2025 Batten Financial Intake Form

Which Tax Expert Are You Looking For?

Are you interested in a cash advance up to $7,000

Name

First NameLast Name

Phone Number

Format: (000) 000-0000.

Who is your cell phone carrier? (see examples below)

**AT&T, Verizon, T-Mobile, Etc**

Email

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Social Security Number?

Date Of Birth

What is your occupation?

What is your filing status?

Filing status is a category that defines the type of tax return form a taxpayer must use when filing their taxes. If you are Head of Household you must provide a lease or utility bill.

Spouse Name

First NameLast Name

What is your spouses date of birth?

What is your spouses Social Security Number?

Phone Number

Format: (000) 000-0000.

Cell phone carrier?

AT&T, Verizon, T-Mobile, Etc

Email

What is your spouses occupation?

Do you or any dependents have an identity pin?

If yes then what is it? and who do it belong to?

Select the type of income you received in 2025

What was your income this year?

Did you receive any payments from a 3rd party companies?

Cash app, Zelle, PayPal etc.

Was your income less than $20,000?

If yes, how were you able to financially manage?

Did you receive assistance from the state, received assistance from children's other parent, friends and family assisted, etc.

Were you or your dependent enrolled in college and received a 1098-T?

Did you purchase marketplace (Obama Care) health insurance?

If so please have documentation ready

Did you collect social security retirement income?

If so please have documentation ready

Did you have self-employment or 1099 income in 2025?

Business Name (or your name if none)

Describe your business activity

Example: Uber driver, hairstylist, online sales

Business Start Date

Date

Business Structure

Total 1099 Income

Cash or Other Income (not reported on 1099s)

Upload 1099 Forms (if applicable)

Enter your total business expenses for the year

Rows	Amount ($)
Advertising
Car & Truck Expenses
Insurance
Office Expenses
Supplies
Repairs & Maintenance
Meals (Business Only)
Travel
Utilities
Phone & Internet
Software / Subscriptions
Rent / Lease
Legal & Professional Fees
Contract Labor
Other Expenses

Did you use a vehicle for business?

Business Miles:

Total Miles:

Personal Miles:

Vehicle Expenses Table

Rows	Amount $
Gas
Repairs
Insurance
Lease

I certify the income and expenses entered are accurate.

Signature

Date

Do you plan on purchasing a home in the next 2 years?

Do you owe any federal agency's?

To find out call 1-800-304-3107 ( child support, federal or state taxes, student loans, etc.)

How many people live with you?

Did anyone help support you through the year? If so, please list how much.

In the case of audit can you prove financial responsibility and residency for any of the Dependents being claimed?

Great! Now, do you have any dependents?

PSST! A dependent is someone who relies on another person for financial support, such as for housing, food, clothing, necessities, and more. Typically, this includes your children or other relatives, but it can also include people who aren’t directly related to you, such as a domestic partner.

Dependents Information (Enter All Dependents You Are Claiming)

Rows	Dependent Full Name	Social Security Number	Date of Birth	Relationship
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5

Can any of your dependents be claimed by anyone else?

Were you ever disallowed to the EITC prior to this year?

Are any of the dependents being claimed disabled? Please list the nature of the disability. Does the dependent receive Social Security benefits? If so, what type?

Are any of the dependents listed on this return not your biological son or daughter? If yes, why are the parents not claiming the child?

(Please explain and list the child’s name(s) if more than one is listed on the return).

Did you pay facility (daycare or after school program) or someone to keep your child or children?

13 & Under

Provider Name

Phone Number

Format: (000) 000-0000.

Social Security Number

Amount Paid

How would you like to receive your refund?

The IRS issues more than 9 out of 10 refunds in less than 21 days. However, it’s possible your tax return may require additional review and take longer. Mailed-in refunds usually take up to 6 weeks.

Type your bank details

Please re-type your bank details

Are you the owner of this bank account?

Are you applying for the advance?

Were You Referred? If So By Who?

Upload ALL Tax Documents

Taxpayer (and spouse if applicable) : Unexpired Drivers License, State ID, Passport + Social or Birth Certificate. Filing Status Head of Household: Lease or Utility bill. Dependents: Birth Certificate + social security card. Income: W2, 1099, Quickbooks, 1098T, etc. Childcare: End of Year statement. Market Place insurance: 1095A. ETC

Signature

Batten Financial Intake Form

Please enter your spouses information below:

Schedule C – Business Income & Expenses

If you paid an individual, let us know a little more information