Tax Client Intake Form

Tax Client Intake Form

Please provide your information to help us prepare your tax return accurately.
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Tax Identification Type*
Tax Identification Number*
Filing Status*

SingleMarried Filing JointlyMarried Filing SeparatelyHead of HouseholdQualifying Widow(er)Other
Dependents*

0123 or more
First Name Last Name DOB SSN Number Relationship
First Name Last Name DOB SSN Number Relationship
First Name Last Name DOB SSN Number Relationship
What types of income did you receive during the year? (Select all that apply)*

Wages/Salary (W-2)Self-Employment/Business Income (1099)Interest/DividendsRental IncomeUnemployment BenefitsRetirement Income (Pension/Social Security)Capital GainsOther
Which deductions or credits may apply to you? (Select all that apply)

Student Loan InterestMortgage InterestMedical ExpensesCharitable ContributionsChild Tax CreditEarned Income CreditEducation CreditsOther
Upload any relevant tax documents (such as W-2s, 1099s, prior year returns, etc.)

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Additional notes or questions regarding your tax situation
Should be Empty: