Tax Preparation Intake Form

Tax Preparation Intake Form

Please provide your information to begin the tax preparation process.
Client Status
How did you hear about us?

Other
Name/Other
Tax Year

Other
Filing Status

Other
- Full Name
  
  First NameMiddle NameLast Name
- Date of Birth
  
  MonthDayYear
  Date
- Social Security Number
  Enter 'without' dashes
- Email Address
  example@example.com
- Cell Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Mailing Address
  
  Street Address
  
  Street Address Line 2
  CityStateZip Code
- Occupation
  What 'kind' of work do you do?
- Spouse Full Name
  
  First NameMiddle NameLast Name
- Spouse Date of Birth
  
  MonthDayYear
  Date
- Spouse Social Security Number
- Spouse Email Address
  example@example.com
- Spouse Cell Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Spouse Mailing Address
  
  Street Address
  
  Street Address Line 2
  CityStateZip Code
- Spouse Occupation
  What 'kind' of work do you do?
- Do you have any dependents to claim?
- Dependents
- Are you totally and permanently disabled?
- Are you legally blind?
- Are you the dependent of another taxpayer? (e.g., Will your parent(s) claim you?)
- Did your marital status change during the year?
- Have you ever been denied the Earned Income Tax Credit(EITC)?
- Did your address change during the year?
- What types of income did you receive in the past year? (Select all that apply)
  
  Other
- Do you have any itemizing documents? (Select all that apply)
  
  Other
- Did you pay for childcare services?
- Did you purchase health insurance through the Marketplace? (ObamaCare)
- Please upload all ID's and documents related to your tax file.
  
  Cancelof
- Do you have an IP Pin?
- IP Pin
- Would you like to apply for a refund advance?
- If you are entitled to a refund, how would you like to receive it?
- Do you want to electronically file your taxes?
- Please list any special tax situations, deductions, or credits you would like us to know about (optional)
- Type a question
  
  I certify that all information in this questionnaire, including any supporting documentation and information, is true and complete to the best of my knowledge. I agree and acknowledge that falsified information, misrepresentation, and omissions may disqualify me for specific tax credits as determined by the IRS. I allow TaxSupreme to capture my sensitive data, including ID's Social Security Numbers, and other submitted information.
- Today's Date
  
  MonthDayYear
  Date
- Should be Empty: