2025 TAX CLIENT INTAKE FORM

TAX SEASON CLIENT INTAKE FORM

Please complete this form to submit your tax return information. The details you provide are essential to help us prepare and file your return accurately. When you’re finished, scroll to the bottom and click “SUBMIT” to send everything directly to our office. You’ll receive an email confirmation once your submission is received. If you have any further questions or concerns before completing the form, feel free to contact us via Email: protegetax@gmail.com or Phone: (954) 395-5751 Thank you.
OUR RESPONSIBILITIES
Our work (whether consultation, tax return, tax plan or related product) is based on data you provide.
- We are not responsible to audit or verify the data that you give to us.
- We may ask for clarification of your data or additional information.
- We are not responsible to discover fraud or other irregularities, should any exist.
- We will work to find all the credits and deductions you are legally entitled to.
YOUR RESPONSIBILITIES
- To provide all the information required for a complete and accurate finished product.
- To provide this information in a timely manner.
- To retain, with the completed work, all the documents, cancelled checks and other data that form the basis of income and deductions since you may later have to provide them to a taxing authority.
- To carefully review all work completed by our office before you sign. You have the final responsibility for anything submitted to a taxing authority.
- You are responsible not to commit fraud.
PENALTIES, EXAMINATIONS AND NOTICES
The IRS and state taxing authorities impose penalties for certain offenses, including understatement of income, filing after the deadline, underpaying estimated taxes, or under withholding taxes (If you would like more information, please contact us.) They can also select any return for examination.

PRIVACY POLICY
Tax preparers are bound by professional standards of confidentiality. Therefore, we have always protected your right to privacy. For current and former clients, we do not disclose any nonpublic personal information obtained in the course of our practice except as required or permitted by law, and as is necessary to properly provide our services to you.

Types of Nonpublic Personal Information We Collect. We collect nonpublic personal information about you that is provided to us by you or obtained by us with your authorization.

Parties to Whom We Disclose Information. We make available information to our employees and to nonaffiliated third parties who need to know that information to assist us in providing services to you. In all such situations, we require a contractual agreement that includes procedural safeguards that protect the confidential nature of the information being shared.

Protecting the Confidentiality and Security of Current and Former Client Information.
We retain records relating to professional services that we provide so that we are better able to assist you with your professional needs and, in some cases, to comply with professional guidelines. In order to guard your nonpublic personal information, we maintain physical, electronic, and procedural safeguards that comply with our professional standards.

OUR FEES
We invoice for time spent, depending on schedules and forms completed and out-of-pocket expenses incurred. Our rates vary depending on the nature of the work performed. We may invoice for partially completed work that is placed on extension or remains undone.

TAX DOCUMENTS
All clients are provided a copy of their tax documents at the conclusion of their tax preparation, if return is e-filed to the IRS. Tax documents are issued via email or in office only. In order to provide you with a copy of your tax documents, tax return must be e-filed and submitted to the IRS.

*A retainer will be required when working on ALL tax returns and before undertaking projects for new clients.

ARBITRATION
If a dispute arises out of or relates to this contract or engagement letter, or the obligations of the parties therein, and if the dispute cannot be settled through negotiation, the parties agree first to try in good faith to settle the dispute by mediation administered by the American Arbitration Association under its commercial Mediation Rules before resorting to arbitration, litigation, or some other dispute resolution procedure.

AGREEMENT
The foregoing is in accordance with my (our) understanding of your engagement to provide tax and financial services and you are hereby advised that each item of revenue or expense can be substantiated by receipts, cancelled checks, or other documents. This information is true, correct, and complete to the best of my (our) knowledge. Further, it is my (our) understanding that these terms will continue to be in force for the succeeding years of our engagement.
Print Taxpayer Name *
Date*

MonthDayYear
Date
Taxpayer Signature *
Date*

MonthDayYear
Date
Print Spouse’s Name (if applicable)
Date

MonthDayYear
Date
Spouse Signature (if applicable)
Date

MonthDayYear
Date

Rows	Taxpayer	Spouse
Blind
Disabled
Pres. Campaign Fund

BANK ACCOUNT INFORMATION
Owner of account

TaxpayerSpouseJoint
Type of account

CheckingSavings
Name of financial institution
Financial Institution Routing Transit Number
Your account number
IRS Required Documents to file Section:

Please make sure all uploads are clear, verifiable, and backgrounds placed on clear surface.

