Tax Preparation Client Intake Form

Tax Preparation Client Intake Form

Thank you for choosing my tax preparation services. Please complete the following form to provide me with the necessary information for your tax preparation. After Intake is completed, you will receive a response within 48 hours to begin the process of your return or provide you with a consultation. If you have any questions, please reach out to taybiny@gmail.com
Client Information
Full Name

First NameLast Name
Birth Date

MonthDayYear
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Your Social Security Number
IP PIN provided from IRS for you and/or Dependents, spouse (if applicable)
Occupation
Were you (or your spouse, if filing jointly) a Veteran or considered Disabled in the reflected tax year? Please check all that apply:
What is Last Year's AGI (Required to e-file and verify identity)
If you were referred by someone please list who referred you
Tax Information
Tax Year
Filing Status
Married filing joint- please enter spouse name, date of birth, social security number, income information, email address, residential address
Dependents
Dependent(s) Social Security Number
Were you a College Student in the tax year?
Income

Please provide the following income information for the tax year.
Income
Did you earn any income outside of your main W-2 job? This includes "side hustles," gig work, or hobbies that generated money. Even if you were paid in cash or via apps like Venmo/CashApp. Common Examples (Check all that apply):
Business Expenses (Estimates): If you checked any of the above, Please provide an estimated total for the following: Supplies & Materials: (e.g., Hair products, cleaning supplies, tools) Travel/Vehicle: (e.g., Total miles driven for work, tolls, or parking) Equipment: (e.g., New phone for work, specialized machinery, laptop) Advertising: (e.g., Business cards, Facebook ads, website fees) Other Out-of-Pocket Costs: (e.g., Safety gear, licenses, or uniforms)
Did you receive any income from investments, retirement accounts, or pensions in the tax year? Please check all that apply and provide the corresponding 1099 forms
Did you Pay Child care or Camp Expenses? Please provide Name, EIN/SSN in additional information field
Total Income During the Year $
Did you work overtime? If so, What is the YTD from your last paystub
Did you give to a church, non-profit, or other qualified charity? Total Estimate
Did you purchase or lease a vehicle during tax year?
If yes, provide purchase date and Vehicle Identification Number (VIN)
Electric/Hybrid
Did you install a home charging station?
Vehicle Status
Loan Interest
Vehicle Type
What type of health insurance did you have in the tax year?
Did you spend money on any of these? Please provide the total annual amount spent in additional information field.
What was your housing status for the tax year?
What was the Total Rent Paid for the year?
For Homeowners: What was your Total Mortgage Interest Paid in the reflected tax year? (Please refer to Box 1 of your Form 1098 from your bank). --------------------------------------------------------------------- For Homeowners: What were the Total Property Taxes Paid in the reflected tax year? (This can be found in Box 10 of your Form 1098 or on your local township tax bill)
Checklist for Final Filing
Additional Information
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Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature
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Tax Preparation Client Intake Form

Client Information

Tax Information

Income