• TER A TAX SOLUTIONS

  • CLIENT INTAKE & DUE DILIGENCE

  • CLIENT INFORMATION

  • Date of Birth:
     - -
  • Format: (000) 000-0000.
  • Marital Status (as of 12/31 of tax year):

  • HOUSEHOLD & DEPENDENTS (REQUIRED)

  • Do you have dependents you are claiming?

  • Dependent 1 Information

  • DOB:
     - -
  • Is this dependent a full-time student?
  • Is this dependent permanently or totally disabled?
  • Did this dependent provide more than 50% of their own support?
  • Did anyone else provide more than 50% of this dependent's support?

  • Dependent 2 Information

  • Is this dependent a full-time student?
  • Is this dependent permanently or totally disabled?
  • Did this dependent provide more than 50% of their own support?
  • Did anyone else provide more than 50% of this dependent's support?

  • Dependent 3 Information

  • Is this dependent a full-time student?
  • Is this dependent permanently or totally disabled?
  • Did this dependent provide more than 50% of their own support?
  • Did anyone else provide more than 50% of this dependent's support?

  • HEAD OF HOUSEHOLD QUALIFICATION

  • Were you unmarried or considered unmarried on 12/31?
  • Did you pay more than 50% of the cost of keeping up your home?
  • Expenses you paid (check all that apply):

  • INCOME INFORMATION

  • Select all income sources you received:
  • Have you provided ALL income earned during the tax year?

  • SELF-EMPLOYMENT (IF APPLICABLE)

  • Do you maintain income and expense records?
  • Expenses Included (check all that apply):

  • DEPENDENT CARE CREDIT (DAYCARE / NANNY)

  • Did you pay for childcare so you could work or look for work?
  • Childcare Provider Information (Repeat per provider)
  • Type of Care:

  • EARNED INCOME CREDIT (EIC) - REQUIRED QUESTIONS

  • Did you earn income from working or self-employment?
  • Did you live in the U.S. more than half the year?
  • Can another person claim you or your dependents?

  • CHILD TAX CREDIT / ACTC

  • Are claimed dependents under age 17?
  • Are dependents U.S. citizens, nationals, or resident aliens?
  • Did dependents live with you more than half the year?
  • DUE DILIGENCE & CLIENT ATTESTATION (REQUIRED)
  • Date:
     - -

  • Please upload all documents such as 

    Taxpayer 

    Valid I.D (unexpired ID)

     

    Dependents will need to forms of Identification

    Social security card 

    Medical Card/birth certificate

     

    Head of household proof 

    Lease or Utility bill 

     

    Wages/ Income 

    W2 from employer 

    Business income and expenses Schedule C

    1099's

    1099G

     

    Deductions 

    1098 T for proof of school enrollment 

    1099- R

    investments 

    Mortgage interest 

    property taxes 

     

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