CD_Consulting_Tax_Client_Intake

Tax Preparation Client Intake Form

Please complete this form accurately. All information provided is confidential and used solely for tax preparation
Full Legal Name
Social Security Number
Date of Birth

MonthDayYear
Date
Marital Status
Phone Number
Format: (000) 000-0000.
Email Address
example@example.com
Current Address
Is this your first time filing with us? Yes / No Did you file taxes last year? Yes / No Do you have a copy of last year's return? Yes / No
List dependents Name DOB Relationship SSN
Cash Income Self-Employed UnemploymentSocial SecurityDisabilityOther

EducationRental ChildcareHomeowner None MedicalBusiness Expenses
Banking Information (Optional)

Refund Method: Direct Deposit / Paper Check
Bank Name
Routing Number
Account Number
I certify that the information provided is accurate.
Client Signature
Date

MonthDayYear
Date
Should be Empty: