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Client Intake Form
2025 SFG Tax Preperation
Select Your Preparer
*
Please Select
Shameena Hooker
Aaron Torres
Vicki Leviston
Ashley Brown
LaQuisha Killings
Yolanda Bell
Emmanise Sylvestre
Tasha Calixte
Lillian Robinson
Dominique McCarthy
Anselmo Bryant (Espanol)
Kayler McGill Walker
Keinon Carter
Mykayla Lafalaise
Maurika Jones
Lenilssa Gomez
LaShondra McCaskill
LuAngela Gibson-Wright
Cheryl Brown
Maria Lugo
Erica Bradshaw
Any Available Preparer
Filing Status
Single
Head of Household
Married Filing Separate
Qualifying Widower
Married Filing Joint
Taxpayer Information
Referral Name
Filing for Year
*
2022
2023
2024
2025 (Current Year)
Primary Name
First Name
Last Name
Primary Social
Primary Age
Primary Date of Birth
-
Month
-
Day
Year
Date
Primary Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Primary Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Occupation
Are you a full-time student?
Yes
No
Are you totally and permanently disabled?
Yes
No
Are you legally blind?
Yes
No
Spouse Information
Name
First Name
Last Name
Age
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Occupation
Are they a full-time student?
Yes
No
Are they totally and permanently disabled?
Yes
No
Are they legally blind?
Yes
No
Are they a dependent of other
Yes
No
Dependents
Enter your dependents here
Rows
Name
Date of Birth
Relationship
SSN
1
2
3
4
5
6
Does you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it? (Form 1095-A,1095-B,1095-C)
Rows
Yes/No
Employer
Spouse Ins
Exchange/ Marketplace
Direct with Insurer
Medicare
Medicaid
Taxpayer
Yes
No
Spouse
Yes
No
Dependent 1
Yes
No
Dependent 2
Yes
No
Dependent 3
Yes
No
Dependent 4
Yes
No
Dependent 5
Yes
No
Tax Related Questions
Employment Status During 2025(Please Check All That Applies)
*
Employed
Unemployed
Self-employed
Are you contributing to 401k or other pre-tax account?
Yes
No
Does your dependents have tuition expenses?
Yes
No
Do you have any expenses for child care?
Yes
No
Do you have energy star rated improvements to your home?
Windows
Doors
Furnace
Other
Are you currently renting?
Yes
No
What is the monthly rental amount?
How long have you lived at the property?
# of months
Do you have your own home?
Yes
No
Do you have documents that shows you paid for property taxes?
Yes
No
Did you sell any stock? 1099-B
Yes
No
Did you take money from your 401K?
Yes
No
Did you pay your vehicle tax/personal property ?
Yes
No
Do you have mortgage interest? (Form 1098)
Yes
No
Do you have real estate tax?
Yes
No
Did you receive a federal tax last year?
Yes
No
Are you a victim of identity theft?
Yes
No
Expenses
Please fill-up the information within the current 2025 Tax year only.
General Expenses(Without A Business)
Rows
Amount
Out of Pocket Medical Expenses
Out of Pocket Dental Expenses
Out of Pocket Insurance Premiums paid
Out of Pocket Long Term Care Premiums
Out of Pocket Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses
Total Expenses
Self-Employed Business
Business Name
Business Ein #
Type of Business (Describe)
Please Provide All Business Expenses
Rows
Business Expenses
Commission & Fees
Contract Labor
Depreciation
Employee Benefit Program
Insurance (other than health)
Interest
Mortgage
Legal and Professional Fees
Office Expenses
Rent or Lease
Supplies
Repairs and Maintenance
Taxes and Licenses
Travel & Meals
Business miles driven
Car and Truck Expenses
Marketing
All Business Income total:
PLEASE UPLOADED ALL FINANCIAL STATEMENTS, 1099’S AND EXPENSES SHEETS FOR THE BUSINESS
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PROOF OF BUSINESS (LLC OR EIN FORM)
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Direct Deposit information
Bank Name
Bank Type
Please Select
Checking
Savings
Bank Routing Number
Bank Account Number
Additional Services Offered
Sincere Financial Group and our partners strive to help with all of your financial needs by offering a host of services . Do you need help with any of the following?
Business Startup
Bookkeeping
Business Credit
Credit Repair Analysis
Other
PLEASE UPLOAD ALL TAX DOCS and IDENTIFICATIONS
Please Upload W2s|1099S
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of
SS CARDS FOR ALL
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of
Birth OR DEATH Certificates For ALL
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of
STATE ID OR DRIVERS LICENSES
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of
BUSINESS INCOME
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of
Utility BILL (IF HEAD OF HOUSEHOLD)
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of
Acknowledgment & Signature
I confirmed that all information I entered here is accurate and true.
I allow Sincere Financial Group to capture my sensitive data, like personal ID, government ID, and other information.
I have read the terms and conditions and privacy policy of Sincere Financial Group.
By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
What is your complimentary vacation choice?
*
Please Select
Las Vegas, NV - 4 Days/3 Nights - Nightly Taxes or Fees: $33.24
Cancun, Mexico - 6 Days/5 Nights - Nightly Taxes or Fees: $38.95
Cabos San Lucas, Mexico - 5 Days/4 Nights - Nightly Taxes or Fees: $38.95
Bali, Indonesia - 8 Days/7 Nights - Nightly Taxes or Fees: $29.95
Note: Food, Flight, and Taxes are not included.
Date Signed
-
Month
-
Day
Year
Date
Taxpayer Signature
Date Signed
-
Month
-
Day
Year
Date
Spouse Signature
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