NextEra Tax Client Intake Form

Dear Client:

We are looking forward to working with you this year in preparing your taxes! To minimize the possibility of a misunderstanding between us, we are setting forth pertinent information about the services we will perform for you. Please note that we must receive a signed copy of this engagement letter before we are able to work on your tax return. Also attached are tax data forms that we have specially created to help you in organizing your tax information. Please return these along with any supporting documents in person, via email, or using our App. Keep a copy for your records. We will prepare your federal and state individual income tax returns for the information you furnish to us. While we will not audit what you submit, we may verify your information and the data you submit and ask you to clarify some of the information.

If we have not received ALL your information by March 31st of the current filing year, we will be happy to file an extension for you. Filing an extension is a complimentary service and will only be provided upon request. If an extension is filed, we must receive ALL tax information by September 30th of the current filing year. While an extension provides additional time to file your return, it does NOT provide an extension of time to pay taxes that may be due on your tax return. Information received after March 31st of the current tax year will be subject to additional fees if the return is expected to be completed by the April 15th deadline.

It is your responsibility to maintain in your records the supporting documentation necessary to support your tax returns. If you have any questions as to the type of records required, please ask us for advice regarding that.

We are responsible for preparing only the returns referred to in this letter. Our fee does not include responding to inquiries from the IRS or state received after the return is filed, or examination by taxing authorities. However, we are available to represent you should such a need develop, and this would be covered under a separate engagement letter unless you opted into our Audit Protection Program. Should we encounter instances of unclear tax law, or of potential conflicts in the interpretation of the law, we will outline the reasonable courses of action and the risk and consequences of each. We will ultimately adopt, on your behalf, the alternative you select. If the IRS should contest the position taken, disallow doubtful deductions, or inadequately supported documentation, there may be an assessment of additional tax, plus interest and penalties or assessments. Federal law has extended the attorney-client privilege to some, but not all, communications between a client and the client's tax preparer. Communications solely concerning the preparation of a tax return will not be privileged.

To protect sensitive data, client copies of tax returns will be delivered in person or via email, which will allow you to download an electronic copy of your tax return and print an unlimited number of copies at any time needed. A paper copy can be requested. We will not be held liable for any lost or stolen mail. You may also pick up a copy of your tax return from our office, which will require you to show a photo id. Please keep your paper copy in a secured location, as replacement paper copies are $25 per year requested.

We are dedicated and determined to get you all the deductions that you are entitled to. Since your return is unique to your circumstances, we cannot guarantee the outcome or whether you will view it as good or bad. This does not relieve you of the obligation to pay our fees. Payment for service is due when rendered, fees are not. If the above sets forth your understanding, please sign a copy of this letter and return it to us. We are pleased to have you as a client and look forward to a long, mutually satisfying professional relationship with you.

Signature*

Referred By: (Type N/A if None)*

TauraahDemi (Aja Zhane)Other

Tax Payer SSN*

Tax Payer Name*

First NameMiddle NameLast Name

Spouse SSN

Spouse Name

First NameMiddle NameLast Name

Tax Payer Occupation*

Spouse Occupation

Check all that apply*

Self-employedCollege studentTotally or permanently disabledEmployed

Tax Payer Phone Number*

Area CodePhone Number

Spouse Phone Number

Area CodePhone Number

Tax Payer Date of Birth*

Date

Spouse Date of Birth

Date

Are you new to our firm?

YesNo

Email*

example@example.com

Tax Payer Address*

Street Address

County

CityState / Province

Postal / Zip Code

Spouse Address (Enter "SAME" if same as Tax Payer Address)

Street Address

County

CityState / Province

Postal / Zip Code

Was this your address all of 2025? If no, please enter previous address

Tax Payer Driver's License Information*

Spouse Driver's License Information

Filing status*

Were you divorced or separated during the year?*

YesNo

Have you received any notices from the IRS or state revenue department within the past year?*

YesNo

If you have an Identity Protection Pin, (IP PIN), list it here.

Dependent 1

Dependent 2

Dependent 3

Dependent 4

Dependent 5

Did any of the children have income above $1,050 for the tax year?

YesNo

If yes, which child?

Is it anticipated that a different taxpayer will seek to claim a child listed above as their dependent?

YesNo

Other Dependent or person who lived with you

Are these your biological children? If not please explain where the parents are*

Do you agree you provided care for these children more than half the year?*

If you are due a refund, would you like it directly deposited into your bank?

