New Customer Registration Form

2025 Tax Client Intake Form
Customer Details:
Taxpayer Legal Name (as shown on Social Security card)

First NameLast Name
Date of Birth (MM-DD-YYYY)

MonthDayYear
Date
Taxpayer SSN / ITIN
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
Filing Status
Social Security Verification

Social Security Verification Upload a clear photo of your Social Security Card or SSA-1099.
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ID Verification

ID Verification Upload a clear photo of your Driver License or State ID. Front & back if possible.
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Did you have dependents who lived with you for more than half of the year?
Dependent Full Legal Name

First NameLast Name
Dependent Date of Birth (MM-DD-YYYY)

MonthDayYear
Date
Dependent Social Security Number
Relationship to Taxpayer
Number of months the dependent lived with you during the year
*Please Note: If you have more than one dependent, please submit this form separately for each dependent.*
Proof of Residency for Dependent

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Income Information
Did you receive any W-2 wages during the year?
W-2 Upload (Required if answered Yes)

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Did you have any 1099, self-employment, or cash income?
1099 / Self-Employment Income Upload

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Did you receive any other income? (Unemployment, Social Security, retirement, disability, etc.)
Other Income Documents Upload

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Banking Information

For Refund Advance / Direct Deposit
Name on Bank Account
Routing Number (9 digits)
Account Number
Bank Name (optional)
Account Type: Checking / Savings
(If you do not want to apply for a Refund Advance, your banking information will only be used for direct deposit of your refund.)
Please review all sections carefully. Once signed, scroll down and click Submit to send your form
Signature
Should be Empty:

2025 Tax Client Intake Form

Banking Information