Ashley Lang - Tax Preparation Client Interview

Ashley Lang - Tax Preparation Client Interview

Please complete this form to provide the information needed for your tax preparation. All client information is securely safeguarded and maintained in accordance with applicable IRS rules and regulations, including Internal Revenue Code §7216. Our organization is committed to protecting client privacy, and no personal or financial information is shared with third parties without the client’s written consent, except as required or permitted by law.
Full Legal Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Current Address of Residency*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
What tax year are you filing for?
SingleMarried Filing JointlyMarried Filing SeparatelyHead of HouseholdQualifying Widow(er)Other
YesNo
Are any dependents disabled?
Please list the names, relationships, and dates of birth of each dependent. List the amount of months each child has lived with you during this year.
YesNoNot applicable
Wages/Salary (W-2)Self-employment/Business Income (1099)Interest/DividendsRetirement/Pension IncomeUnemployment BenefitsSocial Security BenefitsRental IncomeInterest (1099-INT)Dividends (1099-DIV)Stocks/Crypto SalesAlimony ReceivedOther
Education ExpensesMedical ExpensesMortgage InterestCharitable ContributionsChildcare ExpensesRetirement Account ContributionsCasualty LossesHSA ContributionsIRA ContributionsStudent Loan InterestAlimony PaidOtherNone
Child Tax CreditEarned Income CreditChildcare CreditEducation Credits (1098-T)Adoption ExpensesEnergy Credits (solar panels, EV, home improvements)First-Time Homebuyer?Sold a home?Bought/sold crypto?Identity theft PIN?OtherNone
Is there any additional information or special circumstances we should know about for your tax preparation?
If you are self-employed (if no, skip response),
What type of business do you have?   Type a label
Are you an independent contractor?Type a label
EIN or SSN associated with business?   Type a label
Any 1099s/W2s issued to others?   Type a label
Did you keep records of income and expenses?   Type a label
YesNo
YesNo
YesNo
YesNo
1-3 months4-6 months7-9 months10-12 months
Did you file a tax return last year?
Have you received any IRS letters or notices?
Do you owe any back taxes?
Are you currently on a payment plan with the IRS?

Upload all necessary documents here, please ensure documents are clear and accurate: (DOCUMENTS NEEDED: taxpayer driver's license, taxpayer social security card, proof of address such as copy of lease/mortgage, water, or light bill, proof of last year's tax return, social security card for all dependents, W-2, 1098, 1099, SSA-1099, W-2G, 5498-SA, 1095-A, Schedule B, Schedule C, Schedule F, Alimony received, Income Summary if paid in cash via Zelle, Cash App, Venmo, Paypal, etc.)

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SELF EMPLOYED ONLY: Please upload business expense documents here (Receipts for advertising & marketing, supplies & equipment, software & subscriptions, phone & internet, insurance, education/training, travel & meals, vehicle mileage log/total business miles, home office square footage, business license (if applicable), EIN letter (CP 575, if applicable), 1095-A, receipts for energy credits

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Full Legal Name:   First Name   Last Name
Social Security Number:
DOB:   Date
Occupation:   Type a label
Did you live in another state at any time during the year?   Type a label

Spouse's Full Legal Name:   First Name   Last Name
Spouse's SSN:   Type a label
DOB:   Date
Occupation:   Type a label
Did spouse have any income:   Type a label
Are you legally married as of December 31?   Type a label
List name/social security number for each dependent:
YesNo
YesNo
YesNo
Yes
Client Signature:

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Date of Signature

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Date
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