GraysWealthFinancial Intake Form

2026 TAX FORM GRAYS WEALTH FINANCIAL

Please submit all Tax Filing documents including your ID, & Social Security Documents for all dependents (If Applicable) Failure to submit required documents on time will result in a delay of your filing process. We have a 24-48 hour completion rate on all forms filled out completely and accurately. Get paid to refer a client to us!
Referred by: (if you are a returning client please leave blank)
Marital Status*

SingleMarried Filing JointlyMarried filing SeparatelyHead of HouseholdWidow(er)
PART 1 PERSONAL INFORMATION
Name: *

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
SSN/ITIN*
ARE YOU CLAIMED AS A DEPENDENT ON ANOTHER PERSON'S RETURN?
If someone else can claim you as a dependent, this may affect your filing options
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address**

Street Address

CityState / Province

Postal / Zip Code
Email*
example@example.com
IDENTITY PIN# (If applicable)
This is a PIN issued by IRS for Identity Protection
RENT OR HOMEOWNER?*
HOW MUCH DO YOU PAY FOR RENT OR MORTGAGE?

RENTMORTGAGE
Employment Status*

EmployedSelf-EmployedUnemployedRetiredOther
Spouse Information (IF MARRIED FILING JOINTLY OR SEPARATELY)
Name:*

First NameMiddle NameLast Name
Spouse Date of Birth*

MonthDayYear
Date
Spouse SSN/ITIN*
Spouse Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Spouse IDENTITY PIN# (If applicable)
This is a PIN issued by IRS for Identity Protection
Spouse Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Spouse Email*
example@example.com
IRS DEBTS & NOTICES

Do you currently owe any of the following that may reduce your refund?
IRSSTUDENT LOANSCHILD SUPPORTSTATE DEBTUNEMPLOYMENT OVERPAYMENTNONE
Have you received any IRS letters or Notices this year?

YesNo
UPLOAD IRS LETTERS OR NOTICES:

Cancelof
Dependent Information
Are you claiming any dependents on your 2026 tax return?

YesNo
Number of Dependents*
Name:*

First NameMiddle NameLast Name
Date of Birth:

MonthDayYear
Date
DEPENDENT SSN/ITIN*
Relationship:*
(Son, Daughter, Adopted, Foster, Etc)
Months lived with you in the year 2025:*
Disabled (Yes/No)

YesNo
Student (Yes/No) :*

YesNo
Did anyone else support this dependent?

YesNo
What Documents will you be filing this Tax Year?*

W2 Work for Employer1099 Independent ContractorSide Hustle Cash IncomeSelf Employed (Schedule C)
BUSINESS RETURN SCREENING
Are you filing a business return this year? (1120, 1120-S or separate Schedule C)

YesNo
What type of business return are you filing?

Schedule C- Sole ProprietorLLC (Single Member)LLC (Multi Member)S- CorpPartnershipNon ProfitNone
BUSINESS INFORMATION:

Business Identity Fields:
Legal Business Name:
DBA (if any)
EIN:
Business Address:
Business Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Business Email:
State of Formation
Upload EIN Letter

Cancelof
Upload Articles/Organization Docs

Cancelof
If Multi-Members: List all owners and their ownership percentages
If S-Corp or Partnership

Upload prior year Business Return
Cancelof
Upload Balance Sheet or QuickBooks Reports

Cancelof
If Single Member LLC (Schedule C)

Business Address

CityState / Province

Postal / Zip Code
INCOME DOCUMENTS
UPLOAD BOX - 2 - ALL SUPPORTING INCOME/TAX DOCUMENTS (W2'S , 1099'S, 1098'S, K1'S, 1095A'S ETC)

Cancelof
Any Cash Income not reported on a form?

YesNo
Self-Employed/ Gig Workers

If 1099-NEC OR 1099-K OR Schedule C was selected:
Business Name:
Business Address

Street Address

CityState / Province

Postal / Zip Code
Nature of Work:
Deductions & Credits

Life Events
Move States?

YesNo
New Baby?

YesNo
Marriage/Divorce?

YesNo
Bought/sold a home?

YesNo
1095-A HealthCare?

YesNo
Please Note any questions or needs for this upcoming 2026 Tax Season and any additional documents you may have to upload.
DIRECT DEPOSIT INFORMATION (IF APPLICABLE)

By entering my bank account information below, I understand that this is where my tax refund (if Applicable) will be deposited. I confirmed that the routing and account numbers i provide are accurate. I understand that any incorrect or incomplete banking information may result in my refund being returned and reissued as a paper check, which may delay my refund by and additional 7- 10 days or longer. I acknowledge that it is my responsibility to double check all banking information before submitting.
Banking Information*

Bank Name

Routing Number

Account Number
IRS DUE DILIGENCE QUESTIONS
"I confirm all information i provided is true and correct"

YesNo
"I understand the preparer will not guess numbers for me"

YesNo
"I understand i must provide accurate Information"

YesNo
"I understand fraudulent information will terminate services"

YesNo
"I understand all documents and questions asked is required by the IRS to accurately file my taxes"

YesNo
Identity Verification
Taxpayer ID*

Cancelof
SSN Card*

Cancelof
Spouse ID AND SSN CARD

Cancelof
Dependents ID AND SSN (if any)

Cancelof
Prior Year Return
Did you file a return for 2024?

YesNo
Please upload last year's return

Cancelof
What other Services Do you Need?

Credit RestorationLife InsuranceOPEN A HIGH YIELD SAVINGS ACCOUNTTax Planning Session $25Open a Bank AccountNone
Are You Interested in Cash Advances UP TO $9500 starting January 2nd

YesNo
DUE DILIGENCE Consent Forms

By signing the below, I acknowledge and agree that I am authorizing Monique Gray & Grays Wealth Financial to prepare and electronically file my 2025 tax return using all the information and documents i have provided. I confirm that all information submitted is true, accurate and complete to the best of my knowledge. I understand that once my tax return is submitted to the IRS, the transmission cannot be stopped, canceled, or reversed. I agree to the filing fee associated with my tax preparation, If any portion of my refund is reduced due to and offset adjustment, i authorize Grays Wealth Financial to pursue collection of any unpaid preparation fees. I understand that all personal information and documents shared are protected, stored safely and used solely for the purposes of filing my return with the IRS and applicable state agencies. By signing i give full permission for my information to be reviewed, submitted and processed for tax filing purposes.
Kindly please sign with your signature and agree to the terms below*
Should be Empty:

2026 TAX FORM GRAYS WEALTH FINANCIAL

PART 1 PERSONAL INFORMATION

Spouse Information (IF MARRIED FILING JOINTLY OR SEPARATELY)

IRS DEBTS & NOTICES

Dependent Information

BUSINESS RETURN SCREENING

BUSINESS INFORMATION:

INCOME DOCUMENTS

Self-Employed/ Gig Workers

Deductions & Credits

DIRECT DEPOSIT INFORMATION (IF APPLICABLE)

IRS DUE DILIGENCE QUESTIONS

Identity Verification

Prior Year Return

DUE DILIGENCE Consent Forms