• Tax Preparation Client Intake Form

  • Filing Status
    • Taxpayer Information 
    • Date of Birth
       - -
      2 digit month, 2 digit day, 4 digit year
    • Format: (000) 000-0000.
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    • Are you a full-time student?
    • Are you totally and permanently disabled?
    • Are you legally blind?
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    • Spouse Information 
    • Date of Birth
       - -
      2 digit month, 2 digit day, 4 digit year
    • Format: (000) 000-0000.
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    • Are they a full-time student?
    • Are they totally and permanently disabled?
    • Are they legally blind?
    • Are they your dependent?
    • Dependents 
    • Enter your dependents here
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    • Is there anyone who can claim the dependent’s?
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    • Does you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it?
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    • Tax Related Questions 
    • Employment Status
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    • Does your dependents have tuition expenses?
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    • Do you have any expenses for child care?
    • Are you currently renting?
    • Do you own a home?
    • Do you have documents that shows you paid for property taxes?
    • Did you sell any stock?
    • Did you take money from your 401?
    • Are you a victim of identity theft?
    • Do you owe ANY tax liabilities? (student loans, child support, etc)
    • Do you give us permission to check for outstanding tax liabilities you may have?
    • Expenses 
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    • Acknowledgment & Signature 
      • I confirmed that all information I entered here is accurate and true.

      • I allow C & A Tax Services to capture my sensitive data like personal id, government id, and other information.

      • I have read the terms and conditions and privacy policy of C & A Tax Services.

      • By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
    • Date Signed
       - -
      2 digit month, 2 digit day, 4 digit year
    • Date Signed
       - -
      2 digit month, 2 digit day, 4 digit year
    • Engagement Letter 
    • Thank you for choosing C & A Tax Services to assist you with your tax preparation needs. This letter outlines the scope of our services, your responsibilities, and the terms of our engagement.
      Scope of Services We will prepare your federal and state income tax returns based on the information you provide. Our services include: Preparation and electronic filing of your federal and state tax returns. Assisting you in applying for available refund advance loans or refund transfers (Bank Products). Reviewing your tax return with you to ensure accuracy before submission.

      Bank Products If you choose to apply for a Refund Advance Loan or use a Refund Transfer option, you authorize us to: Use your tax return information to apply for the bank product. Deduct our preparation fees from your tax refund. Provide your tax information to the financial institution that offers the refund product. *Please note that we are not responsible for the approval or denial of any refund advance loans or for any delays caused by the IRS or state tax authorities. Additional fees may apply for bank products, which will be disclosed to you during the application process.

      Your Responsibilities You agree to provide complete and accurate information necessary for the preparation of your tax return. You acknowledge that you are responsible for maintaining all relevant documents and receipts. You agree to review your tax return carefully before signing the IRS e-file authorization (Form 8879).

      Fees Our fee for tax preparation and bank product services will be deducted from your refund. If your refund is insufficient to cover our fees, you are responsible for paying the remaining balance.*Please note that additional fees for bank products may apply, as outlined by the financial institution.

       Confidentiality We are committed to protecting your personal and financial information. We will not disclose your tax return information to any third party without your consent, except as required by law or to facilitate the bank product.

       Limitation of Liability While we will make every effort to prepare your return accurately, it is your responsibility to provide correct and complete information. We cannot be held liable for any penalties or interest that may arise from incomplete or inaccurate information provided by you.

       Acknowledgment By signing below, you acknowledge and agree to the terms of this engagement letter and authorize us to proceed with preparing and filing your tax return. You also authorize the application of any bank products if requested.

    • Date
       - -
      2 digit month, 2 digit day, 4 digit year
    • Date
       - -
      2 digit month, 2 digit day, 4 digit year
    • Due Diligence  
    • This Due Diligence Acknowledgment confirms that you, the client, have provided complete and accurate information for the preparation of your federal and state tax returns.

      Client Responsibility

      You have provided all necessary documentation, including but not limited to:

      Income information (e.g., W-2s, 1099s, business income)


      Responsibility’ information (e.g., birth certificates, school records)


      Proof of residency for dependents (e.g., lease agreements, utility bills)


      Proof of eligibility for tax credits (e.g., Child Tax Credit, Earned Income Tax Credit, American Opportunity Credit)

      Any additional documents required to substantiate the claims made on your tax return. You acknowledge that you are responsible for the accuracy and completeness of this information, and that any incorrect or incomplete information could result in changes to your tax liability, penalties, or disallowance of certain credits.

       Tax Preparer's Due Diligence

      As your tax preparer, I have followed the necessary due diligence procedures to ensure that your return complies with IRS requirements. These procedures include:

      Asking the appropriate questions to verify your eligibility for any tax credits.
      Reviewing the information and documents you provided.
      Completing the appropriate due diligence checklists and worksheets for refundable credits (EITC, CTC, AOC).

      IRS Penalties and Consequences

      Failure to provide accurate information may result in the IRS denying certain credits or imposing penalties. If the IRS audits your return, you may be required to provide additional documentation to support the claims made on your return.

       Acknowledgment of Understanding

      By signing this form, you confirm that the information you provided to prepare your tax return is accurate and complete to the best of your knowledge. You also acknowledge that I, as your tax preparer, have performed the necessary due diligence in accordance with IRS regulations.

    • Date
       - -
      2 digit month, 2 digit day, 4 digit year
    • Date
       - -
      2 digit month, 2 digit day, 4 digit year
    • Fee Agreement  
    • This Fee Agreement and Acknowledgment outlines the fees associated with the tax preparation and other services provided by C & A Tax Services . By signing this agreement, you acknowledge and agree to the payment terms and conditions as described below.

       Tax Preparation Fees

      The total fee for the preparation and filing of your federal and state tax returns starts at $300. This fee includes:

      Preparation of federal and state tax returns
      Electronic filing of your tax returns
      Review and consultation of your tax return prior to filing

      Additional Service Fees

      If applicable, the following services will incur additional fees:

      Audit support 
      Refund advance loans or refund transfers: (additional bank fees may apply)
      Other services

      Payment Options

      You agree to pay the total fee for tax preparation services using one of the following methods (check one):

    • Check one*
    • Late Payment and Additional Charges

      If you choose to pay through a refund transfer or refund advance loan and your tax refund is insufficient or delayed, you agree to pay the remaining balance within 30 days of notification. Failure to pay within this timeframe may result in additional charges, including:

      Late fee: $50
      Interest on unpaid balance: 10% per month until the balance is paid in full
       

      Acknowledgment of Fees

      By signing this agreement, you confirm that you have reviewed and agree to the fees listed above and understand the payment options. You agree to pay the total fee as outlined, either through upfront payment or a refund transfer/advance. You acknowledge that additional charges may apply if payment is not received within the agreed timeframe.

    • Date
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      2 digit month, 2 digit day, 4 digit year
    • Date
       - -
      2 digit month, 2 digit day, 4 digit year
    • Should be Empty: