Client Tax Intake & Authorization Form

Please pick your preferred Financial Expert below:

Client Full Name:

Email Address:

Phone Number:

Cell Number (Optional)

How did you hear about us?

Were you referred to us? If yes, please provide the referrer’s name.

Which filing year are you filing for?

Did you have health insurance coverage during the tax year(s)?

IMPORTANT INFORMATION BELOW

If you had Marketplace insurance, please upload your Form 1095-A (download from HealthCare.gov under “Tax Forms” or call 1-800-318-2596). If you had private or employer insurance, no form is required—just confirm coverage.

What services are you interested in?

Filing status (Final status will be determined after review)

What type(s) of income did you have? (Check all that applies)

How many jobs or income sources did you have?

How many dependents do you have?(If applicable)

Do you currently have a TaxPass client portal? (If not, you will receive an email to set up a secure client portal)

What is your preferred method of communication?

By selecting “Yes,” you acknowledge and agree to the Refund Advance Disclaimer. Refund advances are available to eligible current clients. New clients may be considered; however, approval is not guaranteed. All refund advances are subject to bank approval and are not determined by the taxpayer or the tax preparation company.By signing, you further acknowledge that you are required to review and separately sign the Refund Advance Agreement prior to any refund advance being requested or issued.

By checking this box and submitting this form, I acknowledge that I am required to create a TaxPass portal to upload my information and supporting documentation. I further confirm that all information provided is accurate and complete to the best of my knowledge.