KC HIM Tax Pro Client Intake Form KC

PERSONAL INFORMATION
Taxpayer Name

PrefixFirst NameMiddle NameLast NameSuffix
Taxpayer Social Security Number
Taxpayer Birthday

YearMonthDay
Date
Taxpayer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Taxpayer Email
example@example.com
Taxpayer Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please Provide IP Number If You Require One
SPOUSE INFORMATION
Spouse Name

PrefixFirst NameMiddle NameLast NameSuffix
Spouse Social Security Number
Spouse Birthday

YearMonthDay
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Cell phone number
Please enter a valid phone number.Format: (000) 000-0000.

REFUND PREFRENCE
What Method of refund would you prefer?
Enter Bank Name, Account Number & Routing Number Here:
Fast Forward: Would you like to opt-in to direct deposit or check disbursement with Fast Forward? With this option, you agree to pay a $25.00 fee to receive your federal refund up to 5 days early. Please confirm your selection to participate by checking yes.
Fast Forward Check Disbursement Agreement By selecting Fast Forward – Check Disbursement, you acknowledge and agree to the following: You have voluntarily selected the Fast Forward check disbursement option. This option includes a $25.00 fee to receive your federal tax refund up to 5 days early, subject to IRS and bank processing times. The fee will be deducted from your refund or charged as disclosed during your filing process. Early availability of funds is not guaranteed and depends on IRS release timing and third-party processing. This selection cannot be changed or refunded once your return has been submitted. By signing below, you confirm your agreement to the Fast Forward option you selected and authorize the associated fee. YES, I AGREE TO FAST FORWARD DIRECT DEPOSIT OR CHECK DISBURSEMENT

FOR THE PROTECTION OF YOU THE "TAX PAYER" AND HIM TAX PROS, ITS AFFILIATES, AND TAX PREPARERS, YOUR SIGNATURE MUST MATCH YOUR ID/ DRIVERS LICENSE. FAILURE TO DUE SO COULD CAUSE REJECTION OF SERVICES. HIM TAX PROS WILL NOT SUBMIT YOUR TAX RETURN WITHOUT THE CORRECT SIGNATURE AND WILL REJECT ANY SERVICES.

SUPPORTING DOCUMENTS
Please Upload Front of Taxpayer Id

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Please Upload Back of Taxpayer Id

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Please Upload A Photo Of You Holding Your ID:

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Please Upload Taxpayer Social

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Please Upload Your IRS Compliance Report:

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Please Upload Your Healthcare Form:

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Please Upload W-2's

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Please Upload 1099

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Please Upload Dependent(s) Social, Birth Certificate and/ or Any Supporting Dependent(s) Documentation

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Please Upload Other Required Documents

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DUE DILIGENCE QUESTIONNAIRE
1. I/ We certify that the child(ren) for whom the tax credit(s) will be requested can be claimed as my/ our dependent(s), as per the information provided at the end of this questionnaire.:
2. The child(ren) for whom the tax credit(s) will be requested lived with me/us for the year, except for temporary absences:
3. I am the custodial parent of the child(ren) for whom the tax credit(s) will be requested, and I released the dependency deduction to my former spouse for 2026 by signing Form 8332 (Release/Revocation of Claim to Exemption for Child by Custodial Parent).
4. I am not the custodial parent of the child(ren) but I have been given a signed Form 8332 by my former spouse, the custodial parent, allowing me to claim the child(ren) as the dependent(s) on my 2025 tax returns (you must give me the Form 8332.
5. I/we, or my child(ren), have documentation to substantiate the credit(s) being claimed, such as Form 1098-T, bills, statements, and receipts for college tuition, fees, and book and material costs (you are responsible for keeping this documentation and providing it to the IRS if you are audited or questioned):
6. Was a Child Tax Credit, Additional Child Tax Credit, or American Opportunity Credit claimed by you disallowed or reduced by the IRS on a past tax return?
7. I claim I am unmarried or separated, support a qualifying person as your dependent, and pay more than half the cost of maintaining your household.:

ACKNOWLEDGEMENTS
I (We, if filing jointly) acknowledge that the above information provided by me is true and accurate to the best of my knowledge. I hereby relieve HIM Tax Pros and its agents and affiliates from any liability whatsoever, regarding the preparation of this/these tax returns, and agree to hold harmless from any damages I may suffer and understand that my sole relief is limited to the return of any fee paid for the preparation of these tax documents. I (we) guarantee payment of the preparation fee and any related charges. Acknowledgements

FOR THE PROTECTION OF YOU THE "TAX PAYER" AND HIM TAX PROS, ITS AFFILIATES, AND TAX PREPARERS, YOUR SIGNATURE MUST MATCH YOUR ID/ DRIVERS LICENSE. FAILURE TO DUE SO COULD CAUSE REJECTION OF SERVICES. HIM TAX PROS WILL NOT SUBMIT YOUR TAX RETURN WITHOUT THE CORRECT SIGNATURE AND WILL REJECT ANY SERVICES.
Please allow up to 48-72 hours for preparation of your
tax return. Should you have any questions please
contact YOUR preparer directly!
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HIM Tax Pro Client Intake Form