INTAKE/INTERVIEW FOR THE IRS

Tax Filing Year *

MonthDayYear
Date
Select Your Tax Professional
Please Provide who referred you
What Filing Status in previous year did you file? (This is (our)Tax Pro job to decide after your interview of this current year living and financial situation)*

SingleMarried Filling JointlyMarried Filling SeparateQualifying Widow with Dependent
If you’re filing married separately, how many months out of the year were your living apart from your spouse?
If you are filing head of household, are you unmarried?*

YesNo
Are you filing as head of household*

YesNo
Did you file last year?*

YesNo
Do You or Your Children Have an IP PIN?*

YesNo
IP PIN (issued from IRS yearly) EVERYONE DOESNT HAVE THIS. IF IT DOESNT APPLY SKIP
Phone Number*
Please enter a valid phone number.
Full Name*

First NameLast Name
Email*
example@example.com
Tax Payers Date of Birth*

MonthDayYear
Date
Tax Payers Social Security Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation *
Did you receive health insurance through the Market Place?*

YesNo
Spouse Information

If no spouse, please skip
Spouse's Name

First NameLast Name
Spouse's Date of Birth

MonthDayYear
Date
Spouse's Social Security Number
Spouse's Occupation
SPOUSE IP PIN (issued from IRS yearly) EVERYONE DOESNT HAVE THIS. IF IT DOESNT APPLY SKIP
Spouse - Please Check Any That Apply

Spouse can be claimed as a dependent on someone else's return.Spouse was over age 18 and a full-time student at an eligible educational institution.Spouse is blind.Spouse is deceased.Spouse has received, sold, sent, exchanged, or otherwise acquired financial interest in virtual currency during the current tax year.Spouse prefers to receive written communications from the IRS in a language other than English.Spouse prefers to receive written communications from the IRS in an accessible format.Spouse is disabled.
Dependent Information

The Earned Income Credit (EIC) increases with the first 3 Children you claim. The maximum number of dependents you can claim for Earned Income Purposes is Three. You MUST also meet other requirements related to your Adjusted Gross Income (AGI) to qualify for EIC. If you are MARRIED and FILING SEPARATE you CAN'T claim the credit
1st Dependent
Name
SSN
Relationship
Date of Birth

MonthDayYear
Date
2nd Dependent
Name
SSN
Relationship
Date of Birth

MonthDayYear
Date
3rd Dependent
Name
SSN
Relationship
Date of Birth

MonthDayYear
Date
Are you self employed or a business owner?*

YesNo
If so what kind of business do you have?
Business Name ?
How long have you been in business?
Please provide your business EIN Number
Business Adress

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please upload your profit/expense records

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Did you have a vehicle you used for your business?

YesNo
If so, list the year make and model of the vehicle
Do you have a separate personal vehicle not for work?

YesNo
College Student Information

Please complete if anyone in your household went to college.
Did Anyone Listed On This Return Attend College this Tax Season?*

YesNo
Was the student ever charged with drug related felonies?

YesNo
If so - please upload form 1098-T and other college related documents below.

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Name(s) of the person who attended college
How many tax years have you claimed the American Opportunity Tax Credit?
If so please upload your Form 1098-T - Student loan Interest

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Upload Requested Documents

PLEASE NOTE: YOU CAN UPLOAD MULTIPLE DOCUMENTS
Upload ID/DL (for anyone over 18 years old on this filing)*

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Please upload a copy of utility bill*

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Upload Social Security Card (for all listed on this filing)*

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Please upload all W2's HERE - You can upload multiple files

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If you received Unemployment Please Provide 1099-G form

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Withdrawal out of 401K? Please attach documentation if available.

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Please provide Mortgage / Property Tax form(s) if paid taxes / insurance

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Please Upload any Additional Tax Forms that you have Received

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Please upload Birth Certificates for all dependents.

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Upload copy of prior year tax return or transcript (include the schedule c if was self employed)

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Banking Information
Signature Consenting to Form 7216 Bank Consent to Disclosure of Tax Return Information*

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How would you like your refund to be deposited when ready?**

Direct DepositPre-Paid Debit CardI have a Tax Obligation and will not be receiving a refundPaper check printed in the office
Bank Name*
Routing Number
Confirm Routing Number
Account Number
Confirm Account Number
Due Diligence Questions
Have you ever been disallowed the Earned Income tax Credit, The additional child Tax credit, or the Child tax credit?

YesNoType option 3Type option 4
If you are a single parent, Where's the other parents of your child/children
Why is the other parent not claiming the child?
If you are divorced or separated, when did you last live in the same home?
Do you have joint custody of your child? (If so which child/children
Did you pay someone to watch your child/children?

YesNoNot Applicable
If so please upload any childcare statements.

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Did you receive any type of supplemental, non taxable income such as child support, Welfare benefits, Social security, etc?*

YesNo
Have you ever been audited by the IRS?*

YesNo
In the case of a random IRS audit, can you provide all documentation reported?*

YesNo
Signature

Please Review & Sign Consent Forms
Acknowledgment and Consent

I confirm that all the information I have provided here is accurate and true to the best of my knowledge.

I authorize LATORIA CHERIE ACCOUNTANT SERVICE LLC to securely capture and use my sensitive information, including but not limited to personal identification, government-issued ID, Social Security Number (SSN), and other required details for the purposes of this service.

By typing my name and signing below, I acknowledge that I have read, understood, and agreed to the outlined responsibilities of both myself and LATORIA CHERIE ACCOUNTANT SERVICE LLC in completing this process.

Your trust and security are our priority.
Signature Consenting to Consent To File Tax

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Type a question
Tax Filing Year*

20252026
Should be Empty:

Spouse Information

Dependent Information

1st Dependent

2nd Dependent

3rd Dependent

College Student Information

Upload Requested Documents

Banking Information

Due Diligence Questions

Signature