Client Intake Form
Please complete the form and submit all supporting documents to ensure an accurate calculation of your tax return.
How did you hear about us?
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Are you a returning client of Priority One Tax Services?
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Yes
No
Please check which apply:
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Single
Head of Household
Married Filing Jointly
Married Filing Separately
Qualifying Surviving Spouse
Taxpayer's Name:
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First Name
Middle Name
Last Name
Taxpayer's Email:
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example@example.com
Taxpayer's SSN:
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Taxpayer's Home Address:
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Taxpayer's DOB:
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-
Month
-
Day
Year
Date
Cell Phone Number:
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Please enter a valid phone number.
Format: (000) 000-0000.
Alternative Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Did you work in 2025? Yes or No. If yes, what was your occupation?
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What was your marital status as of December 31, 2025?
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Single (not married)
Married living with spouse
Married not living with spouse
Can someone else claim you as a dependent?
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Yes
No
Did you file a 2024 tax return?
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Yes
No
Unsure
Have you been issued an IRS IP PIN? If yes, please enter your IP PIN below.
Are you looking for credit repair?
Yes
No
Do you have any outstanding debts with the IRS, including defaulted student loans, prior-year back taxes, or past-due child support?
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Yes
No
Have you received any IRS letters or notices within the last three years?
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Yes
No
Did you pay more than half of the cost of maintaining your home for the entire year?
Yes
No
Did you support a child or family member for more than 6 months out of the year?
Yes
No
How many dependents are you claiming?
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Please Select
0
1
2
3
4
Dependent 1 Name:
Dependent 1 DOB:
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Month
-
Day
Year
Date
Dependent 2 Name:
Dependent 2 DOB:
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Month
-
Day
Year
Date
Dependent 3 Name:
Dependent 3 DOB:
-
Month
-
Day
Year
Date
Are there any dependents in daycare? If yes, please upload the form you received from your daycare provider.
Yes
No
If you do not have a daycare form, please provide the childcare provider's name, address, EIN or SSN, and the total amount paid for childcare:
Did you have health insurance in 2025?
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Yes
No
Do you and/or your dependents receive medicaid coverage?
Yes
No
If requested by the IRS, do you have documentation (i.e receipts, records) to substantiate your eligibility for the Child Tax Credit, Earned Income Tax Credit and/or Head of Household Filing Status?
Yes
No
Have you ever been denied the Earned Income Tax Credit (EITC)?
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Yes
No
Are you self employed or do you own a business?
Yes
No
Do you rent or own a home?
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Rent
Own
If you own a home, did you receive a Form 1098 for mortgage interest?
Yes
No
Were you or any of your dependents enrolled in a college, university, or technical school during the 2025 calendar year?
Yes
No
Do you trade any virtual currency?
Yes
No
How much was your tax return last year?
Is there any additional information we should be aware of to accurately prepare your 2025 tax return?
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Driver's License/Valid Photo ID:
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Taxpayer Social Security Card:
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Proof of Address:
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W2's and 1099 Forms:
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Health Insurance Statement:
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Medicaid Cards:
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Unemployment Compensation:
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Mortgage Interest Statement:
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Dependent(s) Birth Certificate:
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Dependent(s) Social Security Card:
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College Tuition Statement 1098-T:
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Proof of Business:
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Last Year's Tax Return:
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Additional Documents:
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How would you like to receive your tax refund?
*
Check
Direct Deposit
Bank Name:
Bank Account Number:
Bank Routing Number:
I acknowledge that all information provided to Priority One Tax Services is true and accurate to the best of my knowledge. I understand that I am required to have any supporting documentation necessary to validate the information submitted. I further understand that knowingly providing false information on my tax return and reporting it to the IRS, that I am taking part in a potentially criminal penalty situation and is punishable by law including but not limited to: facing court dates, restitution, and possible imprisonment. I waive Priority One Tax Services and the preparer of any error due to incorrect information provided by me. By signing below, I authorize Priority One Tax Services to file my tax return. I acknowlege by signing this form if I and/or my spouse owes a federal/governement debt such as IRS, child support, student loans etc., I/we are still responsible for tax preparation fees due to Priority Tax Services the time of service. Also, if the federal refund amount is mailed, I/we are still responsible for the tax preparation fees stated on the invoice. If the tax preparation fees are not paid, I understand Priority One Tax Services will take legal action to collect the unpaid tax preparation fees. Signature*
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Date
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Month
-
Day
Year
Date
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