Anderson Expert Tax Bookkeeping Intake Form Final

Anderson Tax Experts Self-Employed Bookkeeping (Reconstruction of income) Form
Client Information
Client Full Name:
Business Name:
Business Structure:
EIN/SSN:
Business Address:
Phone:
Format: (000) 000-0000.
Email:
example@example.com
Preferred Contact:
Business Overview
Type of Business/Services:
Years in Business:
Employees/Contractors:
How Many?
Issue 1099s/W-2s:
Home Office Use:
Monthly Rent/Mortgage: $
Utilities: $
Income Details
Income Received Through:
Sales Tracking Software:
Income Records:
Total Reported Income: $
Expense Categories (Detailed)
Advertising & Marketing - flyers, business cards, website hosting, social media ads, promotional materials, sponsorships. $
Auto Expenses - gas, oil changes, insurance, repairs, lease payments, car washes, and percentage of use for business. $
Bank Fees - business account maintenance fees, overdraft fees, wire fees. $
Contract Labor - payments made to subcontractors or freelancers (attach 1099s if applicable). $
Dues & Subscriptions - professional memberships, software (Canva, QuickBooks, etc.), website hosting. $
Equipment Purchases - tools, computers, printers, tablets, machinery. $
Insurance - business liability, professional indemnity, or other relevant coverage. $
Legal & Professional Fees — attorney, accountant, or consultant fees.
$
Meals & Entertainment — meals during business travel or meetings with clients (keep itemized receipts).
$
Office Supplies - pens, paper, ink, postage, notebooks, office décor, etc. $
$
Rent or Lease - office space rent, coworking fees, or equipment rentals. $
$
Repairs & Maintenance - maintenance on business equipment or workspace. $
$
Taxes & Licenses — local business license fees, permits, state or city taxes. $
$
Travel— airfare, hotels, rental cars, gas, tolls, parking (for business travel). $
$
Utilities — internet, electric, water, or other utilities for business or home office portion. $
$
Total of All Receipts Provided:
Banking & Financial Records
Business Bank Statements Provided
Personal Account Used
Credit Card Statements
Cash Receipts
Mileage Log
Profit & Loss Statements
Total Receipts:
Total Statements:
Tax-Related Questions
Quarterly Payments Made:
Received 1099s:
Have Prior Returns:
Owe Back Taxes:
Major Purchases (Vehicle/Equipment):
Notes / Preparer Observations
Notes / Preparer Observations
File Upload Section
Attach scanned receipts, invoices, or statements here (or staple to form if printed).
File Upload

Cancelof
Signatures
Signatures
Client Signature:
Date:

MonthDayYear
Date
Preparer Name:
Date Received:

MonthDayYear
Date
Should be Empty:

Anderson Tax Experts Self-Employed Bookkeeping (Reconstruction of income) Form

Client Information

Business Overview

Income Details

Expense Categories (Detailed)

Banking & Financial Records

Tax-Related Questions

File Upload Section

Signatures