Client Tax Intake Application

Client Tax Intake Application

Please complete this form to help us prepare your tax return. Sections will appear based on your answers. All information is kept confidential.
Section 1: Service Type

Select all services you are interested in.
What type of services do you need?*

Tax PreparationBusiness Tax ServicesBookkeepingConsultationOther
Section 2: Primary Taxpayer

Enter your personal information.
Primary Taxpayer Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Current Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Date of Birth*

MonthDayYear
Date
Section 3: Spouse Information (if Married Filing Jointly)

Complete this section if you are filing jointly with your spouse.
Spouse Name*

First NameLast Name
Spouse Email Address
example@example.com
Spouse Phone Number
Please enter a valid phone number.
Spouse Date of Birth

MonthDayYear
Date
Section 4: Filing Status

Select your filing status for this tax year.
What is your filing status?*

SingleMarried Filing JointlyMarried Filing SeparatelyHead of HouseholdQualifying Widow(er)
Section 5: Dependents

List your dependents (if any).
Enter Dependent Information (Name, Date of Birth, Relationship, Months Lived with You, Disabled?)
Section 6: Income Types

Select all income types that apply to you.
What types of income did you have in the tax year?*

W-2 Wages1099-NEC / ContractorBusiness / Self-Employed IncomeUnemployment IncomeRetirement IncomeInvestment IncomeOther
Section 7: Business / Self-Employed Income

Complete this section if you had business or self-employed income.
Business Name
Type of Work
Employer Identification Number (EIN), if any
Gross Business Income
Total Business Expenses
Business Miles Driven
Did you use a vehicle for business?

YesNo
Section 8: Health Insurance

Provide your health insurance details for tax compliance.
Did you have health insurance coverage for the entire year?*

YesNo
What type of health insurance did you have?

Employer ProvidedMarketplace (ACA/1095-A)Medicare/MedicaidNoneOther
Section 9: Bank Product Application

Would you like to apply for a bank product with your refund?
Would you like to apply for a bank product?*

Yes – Refund AdvanceYes – Pay fees from refundYes – BothNo
Section 10: Health & Life Insurance Services

Are you interested in learning about or applying for insurance?
Are you interested in learning about or applying for insurance?*

Life InsuranceHealth InsuranceBothNo
Type of Life Insurance Interested In
Type of Health Insurance Interested In
Current Coverage Status

CoveredNot Covered
Preferred Timing for Insurance
Estimated Monthly Budget for Insurance (USD)
Preferred Contact Method

PhoneEmailText Message
Section 11: Document Uploads

Upload your tax documents securely.
Upload Tax Documents (W-2s, 1099s, etc.)

Cancelof
Upload Additional Supporting Documents

Cancelof
Section 12: Price Acknowledgment

Please acknowledge our pricing before submitting.
Do you acknowledge and accept the pricing for services?*

Yes, I acknowledge and acceptNo, I do not accept
Section 13: E-Signature

Sign below to complete your intake application.
Primary Taxpayer Signature*

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Spouse Signature (if Married Filing Jointly)*

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Client Tax Intake Application

Section 1: Service Type

Section 2: Primary Taxpayer

Section 3: Spouse Information (if Married Filing Jointly)

Section 4: Filing Status

Section 5: Dependents

Section 6: Income Types

Section 7: Business / Self-Employed Income

Section 8: Health Insurance

Section 9: Bank Product Application

Section 10: Health & Life Insurance Services

Section 11: Document Uploads

Section 12: Price Acknowledgment

Section 13: E-Signature