Tax Intake Form

Tax Intake Form
Full Name

First NameLast Name
Spouse Full Name (If Filing Joint)

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Spouse Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Social Security Number
Spouse Social Security Number
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Occupation
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Dependent Name
Dependent Social Security Number
Dependent Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Relationship
Dependent Name
Dependent Social Security Number
Dependent Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Relationship
Dependent Name
Dependent Social Security Number
Dependent Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Relationship
Filing Status
Did you file a return last year?
Audited by the IRS?
Did you have Marketplace Insurance?
Did you receive unemployment last year?
Direct Deposit- Routing Number
Direct Deposit- Account Number
Referred By?
Did you file taxes last year?
Do you have access to your IRS.GOV account?
What was your AGI from last year?
Would you like to opt into Credit Repair Services for an additional $150?
Upload Your ID/Drivers License

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Upload Your Social Security Cards

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Upload Your Tax Documents (e.g., W-2, 1099, previous tax return, etc.)

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JFA CAPITAL GROUP will provide professional tax consulting services for your individual tax return based on the information you furnish to us. Our role is to advise, strategize, and guide you through the tax process; however, you, the taxpayer, remain ultimately responsible for the accuracy, preparation, and filing of your tax return.

I, the Taxpayer named above, acknowledge that I have provided JFA CAPITAL GROUP with the attached tax information and, to the best of my knowledge, this information is true, correct, and complete.
Taxpayer Signature
Spouse Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Additional Information or Notes
Should be Empty: