CLIENT INTAKE & IRS DUE DILIGENCE INTERVIEW FORM

(Complete BEFORE personal information) Client Status: New Client Returning Client

 

SECTION 3 - DEPENDENTS & CREDITS

(Complete ONE section per dependent you plan to claim)

Months lived with you in the U.S.:

SECTION 4 - HEAD OF HOUSEHOLD DUE DILIGENCE

(Complete ONLY if HOH is expected)

SECTION 5 - INCOME REVIEW (ALL SOURCES) Self employed small business upload all documents.

W-2G received (GAMBLING) How many W-2G

SECTION 6 - Educational credits (AOTC/LLC)

SECTION 7 - IRS DUE DILIGENCE CHECKPOINT (PREPARER USE)

Interview completed Follow-up questions asked

Form 8867 completed Notes document reasoning

I certify the information provided is true and complete to the best of my knowledge.

SECTION 9 - PREPARER CERTIFICATION

I certify I completed due diligence through inquiry and documentation.

CLIENT ENGAGEMENT LETTER & TAXPAYER RESPONSIBILITY AGREEMENT

1. SCOPE OF SERVICES

This agreement confirms that The Refund Safe Haven ("Tax Professional," "we," "us") will prepare federal and applicable state income tax returns based solely on information provided by the Client ("you"

We do not audit, verify, or independently confirm the accuracy or completeness of information provided by you.

2. CLIENT RESPONSIBILITY FOR TAX RETURN ACCURACY

THE CLIENT IS THE SOLE RESPONSIBLE PARTY FOR THE ACCURACY AND CONTENT OF THE TAX RETURN.

• You understand and acknowledge that: You are legally responsible for the accuracy of your tax return, even if prepared by a tax professional
• You must review the completed tax return and ask questions if you do not fully understand it before signing and filing
• Signing the tax return means it is filed under penalties of perjurThis responsibility is established under, including but not limited to:
• Internal Revenue Code §6011 - Requirement to provide correct information
• Internal Revenue Code §6065 - Return signed under penalties of perjury IRC
• §6694 & Treasury Regulation §1.6694-1(e) - Tax preparer reliance on client- provided information

Business Name: The Refund Safe Haven Tax Year: 2025-26

3. RELIANCE ON CLIENTPROVIDED INFORMATION

We are entitled to rely in good faith on the information and documentation you provide, whether verbal or written. 

We are responsible for:

• False or misleading statements
• Incomplete or inaccurate documentation
• Information you failed to disclose                                                            

Any additional tax, penalties, interest, audits, examinations, or assessments resulting from inaccurate or incomplete information provided by you are your responsibility, not the responsibility of the Tax Professional.

4. DUE DILIGENCE & REFUND SAFE HAVEN

We comply with IRS due diligence requirements through inquiry and documentation. Due diligence does not guarantee:

• Refund approval
• Refund Amount
• Refund timing

Refunds may be delayed, reduced, denied, or offset due to audits, reviews, or government debts including but not limited to child support, student loans, or prior tax liabilities.

5. FEES, PAYMENT & BANK DRAFT AUTHORIZATION

• Tax preparation services are NOT FREE.
• Fees are earned once preparation services are completed
• Refund delays, offsets, or denials do not eliminate your obligation to pay

If preparation fees are not paid by July 31, 2026, you authorize The Refund Safe Haven to initiate a bank draft for the outstanding balance using the payment method on file.

This authorization applies regardless of refund outcome.

6. FREE FILING ALTERNATIVES (CLIENT OPTION)

If you do not agree with these terms, free alternatives are available: 

https://www.irs.gov/filing/free-file-do-your-federal-taxes-for-free (discontinued)

VITA (Volunteer Income Tax Assistance): https://www.irs.gov/individuals/free-tax-return-preparation-for-qualifying-taxpayers

By signing below, you acknowledge you were informed of these options.

7. AUDITS & IRS CONTACT

Tax preparation services do not include audit representation unless separately agreed to in writing.

If contacted by the IRS or a state agency, you agree to:

• Notify our office promptly
• Provide copies of all notices received
• Cooperate fully and truthfully

8. INDEPENDENT CONTRACTORS & LIMITATION OF LIABILITY

Some tax professionals operating under The Refund Safe Haven may be independent contractors.

You agree not to hold individual preparers, contractors, or the firm liable for inaccuracies arising from information you provided or failed to provide.

9. CLIENT ACKNOWLEDGMENT & SIGNATURE (REQUIRED) CLIENT RESPONSIBILITY ACKNOWLEDGMENT (INITIAL REQUIRED)

I ACKNOWLEDGE THAT I AM THE RESPONSIBLE PARTY FOR MY TAX RETURN. I UNDERSTAND THE TAX PROFESSIONAL RELIES ON INFORMATION AND DOCUMENTS I PROVIDE. I HAVE REVIEWED MY RETURN OR HAVE BEEN OFFERED THE OPPORTUNITY TO REVIEW IT AND ASK QUESTIONS BEFORE FILING.

PAYMENT & REFUND FUNDING ACKNOWLEDGMENT (INITIAL REQUIRED)

I UNDERSTAND THIS IS A PAID PROFESSIONAL SERVICE. IF MY REFUND IS DELAYED, OFFSET, DENIED, OR NOT FUNDED, I REMAIN RESPONSIBLE FOR PAYMENT. IF FEES ARE NOT PAID BY JULY 31, 2026, I AUTHORIZE A BANK DRAFT FOR THE BALANCE DUE.