Tax Client Intake Form

Tax Client Intake Form

2026
Filing Status

Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
SSN
Social Security Number
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Have you ever been issued an Identity Protection PIN (IP PIN) by the IRS?
If yes, please list your 6-digit IP PIN below:
Taxpayer Identification

Valid form of ID
Cancelof
Are you a full-time student?

Spouse Name

First NameLast Name
SSN
Social Security Number
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Have you ever been issued an Identity Protection PIN (IP PIN) by the IRS?
If yes, please list your 6-digit IP PIN below:
Is your spouse a full-time student?
Spouse Identification

Valid form of ID
Cancelof

Enter your dependents here

Rows	Name	Date of Birth	Relationship	SSN	IP PIN
1 Dependent
2 Dependent
3 Dependent
4 Dependent
5 Dependent
6 Dependent

Did your dependents live with you for more than half of the year?
Please Upload All Dependent(s) Birth Certificate and Social Security Card

Please upload all of the documents that you can provide to assist with your tax preparation.
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Self-Employed Income + Expenses

Rows	$ Amount
Income/Sales
Ads/Marketing Expenses
Supplies
Repairs/Maintenance
Software/Subscriptions
Phone/Internet Services
Business Meals
Business Insurance
Tax Preparation Fees
Travel Expenses

Total Expenses

Please upload any W-2(s)

All w-2(s) from every employer for this tax year.
Cancelof
Please upload any Health Insurance Form (1095-A, 1095-B, 1095-C)

Cancelof
Please upload any 1098-T forms to determine qualification for any education credit

Cancelof
Please upload All additional income forms received, including, but not limited to; Form 1099-INT, Form 1099-DIV, Form 1099-NEC, and Form 1099-MI, 1099-K

Cancelof

Direct Deposit

Please list information to receive direct deposit.
How to receive your refund?
Name of Bank
Bank Routing Number
Bank Account Number
Account Type

Are you a new or a returning client?
Do you have any specific questions or notes for your tax preparer?
Referral Agent Name/ Phone Number
Please list who referred you
- - I have confirmed that all information has been entered by myself and is accurate and true.
  - I allow, Scale Wealth Financial Services LLC, to capture my sensitive data like my personal or government ID and other information for the completion of my 2026 tax return.
  - By signing below, I acknowledge I have read and understood all respnsibilites and the responsiblities in doing this tax return.
  - I am acknowledging that I, _____ am responsible for any and all fees that are not covered by my income tax refund. If fees are not covered, I will pay them out of pocket no later than thirty (30) days from the date of my scheduled refund.
- Date
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Taxpayer Signature
- Date
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Spouse Signature

Rate your intake process

Optional.
Should be Empty: