Client Intake Form:
Please fill out the below requested information.
Client Details:
Full Name
*
First Name
Last Name
SSN
*
Social Security Number
DOB
*
Date of birth
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
example@example.com
If married, Spouse's Name
Spouse's SSN
Spouse's Social Security Number
Spouse's DOB
Spouse's E-mail
What is your filing status?
Single
Head of Household
Married Filing Separate
Married Filing Jointly
Qualifying Widow
Unsure
Do you have dependents?
Yes
No
If yes, what is the relationship?
Son
Daughter
Niece
Nephew
Sister
Brother
Other
Include Full Name & Date of Birth for each dependent (if any)
What type of income do you have?
W2
1099 contractor
Self Employed
Side Hustle
Other
Did you pay for child care?
Yes
No
Do you pay mortgage?
Yes
No
Were you enrolled in school in 2025?
Yes
No
Are you on disability?
Yes
No
Will you be applying for a house in the next year or two?
Yes
No
Do you currently owe the IRS for any previous tax year?
Yes
No
Do you owe back child support?
Yes
No
Did you receive your refund last year?
Yes
No
What was your 2025 refund amount?
Upload All Required Identification Documents For You, Dependents (if any), & Spouse (if applicable)
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Choose a file
Driver's license, SS cards, etc
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Upload Income Documentation (W2, 1099, 1099R, 1098T, 1098E)
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Choose a file
PLEASE make sure you have received ALL w2s from ALL employers before submitting.
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If self employed, what is your business description? (babysitter, hair dresser, barber, lash tech and etc)
If self employed, How much income did you make in 2025?
Self Employed/Side Hustle
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Drag and drop files here
Choose a file
Please upload ALL expenses for your business for example: supplies, rent, utilities, advertisement, etc
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Will you be willing to recommend me?
Yes
No
Please give reference of at least two people whom you feel could use my services:
Rows
Full Name
Contact Number
1
2
3
4
5
Signature
*
Submit
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