Emmitt Financial Services-Tax Client Intake & Document upload
Welcome to Emmitt Financial Services
Thank you for choosing Emmitt Financial Services for your tax preparation needs. Please complete this secure intake form in full and upload all requested documents. Your information is encrypted and kept strictly confidential.
Previous Customer?
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Yes
No
Taxpayer Full Name
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First Name
Last Name
Date of Birth
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-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Social Security Number
*
Spouse Full Name
First Name
Last Name
Spouse Date of Birth
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Spouse Social Security Number
Filing Status
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Single
Head of Household
Married Filing Jointly
Married Filing Separately
Qualifying Widow (er)
Do you have dependents to claim?
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Yes
No
Dependents
Dependent Full Name
First Name
Last Name
Dependent Date of Birth
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Relationship to Taxpayer
Social Security Number
Months Lived in Home (1-12)
Dependent 2 Full Name
First Name
Last Name
Dependent Date of Birth
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Relationship to Taxpayer
Social Security Number
Months Lived in Home (1-12)
Dependent 3 Full Name
First Name
Last Name
Dependent Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Relationship to Taxpayer
Social Security Number
Months Lived in Home (1-12)
Tax Declaration
Did you, or your spouse receive Social Security income?
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Yes
No
Did you, or your spouse receive unemployment income?
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Yes
No
Did you, or your spouse have business income or any unreported income?
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Yes
No
Did any dependent age 19-24 attend school for at least 6 months?
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Yes
No
If yes, do you have documentation for education expenses?
Yes
No
Additional Information
Do you have any debts with the IRS, U.S. Treasury, child support, student loans, FEMA, or any government entity?
Yes
No
If yes, please list the agency and amount owed.
Did you have health insurance coverage during the year?
Yes
No
Was your health insurance through the Health Insurance Marketplace (Obamacare)?
Yes
No
Are you legally married based on your state's definition of marriage?
Yes
No
Can someone else claim you or your spouse as a dependent?
Yes
No
Did you or your spouse receive any type of military pay?
Yes
No
Document Upload
Please upload clear photos or PDFs of the Documents Listed below. If you don't have all documents now, submit what you have. Additional documents can be requested later.
Upload a valid government-issues photo ID (Driver's License or State ID) for yourself and spouse (if applicable).
Browse Files
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Upload Social Security cards for yourself, spouse, and all dependents.
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Upload all income documents (W-2s, 1099s, or other income statements).
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Upload education documents (Form 1098-T, tuition statements, receipts).
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Client Acknowledgment & Certification
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I confirm that the information provided is accurate to the best of my knowledge and understand that Emmitt Financial Services may request additional documents if needed to complete my tax return.
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