• Routt Insurance — Tax Client Intake

  • Individual & Small Business (Schedule C) Tax Preparation

    3455 Countryside Blvd, Clearwater, FL 33761 ·

    (727) 513-8338

    Confidential Tax Information — For Tax Preparation Purposes Only

  • Filing Status

  • Filing status*
  • Did your marital status change during the tax year?*

  • Taxpayer and Spouse Information

  • Taxpayer date of birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Is the taxpayer legally blind?*
  • Can someone claim the taxpayer as a dependent?*
  • Was the taxpayer a U.S. citizen or resident alien for the full year?*
  • Spouse date of birth
     - -
    2 digit month, 2 digit day, 4 digit year
  • Is the spouse legally blind?
  • Can someone claim the spouse as a dependent?
  • Was the spouse a U.S. citizen or resident alien for the full year?
  • Marital status for spouse details*
  • Do you have dependents?

  • Dependents

  • Dependent 1
  • Do you have another dependent after Dependent 1?
  • Dependent 2
  • Do you have another dependent after Dependent 2?
  • Dependent 3
  • Do you have another dependent after Dependent 3?
  • Dependent 4

  • Contact and Identity / Tax Setup

  • Format: (000) 000-0000.
  • ID Issue Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • ID Expiry Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Did the IRS issue you an Identity Protection PIN (IP PIN) for this tax year?*
  • Do you expect to owe taxes?*
  • Payment Method*
  • Refund Preference*

  • Income Checklist

  • Income sources received*
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  • Self-Employment / Schedule C

  • Business income*
  • Schedule C expense categories
  • Vehicle use details
  • Do you have inventory or cost of goods sold?*

  • Rental Property

  • Rental expense categories
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  • Deductions and Credits

  • Which deduction and credit categories apply?*
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  • Installation date
     - -
    2 digit month, 2 digit day, 4 digit year
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  • Was the contribution made for the taxpayer or spouse?
  • Estimated tax payments and disaster loss details
  • Payment date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Was the payment federal or state?
  • Date
     - -
    2 digit month, 2 digit day, 4 digit year
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  • ACA Health Coverage

  • Did you have health coverage during the year?*
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  • Which months were you covered?

  • Documents Checklist and Uploads

  • Documents you will bring or upload*
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  • Upload Tax Return
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  • Did you receive an IRS or state tax notice during the tax year or regarding this return?
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  • Consents and Authorizations

  • Communication consent
  • IRS third-party designee authorization

  • Meeting and Delivery Preferences

  • Preferred meeting method*
  • How would you like to receive your finished return?*
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  • Please review all answers before submitting, and upload any documents that apply to your selected income, deductions, credits, business, rental, insurance, or tax notice items.
  • Should be Empty: