Client Intake Form

1
How did you hear about us?* This field is required.
Referral
Instagram
Facebook
TikTok
Previous Client
Flyer
2
Are you a new or returning client?* This field is required.
New
Returning
3
If someone referred you, please type his or her name here.
4
Are you trying to buy a new home within the next 2 years* This field is required.
YESNO
5
What is your filing status?* This field is required.
Single
Married filing jointly
Married filing seperately
Widow
Head of Household
Dependent on another return
6
Name* This field is required.
Prefix
First Name
Middle Name
Last Name
Suffix
7
Social Security Number* This field is required.
8
Taxpayer Birthday* This field is required.
Date
Month
Day
Year
9
Occupation
10
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
11
Do you have an IP PIN* This field is required.
YESNO
12
IP Pin Number
13
Email* This field is required.
example@example.com
14
Cell phone number* This field is required.
Please enter a valid phone number.
15
Spouse Name
Prefix
First Name
Middle Name
Last Name
Suffix
16
Spouse Social Security Number
17
Spouse Birthday
Date
Year
Month
Day
18
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
19
Email
example@example.com
20
Cell phone number
Please enter a valid phone number.
21
Do spouse have an IP PIN
YESNO
22
IP Pin Number
23
Dependent
24
Did you paid for Childcare/Daycare
YESNO
25
ARE YOU SELF EMPLOYED
YESNO
26
Can someone else claim you as a dependent?* This field is required.
YESNO
27
Have you ever been denied the Earned Tax Credit (EITC)?* This field is required.
YESNO
28
Were you or any of your dependents in college in 2025?* This field is required.
YESNO
29
Do you have a 1098-T Form for either you or your dependents?** This field is required.
YESNO
30
Did you, your spouse, or a dependent have health insurance under the Affordable Care Act?* This field is required.
YESNO
31
Who was your health insurance cover through in 2024?
Marketplace Insurance
Medicaid
Employer
32
What Method of refund would you prefer?* This field is required.
Paper check
Direct Deposit
33
Which type of account would you like your refund deposited into?
Checking Account
Saving Account
34
Direct deposit form
Bank Name
Routing number
Account number
35
Would you like a Refund Advance Loan?* This field is required.
YESNO
36
Are you interested in AUDIT PROTECTION?* This field is required.
YESNO
37
Please Upload Front of Taxpayer Id
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
38
Please Upload Back of Taxpayer Id
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
39
Please Upload Taxpayer Social
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
40
Please Upload W-2's
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
41
Please Upload 1099
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
42
If you have a 1098-T form, please upload it here.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
43
Please Upload Dependent(s) Birth Certificate(s) and Social Security Card(s)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
44
Please Upload Business Income/Loss Records(Quickbooks data/receipts/Profit & Loss Sheet)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
45
Please Upload Healthcare Marketplace Insurance Docs(1095A)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
46
Please Upload Proof of Residency (Lease/Utility Bill)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
47
Please Upload Childcare/Daycare Receipt/daycare statement
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
48
Other Documents
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
49
Signature/Acknowledgment* This field is required.Purpose of This FormThis client intake form allows us to gather the necessary information to accurately prepare your 2024 income tax return. Please complete all sections carefully and honestly to avoid delays. Do not submit this form until you have all required documents ready and available for upload. Tax returns are prepared in the order received, missing or incorrect information may delay processing Our team may contact you if additional documentation is require. By submitting this form, you confirm that All information provided is accurate to the best of your knowledge. You understand that submission does not guarantee a refund amount. You authorize Better Choice Taxes and Financial Services to prepare and file your tax return
Powered by Jotform SignClear
50
CLIENT NON-PAYMENT / REFUND OFFSET AGREEME* This field is required.At Better Choice Taxes & Financial Services, we are committed to providing accurate, professional, and timely tax preparation services. While we work diligently to maximize every client’s tax outcome, we acknowledge that certain circumstances may arise that are outside of our control. Please be advised that if your tax refund is offset by the IRS or any other agency (including but not limited to student loans, child support, prior tax debts), or if your refund is issued by mail, you remain fully responsible for payment of all fees associated with the preparation and filing of your tax return. By signing this agreement, you acknowledge and agree that: • Tax preparation fees are earned upon completion and filing of your return • Refund delays, offsets, or adjustments do not relieve you of payment responsibility • Full payment is due within 30 days of filing Failure to remit payment in full within 30 days may result in collection efforts and/or legal action to recover the outstanding balance. (By signing below, you confirm that you have read, understand, and agree to the terms stated above.)
Powered by Jotform SignClear
51
Should be Empty: