TruStatement Accounting Services | Tax Preparation Intake Form

If someone referred you, please type his or her name below:

Filing Status

Spouse year of death

The year must fall within two tax years after your spouse’s passing.

Can someone claim you as a dependent?

Select if this applies to your situation:

Upload a document that reflects your ability to claim head of household. An example would be a utility bill (water and electric), mortgage statement, rental payments, etc.

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Your Full Name

First NameLast Name

Your Email Address

example@example.com

Your Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Your Date of Birth

Example: mm/dd/yyyy

Your SSN

Example: xxx-xx-xxxx

Your Job Title

Example: Educator, Manager, Unemployed, etc.

Mailing Address

Street Address

Apt / Suite #

CityState

Zip Code

Do you own a business?

Spouse's Full Name

Full Name

Spouse's SSN

Example: xxx-xx-xxxx

Spouse's Date of Birth

Example: mm/dd/yyyy

Spouse's Phone Number

Example: xxx-xxx-xxxx

Spouse's Email Address

Example: example@example.com

Spouse's Job Title

Example: Educator, Manager, Unemployed, etc.

Does your spouse own a business?

Are you claiming any dependents? If so, select the number of dependents.

Other dependents or people who lived with you

Rows	Name (First, Last)	Date of Birth	Relationship	Full-time student (Y/N)	IP PIN
1
2
3
4
5

Please upload a rental agreement (if claiming dependents be sure their names are listed on it, or upload school records with your address listed).

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Are you claiming a niece, nephew, grandchild, or other relative instead of your own children, and you are providing 50% or more of their expenses?

Please clarify why the parents are unable to claim them. What is the status of the parents?

Please select all forms of income (the form type is listed in the top‑right corner of each document).

Upload all forms of income for you and your spouse (if married filing jointly)

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Did you receive Unemployment Benefits or EDD?

If so, please specify the amount and attach the 1099-G form.

UDS ($)

Please attach the 1099-G form.

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Please select all that apply:

Please select all that apply:

Upload all documentation for expense(s):

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After carefully reviewing the EITC requirements are you eligible?

If requested by the IRS, do you have documentation (i.e. receipts, records) to substantiate your eligibility for the Child Tax Credit, Earned Income Tax Credit and/or Head of Household Filing Status?

Do you live in any of the following States? Alabama, Alaska, Arkansas, Delaware, Florida, Georgia, Idaho, Illinois, Kansas, Kentucky, Louisiana, Mississippi, Nebraska, Nevada, New Hampshire, North Carolina, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Virginia, Washington, West Virginia, or Wyoming.

Select whether you are a Homeowner or Renter

Has your address changed?

Other

Monthly Rent/Mortgage

Example: $900.00

Number of Months Paid At Residence During the Tax Year

Example: 12

Landlord or Property Office's Street Address

Street Address

Street Address Line 2

CityState

Zip Code

Please upload copy of your signed lease, landlord rent receipts, mortgage payment receipts, or official state document below.

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Legal Business Name

Employer Identification Number (EIN)

Example: xx-xxxxxxx

Business Address

Street Address

APT / Suite #

CityState

Zip Code

Please upload EIN letter and Article of Organization Certificate

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Gross Income

USD ($)

List Business Expenses

Rows	Amount (USD)
Subscriptions
Advertising
Travel
Rent/Lease
Meals
Supplies
Taxes
Wages
License
Office Supplies
Labor
Equipment
Utilities
Commission
Insurance
Legal Fees
Repairs
Vehicle Mileage (# of Miles)
MiscMiscMisc

Please provide documentation for the past 12 months of income and expenses related to your business. This should include receipts, invoices, bank statements (including Cash App statements), business logs, booking logs, mileage logs, business cards, sales receipts, electronic records, and any other relevant documents that support claimed deductions or income, such as contracts, agreements, or other business activities.

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Terms and Conditions

Is there anything else we should know to prepare your taxes?

You (and your spouse if married filing jointly) Government Issued ID or Driver's License

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You, (your spouse if married filing jointly), and dependent(s) Social Security Card(s)

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If you (and your spouse if married filing jointly) have a 1098-T form, upload below

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Additional Documents

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If due a refund, how would you like your refund?

If you have a balance due, how would you like to make your payment?

Name of Bank

Which type of account would you like your refund deposited into?

Other

Routing Number

Bank Account Number

Name of Bank

Is this a business bank account?

Which type of account would you like your refund deposited into?

Other

Routing Number

Bank Account Number

Primary Taxpayer's Signature

Date

mm/dd/yyyy

Spouse's Signature

Date

mm/dd/yyyy

Schedule Your Free Consultation Here

For any questions, assistance or concerns, please contact us via phone or text at (318)588-8371, or email the CEO directly at aaliyah@trustatementaccounting.com