Tax Client Intake Form

Tax Client Intake Form

Gathering Essential Tax Information for Individuals and Small Businesses
Client Personal Information

Please provide your personal details as required for tax filing.
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Social Security Number
Email
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Current mailing address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Did your address change during the tax year?*

YesNo
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Bank information ( Account & Routing number)
Occupation or Job title
IRS filing statuses:*

SingleMarried Filing JointlyMarried Filing SeparatelyHead of HouseholdQualifying Widow(er)
Spouse Full Name

First NameLast Name
Spouse Date of Birth

MonthDayYear
Date
Spouse SSN
Spouse income?

YesNo
Date of marriage:
Date of death
Did you live with your spouse at any time during the last 6 months of the year?

YesNo
Are you legally unmarried or considered unmarried under IRS rules?

Never marriedSpouse deceasedDivorcedSeperatedMarried but lived apart from spouse during 6 months of the year
Can you provide the following documents?

Divorce decreeSeparate maintenance agreement or seperate agreementOther
Do you have documentation to support?

YesNo
Who qualifies you for Head of Household?

ChildParentOther dependent
Did this person live with you for more than half of the year?

YesNo
Did you pay more than 50% of household expenses?

YesNo
Which expenses did you pay? (Check all that apply)

Rent or mortgageUtilitiesFoodProperty taxesHome insuranceOther
Do you have documentation to support Head of Household status?

YesNo
Did you receive any nontaxable support/income?

YesNo
Please select all applicable types of non-taxable support received:

Family support (cash or shared household expenses)Food assistance (SNAP / EBT)Housing assistance (Section 8, shelter, rent help)Childcare assistanceOther (please explain)
If available, please upload documentation supporting the non-taxable support selected above.

Cancelof
Is anyone else lives in the home, and provide financially?

YesNo
Name
Relationship
Required Documents (Secure Upload – If Applicable)

Based on your filing status, household situation, and income sources, additional documentation may be required to support your tax return. Please upload any documents that apply to your situation. If you are unsure or do not have certain documents available, you may leave this section blank, we will contact you if additional information is needed.
All documents are transmitted securely and used solely for tax preparation and compliance purposes.Examples of documents you may upload (if applicable):Government-issued photo ID (driver’s license or passport)Social Security card or ITIN letter (if available)IRS letters or notices received during the yearProof of residency or household expenses (for Head of Household, if applicable)Dependent documentation (if applicable)Any other documents you believe are relevant to your tax return

Cancelof
I confirm that the documents uploaded belong to me (and/or my dependents) )and are accurate to the best of my knowledge.

Yes
Dependent Information

Please provide information for all dependents you are claiming.
Do you have dependents you are claiming on this tax return?*

YesNo
Did this dependent live with you more than 6 months?

YesNo
Did you provide more than 50% of their support?

YesNo
Did any dependent live outside of the United States during the tax year?

YesNo
Country where the dependent lived
Dates Lived Outside the U.S. (MM/DD/YYYY – MM/DD/YYYY)
Reason for Living Outside the U.S.
Do you have documents to support claiming this dependent?

YesNo
RESIDENCY & STATE TAX

This information helps determine state residency, part-year filing requirements, and state tax obligations. This section applies to you and your spouse (if married).
Which state(s) did you or your Spouse live in during the tax year?
Did you or your Spouse live in this state for the entire year?

YesNo
List dates you or your Spouse moved in or out of each state
Did you or your Spouse work in a different state than where you lived?

YesNo
Type of income earned in the other state(s)
Which state(s) did you or your spouse work in?
Approximate dates worked in that state
INCOME (ALL SOURCES – NO EXCEPTIONS)

This section applies to you and/or your spouse (if married). Please upload all income and business documents for both spouses, if applicable.
What type(s) of income did you receive? (Select all that apply)

W-2 (employment)1099-NEC / 1099-MISC / 1099-KSelf-employment / side businessCash income (not reported on forms)TipsRental incomeUnemploymentSocial SecurityDisabilityAlimonyInterest / dividendsCrypto / digital assetsForeign incomeOther
Upload all relevant income documents (W-2s, 1099s, etc.)

Cancelof
Was this your only source of income?

YesNo
In addition to the documents you upload, please list and/or add estimate total amount received any other income not shown on forms (cash income, Zelle, Cash App, Venmo, PayPal, or other payments not reported on tax forms).
Upload all relevant income documents.

Cancelof
Client acknowledgment (I understand that all income must be reported, including cash income.)*

Yes, I understand
Small Business Information

Fill this section if you and/or Spouse are self-employed or own a small business(s).
Are you and/or your Spouse self-employed / 1099 or do you own a business?*

YesNo
Business name(s) (if any)
Business Address(s) (if any)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Type of Business Entity (if any)
Business EIN(s) (Employer Identification Number) (if any)
Describe the nature of your business(s)
Did you keep records of income and expenses?

