2025 Tax Preparation Client Intake Form

2025 Tax Preparation Client Intake Form

2025 Tax Preparation Client Intake Form
SingleHead of HouseholdMarried Filing SeparateMarried Filing JointQualifying Widower
YesNo
Who is your Tax Preparer
Who were you Referred by?

Name

First NameLast Name
Date of Birth*

MonthDayYear
Date
Social Security Number*
Occupation*
Did you receive an Identity Theft PIN*
Identity Protection PIN Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Bank Information for Direct Deposit

Routing NumberAccount Number
Select the Type of ID Card from dropdown*
Select your State*
Enter your identification Number*
Issue Date*

MonthDayYear
Date
Expiration Date*

MonthDayYear
Date
YesNo
YesNo
YesNo
YesNo

Name

First NameLast Name
Social Security Number
Date of Birth

MonthDayYear
Date
Occupation
Did you receive an Identity Theft PIN
Identity Protection PIN
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Select the Type of ID Card from dropdown
Select your State
Enter your identification Number
Issue Date

MonthDayYear
Date
Expiration Date

MonthDayYear
Date
YesNo
YesNo
YesNo
YesNo

Enter your dependents here

Rows	Name	Date of Birth	Social Security Number	Relationship	Childcare
1
2
3
4
5
6

Do you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it?

Rows	Yes/No	Employer	Spouse Ins	Exchange/ Marketplace	Direct with Insurer	Medicare	Medicaid
Taxpayer
Spouse
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5

EmployedUnemployedSelf-employed
How many W-2's do you have?
upload all W-2's to your intake form*****
How many W-2's do your Spouse have?
upload all W-2's to your intake form*****
What is your Self Employment
What is your Spouse Self Employment
OTHER:
YesNo

School Name (University, Community College, or Trade School)

Rows	Name	EIN	Address	Phone Number	Amount Paid for the Year 2024	Out of Pocket Expenses for 2024
1

YesNo
YesNo

Childcare Provider Information

Rows	Name	EIN/SSN	Address	Phone Number	Amount Paid for the Year 2025
1
2

WindowsDoorsFurnaceOther
How long have you lived at the property?
# of months
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo

Please fill-out the information within the current year only.

General Expenses

Rows	Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses

Total Expenses
Additional comments

- I certify that I have made full disclosure of all income, expenses, and related supporting information to TNTS and the preparer of this return.
- Therefore, if an assessment of additional taxes, fines, penalties, or interest is levied due to my failure to produce or provide such supporting information to TNTS or one of the examining agents, I shall hold TNTS and their preparers, agents, or employees harmless for such failure.
- Subsequently, the undersigned agrees that they shall be solely responsible for the payment of all taxes, penalties, fines, and/or interest, which may be assessed against TNTS or the preparer of this return.
- I allow Top Notch Tax Service to capture my sensitive data like Personal ID, Government ID, and other information.
- I have read the terms and conditions and privacy policy of Top Notch Tax Service.
- By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Date Signed

MonthDayYear
Date
Taxpayer Signature
Date Signed

MonthDayYear
Date
Spouse Signature
File Upload

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