divorce or separation that has occurred

Your responsibilities

It is your responsibility to monitor and understand the transactions your representative completes on your behalf, and to make sure that the information for your representative is current. It is your responsibility to let us know immediately should your marital situation change to separated or divorced, or should you decide to retract the authorization.
Full name of the person you allow us to speak to*

First NameLast Name
Relationship to this person*
Signature*

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Date Signed*

MonthDayYear

Review
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Personal Tax Client Intake Form

Personal Information

Contact Information

Spouse/Partner Information

Child/Dependant Information

Residency & Filing

Income

Deductions

Document Uploads

Authorizing a representative

Review