Tax Intake Form

Anderson Tax & Business Solutions

Please complete this secure intake form to begin your tax preparation process. Your information is encrypted and protected.
Full Legal Name*

First NameMiddle NameLast NameSuffix
Date of Birth*

MonthDayYear
Date
Social Security Number (SSN) or ITIN*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
PhoneEmailText
SingleMarried Filing JointlyMarried Filing SeparatelyHead of HouseholdQualifying Window(er)
YesNo
First Name   Last Name
Date of Birth
SSN
Relationship to you
# of months lived with you this year
Did they provide more than 50% of their own support? (Yes/No)
W-2 EmploymentSelf-Employment / 1099UnemploymentSocial SecurityRental IncomeInvestmentsOther
Upload Tax Documents*

Cancelof
YesNo
Business Name
EIN
Type of Business
Total Income for the Year
Total Expenses for the Year
Upload Profit & Loss Statement (if available)

Cancelof
Childcare ExpensesEducation Expenses (Tuition, Student Loans)Medical ExpensesCharitable DonationsHomeownership (Mortgage Interest, Property Tax)Retirement ContributionsNoneOther
Refund Method*
Bank Name
Routing Number
Account Number
YesNo
File Upload (Last Return)

Cancelof
YesNo
YesNo
If Yes, Upload Documents

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YesNo
Signature (E-signature field)*

Consent Statement: I confirm that the information provided is accurate to the best of my knowledge. I authorize Anderson Tax & Business Solutions to prepare my tax return.
Today's Date

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Date
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Anderson Tax & Business Solutions