Tax Client Intake Form
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
How did you hear about us?:
*
Social Media
Referral - if referred, please let us know who referred you below
Other
Please list the name of the person or business that referred you to us
Are you scheduled for or already had your free consultation ?:
*
Yes
No
If you are scheduled for or already had your free consultation, please list the date below
-
Month
-
Day
Year
Date
Were you audited by the IRS last year?
*
Yes
No
Did you work overtime ?
*
Yes
No
Not sure
Did you earn any tips?
*
Yes
No
Not sure
Did you finance a NEW vehicle ?
*
Yes
No
Are you 65 or older?
*
Yes
No
Do you have life insurance?
*
Yes
No
Are you interested in learning about life insurance?
*
Yes
No
Were you a college student in 2025 ?
*
Yes
No
Do you have an IP PIN?
*
Yes
No
Do you have any credits that were disallowed or reduced last year?
*
Yes
No
If you have any credits that were disallowed or reduced, please enter here.
If you are considering filing head of household, what documents will you provide for proof of head of household?
Utility bill
Rental lease
Rent receipts
Mortgage interest payments
Property tax payments
Other
Are you a business owner, freelancer or did you do any side hustles in 2025? If so, please complete the next section below.
*
Yes
No
Do you need assistance with organizing your/side hustle business income & expenses?
Yes
No
N/A
If your address is different than the one that's on your government ID or drivers license, please indicate the reason why
Have you received any documents related to filing your taxes yet? I.e- W2, 1099 NEC, 1099-MISC, 1098T, 1099-R, 1098T
*
Yes
No
Notes (anything you think we need to know :)
Thank you ~Filicha Taylor- Keltay Professional Services
info.keltayprofessionalservices.com I 866-738-5129
Date
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Month
-
Day
Year
Date
Signature
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