Do you own and operate a small business/home based business?

YesNo

Do you have a business license?

YesNo

What is your EIN? (If no EIN, enter your social)

Lifestyle and Taxes- Select all that apply

Deductions- Select all that apply

Business- Select all that apply

State Information- Not required for Alaska, Florida, Nevada, South Dekota, Texas, Washington, Wyoming, New Hampshire, and Tennessee*

Full-Year ResidentPart-Year ResidentNonresident (You worked in one of the states not listed above, but did not live there)

State of residence during 2025 and dates*

School District*

Do you rent or own your home

RentOwn

How much do you pay in rent and who do you pay it to?

Business Name

EIN NUMBER

Do you have a business card or flyer?

YesNo

Self-Employed Income

Method used for calculating self-employed income

List Self-Employed expenses with amounts for 2025- If business is home based, please include amount of rent and utilities. If vehicle used for business purposes, please include amount of car note, insurance, maintenance and any repairs PLEASE BE SPECIFIC - OR you may upload your expenses.

If you need to itemize deductions, please provide amounts and/or receipts to your Tax Specialist. These amounts can include, but are not limited to, Medical Expenses, Taxes Paid, Interest Paid, Charitable Contributions, Casualty and Theft Losses and other Miscellaneous Itemized Deductions. Please provide to your Tax Specialist all forms W2, 1099-INT, 1099-DIV, 1099-R, 1099-MISC, and other income reporting statements.

Please upload all income (w2,1099's,receipt ledgers,etc) ID/Driver license and all social security cards below or email to: ateat@nexterafinancialsolutions.com

PRIVACY POLICY

The nature of our work requires us to collect certain nonpublic information. We collect financial and persoanl information from applications, worksheets, reporting statements, and other forms, as well as interviews and conversations with our clients and affiliates. We may also review banking and credit card information about our clients in the performance of receipt of payment. Under our policy, all information we obtain about you will be provided by you or obtained with your permission. Our firm has procedures and policies in place to protect your confidential information. We restrict access to your confidential information to those within our firm who need to know in order to provide you with services. We will not disclose your personal information to a third party without your permission, except where required by law. We maintain physical, electronic, and procedural safeguards in compliance with federal regulations that protect your personal infromation from unauthorized access.

LETTER OF ENGAGEMENT PREPARE TAX RETURN
The undersigned person(s) has/have authorized the Nextera Financial Solutions and its authorized representative in Person of World Class & SMT Agents to prepare their federal and state tax returns. The company claims no responsibility for the tax returns(s) other than preparing the said return(s). The accuracy of the return(s) will be directly related to the information provided by the tax payer(s). The information received by the company will be use in accordance with the rules and regulation of the Internal Revenue Service (IRS).

I agree to electronically sign any document that may require a signature to complete my tax return. I will make two forms of ID available, one of which will include my SSN card. If required, I will also make the following documents (W-2, 1099, 1098, child care information, school information, mortgage information, etc) should be given to the preparer. We will provide you with a copy of your return(s) and advice you to keep it in safe place because you will not be able to get another copy once the office closes. You will have to contact the IRS to get any needed copy.

NextEra does not determine when your tax return will be remitted; please used www.irs.gov to know when your refund will be released.

By signing this Engagement Letter, I have agreed to fully compensate and authorize NextEra to prepare my tax return(s). NextEra is hereby permitted to electronically deduct its compensation as soon as my return is released.

DISCLAIMER STATEMENT
By signing this form, I am agreeing that everything entered on it is correct and true. NextEra is not liable for any false information given.

NOTE: IF YOUR REFUND IS RECEIVED WITH IN THE EXPECTED TIME FRAME, PLEASE CALL THE IRS @ 1800-829-1040

Due to the PRIVACY ACT, ONLY you can request information on the status of your return from the IRS.

PLEASE UPLOAD ID*

Browse Files

PLEASE UPLOAD CHILDRENS SSC*

Browse Files

PLEASE UPLOAD PROOF OF RESIDENCY IF HEAD OF HOUSEHOLD*

Browse Files

PLEASE UPLOAD W2S/1099S/SELF EMPLOYMENT DOCS*

Browse Files

I agree that all information provided is true and factual. I understand that falsifying information is against the law. I agree that upon completion of my tax return, if my return is intercepted and not paid, I am responsible for all preparation fees to be paid to my Tax Specialist*

I AgreeI Disagree

Signature

Taxpayer Information