BlackCard Financials – Tax Preparation Intake

Dependents

Please fill out this section for your dependents
Dependent #1

First NameLast Name
Date of Birth

MonthDayYear
Date
Relationship to you?
SSN Upload

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Dependent #2

First NameLast Name
Date of Birth

MonthDayYear
Date
SSN Upload

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Relationship to you?
Dependent #3

First NameLast Name
Date of Birth

MonthDayYear
Date
SSN Upload

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Relationship to you?
Dependent #4

First NameLast Name
Date of Birth

MonthDayYear
Date
SSN Upload

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Relationship to you?

PRIOR YEAR & IRS HISTORY
Did you receive a refund last year?*

YesNoNot sure
Were you audited by the IRS last year?*

YesNo

DOCUMENT UPLOADS (CRITICAL)

These documents are collected solely to verify your identity and initiate your secure tax portal. All documents are stored securely and accessed only by authorized personnel.
Tax Documents(W-2, 1099, Unemployment, Self-Employment, etc.)*

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Government-Issued Photo ID (front & back)*

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Social Security Card *

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Spouse Social Security Card *

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Other Supporting Documents

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REFUND & BANKING INFO
Bank Name*
Account Number*
Confirm Account Number*
Routing Number*
Confirm Routing Number*

TAXPAYER AGREEMENT
BlackCard Financials will prepare your 2026 individual tax return using the information you have provided.

You, the taxpayer, are ultimately responsible for the accuracy of your return.

By signing below, you confirm that all information submitted is true, complete, and correct to the best of your knowledge.

• I confirm the information provided is accurate

• I consent to receive a secure TaxSlayer client portal invitation

• I understand tax preparation fees are separate from any refund

• I understand refunds are not guaranteed

• I agree to communicate via email/text regarding my tax filing
Taxpayer Signature (Must be legible)*

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Spouse Signature (If Filing Jointly)*

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Today’s Date*

MonthDayYear
Date

NEXT STEPS

Please Read Below ⬇️
Once preparation and review work begins, a $75 preparation & review fee applies if filing does not proceed. This fee covers professional time already completed.

* Prepration Begins Once Agreement Letter Is Signed *

Next Steps:

After submission, you will receive a secure TaxSlayer portal invitation via email within 24 hours.

Inside the portal, you will upload required tax documents and complete all required forms before your return can be prepared.
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