1. TaxPayer Identification Verification:
Upload Taxpayer Identification (ID or Passport)*

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Upload Taxpayer Social Security Card*

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2. TaxPayer Filing Status and Address Verification
Single: (mail with address or any type of bill with address)*

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Head of Household: (Utility Bill, Lease, Rent Statement, Separation Agreement, Bank Statement, etc)*

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Married Filing Jointly: (Marriage Certificate)

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Married Filing Separately: (Marriage Certificate)

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Qualified Widower: (Death Certificate)

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3. TaxPayer Dependent ID Verification:
Upload All Dependent(s) SS Card

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4. Tax Payer Dependent Relationship Verification:
Upload Dependent One Birth Certificate

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Upload Dependent Two Birth Certificate

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Upload Dependent Three Birth Certificate

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Upload Dependent Four Birth Certificate

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Upload Dependent Five Birth Certificate

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5. Tax Payer Dependent Residency Verification
Upload Dependent One School, Medical, or Shot Records

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Upload Dependent Two School, Medical, or Shot Records

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Upload Dependent Three School, Medical, or Shot Records

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Upload Dependent Four School, Medical, or Shot Records

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Upload Dependent Five School, Medical, or Shot Records

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Any other Dependent Documents

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6. Tax Payer Income Statement Verification-W2, 1099, Bank Statement, Income Statement, Receipt Log, Etc
Any Additional Taxpayer Documents*

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Additional documents. (Please upload the following document if available)
Property Sold Income

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IRA (Individual Retirement)

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Dividend Income

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Partnership Trust, Estate Income

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Pension, Annuity Income

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Medical/Dental Expense

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Taxes paid

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Interest Expense (1098-Int)

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Charitable Contribution

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Child and Dependent Care Expenses

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Business Milage or Travel

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Education Expense (College 1098T form)

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To the best of my knowledge the information enclosed in this client tax organizer is correct and includes all income, deductions, and other information necessary for the preparation of this year's income tax returns for which I have adequate records.
Taxpayer Signature
Date

MonthDayYear
Date
Spouse Signature
Date

MonthDayYear
Date

CONSENT TO USE OF TAX RETURN INFORMATION
For the purposes of this consent form, “we,” “us,” and “our” mean Tasha Norteus. Federal law requires this consent form be provided to you. Unless authorized by law, we cannot use your tax return information for purposes other than the preparation and filing of your tax return without your consent. You are not required to complete this form to engage in our tax return preparation services. If we obtain your signature on this form by conditioning our tax preparation services on your consent, your consent will not be valid. Your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature. If you do not consent, you may still have your tax return prepared and electronically filed by us for a fee. For your convenience, we have entered into an arrangement with third parties to provide qualifying taxpayers with the opportunity to apply for an Electronic Refund Disbursement Service and/or Loan product. To determine whether these products may be available to you, we will need to use your tax return information in order to calculate the amount of your anticipated refund. If you would like us to use your tax return information to determine whether these products may be available to you while we are preparing your return, please sign and date this consent to the use of your tax return information. By signing below, you authorize us to use the information you provide to us during the preparation of your 2025 tax return to determine whether to present you with the opportunity to apply for these products and services If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by e-mail at complaints@tigta.treas.gov. ConToUse-Meta-21/22
Name

First NameLast Name
Date

MonthDayYear
Date
Signature
Spouse Signature

CONSENT TO DISCLOSE INFORMATION
For the purposes of this consent form, “we,” “us,” and “our” mean Tasha Norteus. Federal law requires this consent form be provided to you. Unless authorized by law, we cannot disclose your tax return information to third parties for purposes other than the preparation and filing of your tax return without your consent. If you consent to the disclosure of your tax return information, Federal law may not protect your tax return information from further use or distribution. You are not required to complete this form to engage in our tax preparation services. If we obtain your signature on this form by conditioning our services on your consent, your consent will not be valid. If you agree to the disclosure of your tax return information, your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature. You have indicated that you are interested in receiving an Electronic Disbursement Service and/or Loan (or collectively, “Products or Services”) from Refund Advantage, a division of MetaBank, National Association. In order to provide you with the opportunity to apply for one of these Products or Services, we must disclose all of your 2025\ tax return information necessary for evaluating the request to Refund Advantage. If you request a more limited disclosure of tax return information, you will not be eligible to submit an application request for these Products or Services. If you would like us to disclose your 2025 tax return information for this purpose, please sign and date your consent to the disclosure of your tax return information. By signing below, you authorize us to disclose to Refund Advantage all of your 2025 tax return information necessary for the evaluation and processing of your request for a Product or Service. You understand that if you are unwilling to authorize the disclosure and sharing of your tax return information with Refund Advantage, you will not be able to obtain a Product or Service, but you may still choose to have your tax return prepared and filed by us for a fee. If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by e-mail at complaints@tigta.treas.gov.
SMS WORLDWIDE SOLUTIONS
Name

First NameLast Name
Date

MonthDayYear
Date
Signature
Spouse Signature
Should be Empty:

Rows	Name(First, Last)	Relationship	Date of Birth	Social Security Number	Months Lived With You	Disabled	Full Time Student	Dependent's Gross Income	ID Protection PIN
1
2
3
4
5

TAX SEASON CLIENT INTAKE FORM

Client Tax Organizer

1. Personal Information

2. Dependents (Children & Others)

EITC Dependent Section (Relationship/Support/Residency):

Please answer the following questions to determine maximum deductions

CONSENT TO USE OF TAX RETURN INFORMATION

CONSENT TO DISCLOSE INFORMATION

Rows	Name	Soc. Sec. No.	Date of Birth	Occupation	Work Phone
Taxpayer
Spouse