2025 Client Intake Form
New or Returning Client
*
New Client
Returning Client
Filing Status
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Single
Head of Household
Married Filing Jointly
Married Filing Separately
Qualifying Widow(er)
Other
Tax Payer’s Information:
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First Name
Middle Name
Last Name
Date of Birth
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
SSN:
*
Email:
*
example@example.com
Mobile Number
*
Format: (000) 000-0000.
Occupation
*
Address:
*
Street Address
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Are you interested in a Cash Advance?
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Yes
No
Did you have Marketplace Insurance?
*
Yes
No
If Yes, do you have a 1095-A Form?
Do you require an IP Pin to file your return?
*
Please Select
Yes
No
If you answered "yes" to requiring an IP Pin, please provide:
What types of income did you receive in the last year? Select all that apply.
*
Wages/Salary (W-2)
Self-Employement
Unemployment Benefits
Social Security Benefits
Interest/Dividends
Retirement Income
Rental Income
Other
Do you have any dependents to claim?
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Yes
No
Dependent(s) Information (If any)
Identification Information
*
Bank Information: If using Direct Deposit, Please provide the following information.
*
Please list any deductions, credits, or special tax situations you would like us to consider:
Tax Payer's Upload Checklist
File Upload: Please upload all required documentation
*
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Signature
*
Submit Intake Form
Submit Intake Form
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