YesNo
I understand I will be required to:

Complete a Schedule Cprovide expense documentation separately
Upload field label (clean & professional)Accepted documents include Profit & Loss statements, bank statements, spreadsheets, or accounting reports.If you do not have formal records, upload what you have or select “No” above.
Upload all relevant financial documents.

Cancelof
Prior Year Tax Return

Provide information about your previous year's tax return.
Did you file a tax return last year?*

YesNo
Upload your prior year tax return (if available)

Cancelof
OTHER REQUIRED IRS QUESTIONS

These questions are mandatory IRS disclosures and help us prepare your return accurately and in compliance with federal regulations. This section applies to you and your spouse (if married).
At any time during the year, did you and/or your Spouse: Receive, sell, send, exchange, or acquire cryptocurrency?*

YesNo
Have foreign bank accounts?*

YesNo
Receive foreign income?*

YesNo
Deductions & Credits

Indicate if you wish to claim any of the following deductions or credits. This section applies to you and/or your spouse (if married).
Did you and/or your Spouse have health insurance all year? Only health insurance purchased through the Health Insurance Marketplace (Obamacare) may qualify for a tax credit. Other insurance types generally do not qualify for a credit.

YesNo
Upload Form 1095-A/B/C

Cancelof
Did you and/or your Spouse pay any of the following expenses during the year? (Select Yes if any apply) Childcare expenses, College or higher education tuition, Student loan interest

YesNo
Upload relevant deduction or credit documentation. Examples: daycare statements, Form 1098-T (tuition), Form 1098-E (student loan interest), or official receipts.

Cancelof
Did you and/or your Spouse make charitable donations during the year? Cash or non-cash donations to qualified charitable organizations.

YesNo
Upload relevant deduction or credit documentation. Examples: Donation receipts, acknowledgment letters, donation summaries

Cancelof
Did you and/or your Spouse contribute to a retirement account during the year? Examples: Traditional IRA, Roth IRA, SEP-IRA, SIMPLE IRA, 401(k).

YesNo
Upload relevant deduction or credit documentation. Examples: Form 5498, Contribution confirmation.

Cancelof
Did you and/or your Spouse make energy-efficient home improvements? Examples: solar panels, energy-efficient windows, doors, or HVAC systems.

YesNo
Did you and/or your Spouse purchase, sell or refinance a home in 2025?

YesNo
Please upload or provide: Closing Disclosure (HUD-1), form 1098 (Mortgage Interest Statement), Property tax information

Cancelof
Did you and/or your spouse pay mortgage interest or property taxes in 2025?

YesNo
Upload: Form 1098, property tax statement, property address

Cancelof
Vehicle Loan Interest (2025 New Deduction) Did you and/or your Spouse purchase or finance a vehicle in 2025?

YesNo
If Yes, please provide: Vehicle year, make, and model, Loan statement showing total interest paid in 2025, Purchase or financing agreement

Cancelof
Is the vehicle used for:

Personal useBusiness use (Uber, Lyft, delivery, self-employment, etc.)
If business use, please provide: Total mileage for the year, Business mileage. Upload documents here: (Loan statement / financing documents)

Cancelof
Upload relevant deduction or credit documentation. Examples: Invoices, Manufacturer certification

Cancelof
Overtime / Employment-Related Credit (Eligibility Subject to IRS Guidance) Do you believe you and/or your spouse may qualify based on overtime, additional compensation, or increased earned income?

YesNoNot sureI would like my tax preparer to review
Supporting Documents (Optional Upload)Upload any documents related to overtime or additional compensation, if available.Examples: pay stubs, employer statements, W-2s showing overtime, or other supporting records.

Cancelof
Additional Information or Special Circumstances (optional)
Please review my return for any new or updated tax credits I may qualify for

YesNo
Consent and Acknowledgement

Please review and acknowledge the following statement.
I understand BooksRecord LLC relies on this information and understand errors or omissions may delay filing or cause penalties.*

I agree
Date*

MonthDayYear
Date
Signature*
Please rate the ease and clarity of this intake process.

1

2

3

4

5

1 is Worst, 5 is Best
Any comments or suggestions? (optional) This helps us improve future client experiences.
Please verify that you are human*
Need help while completing this form?
We’ve created a short FAQ to help explain common questions on this intake form.

👉 Click here to view the Intake FAQ

Please note: If you still need help after reviewing the FAQ, please contact BooksRecord LLC directly.
Should be Empty:

Tax Client Intake Form

Client Personal Information

Required Documents (Secure Upload – If Applicable)

Dependent Information

RESIDENCY & STATE TAX

INCOME (ALL SOURCES – NO EXCEPTIONS)

Small Business Information

Prior Year Tax Return

OTHER REQUIRED IRS QUESTIONS

Deductions & Credits

Consent and Acknowledgement