Single Member LLC Tax Intake Form
This intake form is required to prepare your business tax return. Please answer all questions accurately and upload all requested documents. Incomplete or inaccurate information may delay your return or affect your refund or balance due.
SECTION 1 – CLIENT & BUSINESS INFORMATION
Business Legal Name
*
DBA (if applicable)
EIN
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Business Email
*
example@example.com
State Business Was Formed In
*
Business Start Date
*
-
Month
-
Day
Year
Date
Business Structure
*
Single-Member LLC (Default / Schedule C)
Single-Member LLC taxed as S-Corporation
SECTION 2 – OWNER INFORMATION
Owner Full Legal Name
*
SSN
*
Date of Birth
*
-
Month
-
Day
Year
Date
Marital Status
*
Please Select
MARRIED
SINGLE
HEAD OF HOUSEHOLD
Do you own 100% of this business?
*
Please Select
Yes
No
Upload a copy of your valid Drivers License or ID
*
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SECTION 3 – S-CORP (IF APPLICABLE)
Was Form 2553 filed with the IRS?
Please Select
Yes
No
Unsure
Date S-Corp Election Became Effective
Payroll Provider
Owner Salary Paid During the Year
If Form 2553 was not filed, your LLC may be treated as a Schedule C by default.
SECTION 4 – BUSINESS INCOME
Describe Your Business Activities
Total Gross Income for the Year
How did you receive income? (Check all that apply)
Cash
Zelle
Cash App
Venmo
PayPal
Stripe
Square
Checks
Bank Transfers
Did you receive any 1099-NEC or 1099-K forms?
Please Select
Yes
No
If Yes: Upload 1099s (File Upload)
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Is there income NOT reported on a 1099?
Please Select
Yes
No
SECTION 5 – BUSINESS EXPENSES
Operating Expenses (Check all that apply and use "Add Option" fields as needed):
Advertising & Marketing
Office Supplies
Software & Subscriptions
Website / Domain / Email
Phone
Internet
Insurance
Professional Fees (CPA, Legal, Coaching)
Education / Training
Licenses & Permits
Repairs & Maintenance
Other (Explain)
Upload Expense Documentation (Optional File Upload)
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SECTION 6 – VEHICLE INFORMATION
Do you use a vehicle for business?
Please Select
Yes
No
If Yes: Enter Vehicle Year / Make / Model / Business Miles Driven / Personal Miles Driven
SECTION 7 – HOME OFFICE
Do you work from home?
Please Select
Yes
No
If Yes: Total Home Square Footage / Office Square Footage / Rent or Mortgage Amount / Utilities Paid Annually
SECTION 8 – ASSETS & EQUIPMENT
Did you purchase equipment or assets this year?
Please Select
Yes
No
If Yes: Item Name / Purchase Date / Purchase Cost / Business Use Percentage
SECTION 9 – CONTRACTORS & PAYROLL
Did you pay any contractors $600 or more?
Please Select
Yes
No
Were any employees paid wages?
Please Select
Yes
No
Were payroll taxes filed timely?
Please Select
Yes
No
SECTION 10 – ESTIMATED TAX PAYMENTS
Did you make quarterly estimated tax payments?
Please Select
Yes
No
If Yes: Total Amounts and Dates Paid
Do you owe back taxes or have an IRS payment plan?
Please Select
Yes
No
SECTION 11 – PRIOR-YEAR INFORMATION
Upload last year’s business tax return
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Any IRS notices received this year?
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Would you like information about bookkeeping services?
Please Select
Yes
No
SECTION 12 – IRS DUE DILIGENCE DISCLOSURE
Due Diligence Acknowledgment
*
I certify that all information provided is true, correct, and complete to the best of my knowledge. I understand that the preparer relies solely on the information I provide and is not responsible for omitted or inaccurate information.
SECTION 13 – AUDIT & LIABILITY PROTECTION
Audit & Liability Disclosure
*
I understand that tax preparation does not guarantee any specific refund or outcome. I acknowledge that I am responsible for maintaining records and supporting documentation. The preparer is not responsible for audits, penalties, or interest resulting from information I failed to disclose or misrepresented.
SECTION 14 – ELECTRONIC SIGNATURE
*
First Name
Last Name
Signature
*
Date
*
-
Month
-
Day
Year
Date
CALIFORNIA-ONLY QUESTIONS
California Secretary of State (SOS) File Number
LLC Status with CA SOS / FTB
Active
Suspended
Unsure
Have you paid the $800 CA LLC tax for this year?
Yes
No
Unsure
Have you paid the $800 CA LLC tax in prior years?
Yes
No
Unsure
Total California Gross Receipts (Number)
Were any gross receipts earned outside of California?
Yes
No
Have you received any CA Franchise Tax Board (FTB) notices?
Yes(Upload below)
No
If Yes Upload here
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I understand that California requires an annual $800 LLC tax and additional LLC fees based on gross receipts. I acknowledge that failure to comply may result in penalties, suspension, or interest assessed by the California Franchise Tax Board.
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