SECTION 1: TAXPAYER INFORMATION
Name
*
First Name
Middle Name
Last Name
Suffix
Social Security number:
*
IP Pin (if applicable)
Date of birth:
*
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Did you move during the tax year?
*
Yes
No
Do you owe any government agency money? I.E. IRS, child support, unemployment, student loans, etc
*
Yes
No
Upload taxpayer ID and SS
*
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SECTION 2: FILING STATUS
SECTION 2: FILING STATUS
Check one
*
Single
Married filing jointly
Married filing separate
Head of household
Qualifying surviving spouse
SECTION 3: SPOUSE INFORMATION (IF APPLICABLE)
SECTION 3: SPOUSE INFORMATION (IF APPLICABLE)
Spouse full name:
First Name
Middle Name
Last Name
Suffix
Spouse SSN:
IP Pin (if applicable)
Spouse date of birth:
Upload spouse ID and SS (if applicable)
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SECTION 4: DEPENDENTS
SECTION 4: DEPENDENTS
Do you have dependents to claim?
*
Yes
No
Dependent(s) full name as shown on social security card, DOB, SSN, relationship to you, months lived with you during tax year and if applicable, IP Pin.
Upload dependent(s) SS and proof of relationship (birth certificate, shot records, school records)
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SECTION 5: INCOME SOURCES
SECTION 5: INCOME SOURCES
Check all that apply:
*
W-2 (employment)
1099-NEC /1099-MISC
Self employment / Gig work
Business income
Rental income
Interest (1099-INT)
Dividends (1099-DIV)
Retirement (SSA-1099 / 1099-R)
Unemployment
Cryptocurrency
Stock / Investment Sales
Gambling / Lottery
Alimony received
Other
Upload all income documents
*
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What was your job title?
*
Did you work overtime?
*
Yes
No
SECTION 6: SELF-EMPLOYED BUSINESS (IF APPLICABLE)
SECTION 6: SELF-EMPLOYED BUSINESS (IF APPLICABLE)
Were you self employed or did you own a business?
*
Yes
No
Business Structure:
Sole proprietor
LLC
Partnership
Corporation
Business Expenses:
Vehicle
Fuel
Insurance (any kind)
Repairs & Maintenence
Advertising & Marketing
Supplies
Phone / Internet
Meals
Travel
Contract Labor
Software / Subscriptions
Other
Upload all expenses (expense reports, P&L reports, receipts, bank statements, etc)
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SECTION 7: DEDUCTIONS & CREDITS
SECTION 7: DEDUCTIONS & CREDITS
Check all that apply
*
Child Tax Credit
Earned Income Credit (EIC)
Education Credits (1098-T)
Student Loan Interest
Mortgage Loan Interest (1098)
Property Taxes
Childcare Expenses
Charitable Donations
Medical Expenses
Retirement Contributions
Medical Expenses
Retirement Contributions
Energy Credits
N/A
Other
Upload deduction forms:
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SECTION 8: HEALTH INSURANCE
SECTION 8: HEALTH INSURANCE
Did you have health insurance during the tax year?
*
Yes
No
Type:
Employer
Marketplace (1095-A)
Private
Medicaid / Medicare
Upload insurance form ONLY if you had Marketplace insurance:
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SECTION 9: PRIOR YEAR & IRS ISSUES
SECTION 9: PRIOR YEAR & IRS ISSUES
Check all that apply:
*
Filed last year's return
Did NOT file last year
Owe back taxes (call 800-304-3107 if unsure)
Received IRS notices
Currently in payment plan
Owe student loans
None
SECTION 10: REFUND DELIVERY (IF APPLICABLE)
SECTION 10: REFUND DELIVERY (IF APPLICABLE)
Check one:
*
Direct deposit
Paper check
Bank Type (if direct deposit)
*
Checking
Savings
Bank Name:
*
Routing number:
*
Account number:
*
Verify account number:
*
SECTION 11: PAID PREPARER DISCLOSURES & DUE DILIGENCE
SECTION 11: PAID PREPARER DISCLOSURES & DUE DILIGENCE
I understand this tax return is being prepared by a paid tax preparer.
I certify that all information provided is true, accurate, and complete.
I understand I am legally responsible for the accuracy of my tax return, even if prepared by a paid preparer.
I understand omissions or false information may result in IRS penalties, interest, audits, or criminal charges
I authorize the paid preparer to prepare and electronically file my federal and state tax returns.
I acknowledge that fees are based on complexity, not refund amount.
I understand refund amounts are not guaranteed.
Abandoned Return Policy: If required documents, signatures, payment, or communication are not received within 7 days of intake, or within 7 days after the completed return has been delivered and is awaiting your approval or signature, the return will be considered abandoned. You expressly authorize the payment method or account information provided to be charged a non-refundable $150 Abandoned Return Fee for preparation time, administrative work, and file maintenance already performed. Work will cease until this fee is paid, and the fee will be in addition to the full tax preparation fee if services resume. By submitting this intake form and providing payment information, you acknowledge and agree to this policy.
SECTION 12: ELECTRONIC FILING CONSENT
SECTION 12: ELECTRONIC FILING CONSENT
I consent to electronic filing of my tax return.
I consent to receive my completed tax return electronically.
I understand that no refund advances, refund loans, or early refund products are offered by the tax preparer.
I understand that any tax refund issued is paid directly by the IRS or state taxing authority, not by the tax preparer.
I understand that refund timing is controlled solely by the IRS and state agencies, and the tax preparer has no ability to speed up, guarantee, or estimate exact deposit dates.
I understand that the tax preparer does not issue funds, front refunds, or provide temporary advances under any circumstances.
I understand that direct deposit or paper check delivery is determined by the IRS or state, and delays may occur due to verification, offsets, audits, or errors.
I understand that direct deposit or paper check delivery is determined by the IRS or state, and delays may occur due to verification, offsets, audits, or errors.
I acknowledge that my tax preparation fee is separate from my refund and is not contingent upon refund amount or timing.
I understand that my tax preparation fee is owed regardless of whether I receive a tax refund.
I understand that tax refunds may be delayed, reduced, offset, intercepted, or taken by the IRS or state taxing authority for reasons including, but not limited to, prior tax debts, child support, student loans, or other government obligations.
I understand that if my refund is partially or fully taken and my tax preparation fee is not paid, I authorize the tax preparer to debit the bank account I selected via ACH for the outstanding balance.
I authorize a one-time ACH debit for the amount owed, including applicable tax preparation fees agreed upon.
I understand this authorization will only be used if my refund does not cover my tax preparation fee.
I understand that failed payments may result in additional collection actions, including re-attempted ACH debit or invoicing.
I certify that the bank account information I provide is accurate and authorized for use.
SECTION 13: SIGNATURE
SECTION 13: SIGNATURE
Taxpayer Signature
*
Todays date:
*
-
Month
-
Day
Year
Date
Spouses signature, if applicable:
Todays date:
-
Month
-
Day
Year
Date
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