Client Intake Form

  • CLIENT INTAKE QUESTIONNAIRE FORM

  • All clients must fill out this form for tax preparation services even if information is still the same as prior year.
  • What tax period are you filing?

  • Personal Information

  • List your name exactly as it appears on your Social Security Card or ITIN documents.

  • Primary Taxpayer

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  • Format: (000) 000-0000.
  • Are you blind?
  • Have you ever been issued an IRS Identity PIN (IP PIN)?

  • If married filing jointly, enter your Spouse Information

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  • Format: (000) 000-0000.
  • Is your spouse blind?
  • Have your spouse ever been issued an IRS Identity PIN (IP PIN)?

  • Other Information

  • Did you (and spouse if married) have health insurance?
  • Did you or spouse have health insurance through the marketplace or receive form 1095-A?
  • Have any of your tax deductions or credit ever been disallowed by the IRS or State?

  • Dependent Information

  • Rows
  • 1. Did anyone else over the age of 18 live in the home with you and the dependent?
  • 5. If audited, can you prove your relationship with each dependent (by providing the Birth Certificate and yours if claiming niece/nephew/brother/sister, Marriage License, etc.)?
  • 6. For each dependent listed, are you able to provide proof this person lived with you for more than 6 months during the tax year, such as: school records, medical, court docs, etc.?
  • Guardian Tax & Business Services Client Questionnaire Form 2

  • What was your Marital Status as of December 31st of the Tax Year you are filing:

  • Marital Status

  • Fill out Questions 1-5 if married. If not married, skip questions 1-5 and start at Question 6

  • 1. Were you married on the last day of the year?
  • 2. Did your spouse die during the year?
    • If you are married and want to file a Joint Tax Return with your spouse, select Married Filing Jointly.
    • If you are marreied and don't want to file a together and don't qualify for another filing status, select Married Filing Separately.
    • If you did not live with your spouse, and want to see if you can claim Head of Household, answer question #4a & 4b. If you meet all the requirements in question 4a & 4b, select Head of Household in #7.
    • If your spouse died during the last 2 years (2024 or 2023), answer the question in #5a. If you meet all the requirements in 5a, select Qualifying Surviving Spouse.
    • Note: If your spouse died during the current tax year (2025), and you don't meet the requirements for another filing status, you must file as Married Joint or Married Separate.
  • Select your filing status:
  • 4a. Did you and your spouse live apart during the last 6 months of the year?
  • 4b. Do All of the following apply? You pay more than half the cost of keeping up a home AND One of the following lived in your home for more than half the year that you provided more than half the support for: Your child, Adopted child, Foster child, Niece, Nephew, Brother, Sister-OR-Did you pay more than half the cost of keeping up a home for your dependent Parent?
  • 5a. If applicable: Did your spouse die in previous 2 years, and do you have a dependent child who you provided more than half the support for, that live in your home where you paid more than half the cost of keeping up the home?

  • Fill out Questions 6 if not married. If you are married, fill out questions 1-5 above.

    • If you are unmarried, and don't meet the requirements to file as Head-of-Household, select Single in #7.
    • If you want to file as Head-of-Household answer the questions in #6 to see if you qualify. If you meet the requirements in #6, select Head-of-Household in #7.
  • 6. Were you unmarried? Did you pay more than half the cost of keeping up your home, and one of the following lived in your home for more than half the year? Your child, Adopted child, Foster child, Niece, Nephew, Brother, Sister-OR-Did you pay more than half the cost of keeping up a home for your dependent Parent?
  • 7. Select your filing status:
  • Guardian Tax & Business Services Client Questionnaire Form 3

  • Income Received

  • You must report all the income you received during the tax year. Read each item carefully, and select either Yes or No. If you received income not listed, enter it in the other box.
  • 1. W2 Wages
  • 2. Did you receive Tip income last year?
  • 3. Income from IHSS: In Home Support Services: as a Live-in Care Provider
  • 4. 1099-NEC Independent Contractor
  • 5. Business Income: Cash/Checks/1099
  • 6. 1099-INT Interest
  • 7. 1099-DIV Dividends
  • 8. 1099-R Retirement Distributions or 1099-SSA Social Security
  • 9. 1099-B Stocks/Bonds or 1099-S Home Sale
  • 10. 1099-G Unemployment or State/Local Refund
  • 11. W2G Gambling Winnings
  • 12. 1099-C Cancellation of Debt
  • 13. 1099-MISC (Prizes/Awards/Other Income)
  • 14. Rental or Royalty Income
  • 15. S Corporation or Partnership Income (Schedule K-1)
  • 16. Alimony Income: If so, what date was the divorce agreement final?
  • 17. 1099-DA Digital Assets Sales such as Virtual Currency, Bitcoin, etc.
  • 18. Other Income received not listed above?

  • If receiving a refund back, do you want it direct deposited, if so, enter account info below:

  • Business & Independent Contractor Information

  • What Type of Business did you operate during the year?
  • Did you start this business this year?

  • Did you receive any of these tax forms or types of business income? Select Yes or No.

  • 1. 1099-NEC Independent Contractor Income
  • 2. 1099-K Debit/Credit Card Transactions
  • 3. Cash or Checks
  • 4. 1099-DA Digital Assets
  • 5. Tips Received
  • 6. 1099-MISC
  • 7. Other Business Income not listed above?

  • Other Information

    Please answer the following questions about your business activity to determine if you are operating a business or hobby.
  • 1) Do you have a separate business account for this activity?
  • 3) Do you advertise or market this business activity? (ex: advertise, social media, etc.)
  • 5) Do you have an income statement or profit & loss statement?
  • 6) If IRS request, can you provide proof of income (invoices, receipts, client list, etc.)
  • 7) If audited, can you provide proof of expenses (receipts, statements, logbooks, etc.)

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  • I certify under penalty of perjury that the information on this form is true and correct to the best of my knowledge, and I can provide proof of all information listed if asked by the IRS or State.

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  • Guardian Tax & Business Services Client Questionnaire Form 5
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