2025-2026 Intake Form

CLIENT INTAKE FORM
Thank you for completing our intake package.

For new clients, this information is essential to ensure accurate tax filing. Please submit at least your prior-year tax return (preferably two years) for comparison.

For existing clients, we kindly ask that you provide this information again to keep our records accurate and up to date. You may indicate sections that remain unchanged from last year to avoid re-entering details. IRS compliance is crucial, and returning clients know we work hard to secure every dollar you deserve.

IMPORTANT: A checklist of commonly required documents is included. You may save your progress and return anytime while gathering your documents. After completing all sections, please click “SUBMIT” at the bottom. Closing your browser without submitting will erase your entries. You will receive a confirmation email once submitted.

Please note: We will request a valid government-issued photo ID during your engagement to comply with federal and state identity theft requirements.

We use industry-leading SSL technology to ensure all sensitive information is securely transmitted and encrypted.
Please choose your tax preparer

CLIENT ENGAGEMENT LETTER
Jackson & Co Financial

Email: info@jacksoncofinancial.com

Phone: 800-320-5171

Adrress: 7111 Harwin Dr Suite 110D
Houston Tx 77036
Dear Valued Client,

This letter outlines the terms of our engagement and the services we will provide. Your signature confirms that you understand and agree to the terms below.

By signing, you acknowledge that the information you provide will be submitted to the IRS and state tax authorities, and that providing false or misleading information is illegal and subject to penalties. You understand that JACKSON & CO FINANCIAL is responsible only for errors or omissions on our part, including related interest and penalties—not any tax due.

If you agree to these terms, please sign where indicated. These terms apply to all tax returns we prepare for you.

Thank you for trusting us with your tax needs.

Sincerely,
JACKSON & CO FINANCIAL
OUR RESPONSIBILITIES
- We prepare your federal, state, and local tax returns based on the information you provide.
- We do not audit or verify your data, but we may request clarification.
- We will work to identify all credits and deductions you are legally entitled to.
- Additional bookkeeping fees may apply if needed.
- We are not responsible for detecting fraud or irregularities.
YOUR RESPONSIBILITIES
- Provide all necessary information for accurate and complete tax returns.
- Respond promptly to any requests for clarification.
- Keep all documents that support your income, expenses, deductions, and credits.
- Review your return carefully before signing.
- Ensure all information you provide is truthful.
You are ultimately responsible for the accuracy of your tax return.
PENALTIES, EXAMINATIONS, AND NOTICES

The IRS and state tax authorities may impose penalties for issues such as underreported income, late filing, underpaid estimated taxes, or insufficient tax withholding. Any return may also be selected for examination.

Taxpayers may face additional penalties if they understate their tax liability.

Your federal or state return—or both—may be chosen for review. Any adjustments proposed by an examining agent may be appealed through the appropriate channels. Optional audit protection is available for an additional fee.
PRIVACY POLICY
We protect your personal information according to professional confidentiality standards. We share information only as required by law or as needed to provide services, and only with parties who agree to safeguard your data.

We maintain physical, electronic, and procedural security measures for all client records, including former clients.
OUR FEES
Fees are based on the time, forms, schedules, and work required—not on your refund amount. Payment is required whether or not you receive a refund.
ARBITRATION
If a dispute arises and cannot be resolved through discussion, both parties agree to attempt mediation through the American Arbitration Association before considering arbitration or litigation.
AGREEMENT
By signing, you confirm that all information you provide is true, correct, and complete, and you understand these terms will continue to apply in future years unless updated.

Please sign to indicate your agreement to the above.
Signature

CLIENT STATUS
Full Name ( First Name, Middle Initial, Last Name, Sufffix [if applicable] )

First NameLast Name
Type of Client
Please list your referrer's name (Put "N/A" if not applicable)
Did you have any delays receiving your refund last year
For which tax year are you submitting documents?
Do not attach documents that are not for the tax year you have selected. If you need more than one year filed, please create a separate submission for each year.

TAXPAYER INFORMATION
Social Security Number
Taxpayer's Date of Birth

MonthDayYear
Date
Taxpayer's Occupation (Note: Do not enter "self-employed")
Phone Number
Secondary Phone Number
Email Address

Confirmation Emailexample@example.com
Address

Street Address

Street Address Line 2

CityState

Zip Code
Filing Status
Please upload a copy of your driver's license/ID

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Are you claiming dependents on your tax return?
Please upload all income documents for taxpayer

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SPOUSE'S INFORMATION
Spouse's Full Name ( First Name, Middle Initial, Last Name, Sufffix [if applicable] )
Spouse's Social Security Number
Spouse's Date of Birth

MonthDayYear
Date
Phone Number
Email Address
example@example.com
Spouse's Occupation (Note: Put N/A if not applicable)
Please upload a copy of your spouse's driver's license/ID

Cancelof
Please upload all income documents for spouse

Cancelof

DEPENDENT'S INFORMATION
1. Dependent's Full Name ( First Name, Middle Initial, Last Name, Sufffix [if applicable] )
Dependent's Social Security Number
Dependent's Date of Birth

MonthDayYear
Date
Relationship to Taxpayer
Number of Months Dependent Lived in the Household (If this dependent was born during the tax year, select 12 months)
2. Dependent's Full Name ( First Name, Middle Initial, Last Name, Sufffix [if applicable] )
Dependent's Social Security Number
Dependent's Date of Birth

MonthDayYear
Date
Relationship to Taxpayer
Number of Months Dependent Lived in the Household (If this dependent was born during the tax year, select 12 months)
3. Dependent's Full Name ( First Name, Middle Initial, Last Name, Sufffix [if applicable] )
Dependent's Social Security Number
Dependent's Date of Birth

MonthDayYear
Date
Relationship to Taxpayer
Number of Months Dependent Lived in the Household (If this dependent was born during the tax year, select 12 months)
4. Dependent's Full Name ( First Name, Middle Initial, Last Name, Sufffix [if applicable] )
Dependent's Social Security Number
Dependent's Date of Birth

MonthDayYear
Date
Relationship to Taxpayer
Number of Months Dependent Lived in the Household (If this dependent was born during the tax year, select 12 months)
Please upload Social Security Card, Birth Certificate, Proof of Guardianship, etc. for the dependent/s (If available)

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Rows	Amount
Advertising
Contract Labor
Commission and fees
Insurance (other than health)
Mortgage interest
Other interest
Legal and professional services
Office expense
Rent or lease of equipment
Rent or lease of property
Repairs and maintenance
Supplies
Taxes and licenses
Travel
Utilities

CLIENT INTAKE FORM

CLIENT ENGAGEMENT LETTER

CLIENT STATUS

TAXPAYER INFORMATION

SPOUSE'S INFORMATION

DEPENDENT'S INFORMATION

IDENTITY PROTECTION

SELF-EMPLOYMENT / BUSINESS INCOME

BUSINESS OWNER WORKSHEET

BUSINESS INCOME INFORMATION

TAX CREDIT DUE DILIGENCE QUESTIONNAIRE

FINANCIAL INFORMATION

REFUND ADVANCE LOAN DETAILS

BANK ACCOUNT INFORMATION

BANK PRODUCT VERIFICATION

ATTESTATIONS & DISCLAIMERS