Language
English (US)
Spanish (Latin America)
Tax Client Intake Form
Please fill out all Required Fields
Who is your Tax Preparer?
*
Destany Shaw
Tamika Wilks
Daphen Williams
Kima Simmons
Kaleigh Anderson
Filing status
*
Single
Head of Household
Married Filing Joint
Married Filing Separate
Widow
Taxpayer name
*
First Name
Last Name
Social Security Number
*
Date of Birth
*
-
Month
-
Day
Year
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Were you referred?
Yes
No
Who referred you?
Spouse Name
First Name
Last Name
Social Security Number
Date of Birth
-
Month
-
Day
Year
Spouse Email
example@example.com
Spouse Phone Number
Please enter a valid phone number.
Upload all Documents(W2, 1099, Social Security cards, IDs, Birth Certificate, etc.)
Browse Files
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Choose a file
Cancel
of
Dependents
First Name
Last Name
SSN
D.O.B
Relationship
1
2
3
4
Did you have Marketplace insurance?
*
Yes
No
If yes, Please upload 1095-A form.
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Choose a file
Cancel
of
Do you have a IP PIN?
*
Yes
No
IP Pin Number
Do you Owe the IRS?
Yes
No
Submit
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