2025 TAX INTAKE FORM

2025 TAX INTAKE FORM
(This is the exact most recent version we created with all updates

NEW ERA BUSINESS SERVICES - TAX INTAKE FORM
Full Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Email
example@example.com
Telephone
Format: (000) 000-0000.
Current Address
(Enter up to 3 dependents; add more if needed
Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
TREASURY OFFSET PROGRAM (TOP) - REQUIRED CHECK BEFORE PREPARATION Call BEFORE we begin your return:Bureau of Fiscal Service Offset Line: 1-800-304-3107
Do you owe any federal or state debts that may reduce your refund?If yes, what type? (Child support, student loans, IRS debt, unemployment, etc
Did you have health insurance this year? If so, Was your insurance through the Marketplace (Obamacare)? If yes to Marketplace or your unsure , call for verification zsk them to provide your 1095-A info 24-Hour Verification Number: 1-800-318-2596
Did you work a job and receive any W-2 forms?
SELF-EMPLOYMENT / 1099 / BUSINESS INCOME. Did you earn income from self-employment, gig work, or a small business?
Estimated annual expenses including anything required to operate your business from utilitites office rent to maintence on your vehicle to personal protection equipment etc.
Did you receive unemployment benefits (1099-G)?
SOCIAL SECURITY / DISABILITY / RETIREMENT INCOMEDid you receive SSA-1099, SSI, pension, or retirement?
EDUCATION CREDITS (American Opportunity or Lifetime Learning)Did you attend college at least part-time this tax year? If yes please include School Name:Did you receive a 1098-T?
Did you pay for childcare?
If so please provide the details: Provider Name
Provider Phone
Format: (000) 000-0000.
Amount Paid
Did you buy or sell a home this year? If so , Did you pay mortgage interest (Form 1098)?
How would you like to receive your refund? Paper Check, Direct Deposit , Refund Advance, or Green Dot prepaid card.?
Are you interested in CREDIT REPAIR services?

Are you interested in LIFE INSURANCE options?

I certify the information provided is accurate to the best of my knowledge.
ARE YOU INTERESTED IN ADDITIONAL SERVICES?
Thank you for deciding to file with New Era Business Services. Now that you have provided the basic questions to maximize your return, please download our user-friendly app and upload your w2s and anuy other documentation.
USE THIS LINK BELOW TO ACCESS OUR SECURE APP!!
https://taxestogo.com/App/Download/79724
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

2025 TAX INTAKE FORM

TREASURY OFFSET PROGRAM (TOP) - REQUIRED CHECK BEFORE PREPARATION Call BEFORE we begin your return:Bureau of Fiscal Service Offset Line: 1-800-304-3107