CLIENT INTAKE FORM - TAX PREPARATION
Full Name
*
Date of Birth
*
/
Month
/
Day
Year
Date
Social Security Number
*
Phone Number
*
Format: (000) 000-0000.
Email Address
*
example@example.com
Address
*
City
*
State
*
ZIP
*
Filing Status
*
Single
Married Filing Jointly
Married Filing Separately
Head of Household
Qualifying Widow(er)
Dependent Information:
*
Name, SSN, Relationship, DOB, Lived with you all year? Claimed by you?
Income Information
*
W-2 (Employment Income)
1099-NEC / 1099-MISC (Self-Employment or Contractor)
1099-INT / 1099-DIV (Interest/Dividends)
1099-B (Stocks, Crypto, or Investments)
Social Security Benefits (SSA-1099)
Education (Tuition / Student Loan Interest)
Mortgage interest / Property taxes
Business expenses (if self-employed)
Retirement contributions (IRA, 401k, etc
Other
Do You Have An Identity Pin? For yourself or any dependents you're claiming.
*
Do You Currently Have A Balance You Owe The IRS?
*
BUSINESS OR SELF-EMPLOYMENT (if applicable)
Business Name
EIN if any
Type of Work
Do you use a home office?
*
Yes
No
Refund Information
Direct Deposit
Bank Name
Routing & Account #
Routing first, Acct second
Did you receive advance Child Tax Credit payments in 2025?
*
Yes
No
Did you receive any IRS letters or notices?
*
Yes
No
Were you a victim of identity theft?
*
Yes
No
Do you want to apply part of your refund to next year's taxes?
*
Yes
No
Drivers License
*
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SSN
*
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Social Security #
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W2
*
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Other Supporting Documents
*
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Other Supporting Documents
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Other Supporting Documents
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Who Referred You?
*
First Name, Last Name, Phone Number
Client Signature
*
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