Blueprint Tax Prep

Tax Year ?

What is your Tax Pro name ?

who is doing your taxes ?

If someone referred you, please type their name here.

Full legal name (as shown on SS card)

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Filling Status

Spouse Info-- (Full Name, DOB, Email,Number,SSN,Job Title.)

Can someone claim you as a dependent?

Did you or your dependent(s) attend college or trade school last year?

Upload your 1098-T form

Date of Birth

Date

Social Security Number

Do you and/or your dependent(s) have a IP PIN issued by the IRS ?

IP PIN (Identity Protection PIN) is a 6-digit number issued by the IRS to help protect your tax identity.

List the Names & IP Numbers of all persons that apply.

Upload all Social Security cards

Upload Government-issued ID (Driver’s license, state ID, or passport)

UPLOAD BACK of Government-issued ID (Driver’s license, state ID, or passport)

NEW YORK STATE ONLY

Current Address

Street Address

Street Address Line 2

CityState

Zip Code

Are you buying a new house within the next 2 years?

Did you have Marketplace Insurance?

Please Upload form 1095 A

Do you have dependents?

Type a question

Rows	Full Name	Date of Birth	Social Security Number	Gender	Relationship to you	Has anyone else claimed this child	Full time Student	Disabled	Did you provide more than half of the support	Childcare Expenses Paid
Dependent #1
Dependent #2
Dependent #3
Dependent #4

Upload Dependent Birth certificate and social security card,

What type of income do you have ? (Check all that apply)

Business Name

EIN Number

Upload W-2 (s), 1099 misc, 1099 NEC, cash receipts, income logs etc.

Bank Name

Direct Deposit

Routing Number

Account Number

**Bankng Account Numbers Don't Match.

Are you interested in Audit Protection?

CLIENT ACKNOWLEDGMENT & AUTHORIZATION

By signing below, I certify that all information provided in this intake form is true, accurate, and complete to the best of my knowledge. I understand this information will be used by Blueprint Financial to prepare and file my tax return(s).

I authorize Blueprint Financial and its affiliated tax professionals to collect, store, and use my personal and financial information solely for tax preparation, electronic filing, and related services. I understand that providing false, incomplete, or misleading information may result in penalties, audits, delays, or other consequences imposed by the IRS or state agencies.

NON-PAYMENT / OFFSET AGREEMENT

I acknowledge that tax preparation fees are owed regardless of refund status. If my refund is offset by the IRS, applied to student loans, child support, other debts, or issued by mail, I remain fully responsible for payment of Blueprint Financial fees.

If payment is not made in full within thirty (30) days of filing, I understand that Blueprint Financial may pursue lawful collection efforts to recover the balance due.

I authorize Blueprint Financial to prepare and file all required tax forms, apply for Refund Anticipation Checks (RACs) and/or Refund Anticipation Loans (RALs) on my behalf, and electronically sign and submit my tax return(s) as permitted by law. I accept full responsibility for the accuracy of the information provided and agree that Blueprint Financial and its affiliates are not liable for errors resulting from false or incomplete information supplied by me.

Signature

Email

example@example.com

Date

Hour MinutesAM/PM Option