2025 Eluxe Tax Solutions Client Intake

This form is for tax year 2025, filed in 2026. If you need help with prior year tax fling(s), please contact us directly.
Tax Preparer Requested
How did you hear about us?
Who referred you?
TAXPAYER INFORMATION
Which filing status applies to you?
# of Dependents
PLEASE NOTE: Head of Household filers must present a lease, utility bill, or mortgage statement as proof.
First Name
Middle Name (if applicable)
Last Name
Suffix (if applicable)
Date of Birth

MonthDayYear
Social Security #
Email
example@example.com
Phone Number

Area codePhone number
Current Address

Street Address

Street Address Line 2

CityState

Zip Code
Employer (primary)
Occupation (primary)
Check all that apply
SPOUSE INFORMATION
Spouse First Name
Spouse Middle Name
Spouse Last Name
Spouse Suffix (if applicable)
Spouse Date of Birth

MonthDayYear
Spouse Social Security #
Spouse Email
example@example.com
Spouse Phone Number

Area codePhone number
Spouse Current Address

Street Address

Street Address Line 2

CityState

Zip Code
Spouse Employer (if applicable)
Spouse Occupation (if applicable)
Check all that apply to spouse
DEPENDENTS INFORMATION
Dependent 1 Name

First NameMiddle NameLast NameSuffix
Dependent 1 Date of Birth

MonthDayYear
Dependent 1 Social Security #
Does other parent provide any financial support for Dependent 1?
Dependent 1 Relationship to you
Dependent 2 Name

First NameMiddle NameLast NameSuffix
Dependent 2 Date of Birth

MonthDayYear
Dependent 2 Social Security #
Does other parent provide any financial support for Dependent 2?
Dependent 2 Relationship to you
Dependent 3 Name

First NameMiddle NameLast NameSuffix
Dependent 3 Date of Birth

MonthDayYear
Dependent 3 Social Security #
Does other parent provide any financial support for Dependent 3?
Dependent 3 Relationship to you
Dependent 4 Name

First NameMiddle NameLast NameSuffix
Dependent 4 Date of Birth

MonthDayYear
Dependent 4 Social Security #
Does other parent provide any financial support for Dependent 4?
Dependent 4 Relationship to you
Dependent 5 Name

First NameMiddle NameLast NameSuffix
Dependent 5 Date of Birth

MonthDayYear
Dependent 5 Social Security #
Does other parent provide any financial support for Dependent 5?
Dependent 5 Relationship to you
If low income, how are you able to provide for dependent(s)?
TAX SPECIFIC QUESTIONS
Did you pay any child care expenses?
Did you pay any tuition expenses for yourself or any dependent and received a 1098-T form?
Did you purchase health insurance through government marketplace insurance (Obama Care)?
Did you receive a 1095-A form from the marketplace?
Did you receive any social security or retirement income?
Do you have a 401K account?
Did you make a withdrawal from your 401K account?
Did you receive unemployment compensation and receive a 1099-G form?
Which one applies to your unemployment compensation?
Do you have any other income (freelance work, gambling, etc)?
Did you receive a 1099-NEC (freelance work) and/or W-2G form (gambling winnings)?
Are you delinquent in any of the following? (you can choose multiple)
Are you interested in a tax refund advance?
Do you have an IP pin?
What is your IP pin?
How would you like to receive your refund?
Name of Bank
Routing Number
Re-enter Routing Number
Account Number
Re-enter Account Number
REQUIRED DOCUMENTS
Head of Household Proof (Lease, Utility Bill, Mortgage Statement)

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Driver's License / ID card

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Social Security Card

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Dependent(s) Birth Certificate(s)

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Dependent(s) Social Security Cards(s)

Cancelof
W-2(s)

Cancelof
1099(s) (Self-Employed, Gambling Winnings, etc.)

Cancelof
Child Care Annual Statement (from facility) or W-10 (for babysitter, nanny)

Cancelof
1098(s) (Tuition / Education Expenses)

Cancelof
1095(s) (Healthcare)

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Direct Deposit

Cancelof
IP Pin (IRS document)

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Previous Year Tax Return (if available)

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Misc. Forms

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Take Selfie with your ID next to your face
Signature
Please verify that you are human
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