Destiny Helpers Tax Services LLC – Client Due Diligence Questionnaire
This questionnaire is required for all clients. Please answer truthfully and completely. Incomplete or false information may delay or prevent filing.
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Full Legal Name
SSN / ITIN
Date of Birth
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Month
-
Day
Year
Date
Email
Phone Number
Current Address
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Did You Move during the Tax Year?
yes
no
If Yes Please enter Prior Address
Marital Status
Please Select
Single
Married
Divorced
Legally Separated
Widowed
Did your martial status change?
yes
no
Were you legally married on December 31?
yes
no
Did you live with your spouse during the last 6 months of the year?
yes
no
Did you pay more than half the cost of keeping up your home?
yes
no
If claiming Head of Household, who qualifies you?
Relationship to you
Did this person live with you more than half the year?
yes
no
Did you pay more than 50% of household expenses?
yes
no
Dependent Name/Relationship/Date of birth
Student?
Enter name of Student or N/A
Disabled?
Enter name of disabled dependent or N/A
For each dependent, I confirm:
I provided more than 50% of their support
No one else can legally claim this dependent/s
The dependent/s did not provide more than half their own support
The dependent did not file a joint return
Did you receive income from any of the following:
W-2 job
1099-NEC
1099-K
Self-Employment
Cash Income
Tips
Uber/Lyft/DoorDash
Nails/Hair/Braiding
Online Sales
Content Creation
Disability
Social Security
Unemployment
Crypto
Gambling
Marketplace Insurance (1095-A)
Other
Did you receive any income not reported on tax forms? If yes please explain
yes
no
Did you operate a business or a side hustle (type yes or no)
Business name
Type of Business
Business Start Date
-
Month
-
Day
Year
Date
How were you paid?
Cash
Zelle
CashApp
Venmo
PayPal
Square
Stripe
Other
Estimated Gross Income (How much did you make?)
Do you keep income records?(yes or no)
Did you keep expense receipts? (yes or no)
Did you have business expenses
Advertising
Supplies
Equiptment
Phone
Internet
Rent
Utilities
Insurance
Gas
Meals
repairs
Office Supplies
Personal fees
Software
Licenses
Uniforms
Education
Bank Fees
Other
Estimated Total Expenses
I understand only legitimate business expenses can be claimed (type yes or no)
Did you use a vehicle for Business? yes or no
Did you keep mileage logs? yes or no /enter number
Personal miles? yes or no/ Number of miles
Did you use part of your home exclusively for business? yes or no
Square footage of home
Square footage of office
Did any of the following apply
Child care expenses
Attended school
Bought a home
Sold a home
Marketplace insurance
IP PIN
Owe IRS
Identity theft
Retirement withdrawal
Explain anything selected above
Did you file last year? yes or no
Do you owe the IRS? ye or no
Do you have unfiled years? yes or no
Are you currently being audited? yes or no
Are you on a payment plan?
I understand and agree:
I am responsible for the accuracy of my return
Destiny Helpers Tax Services LLC relies on the information I provide
False information may result in penalties or audits
Refund timing is controlled by the IRS
I authorize Destiny Helpers Tax Services LLC to prepare and file my tax return
Full Name
Signature
Date
-
Month
-
Day
Year
Date
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