01 - Tax Client Info & ID Verification

Taxpayer Information
Client Info & ID Verification

Please complete this secure form so we can ensure your info is up-to-date and help us remain in compliance with IRS regulations.
Who are we filing taxes for?*

IndividualMarried CoupleBusiness
Filing Status (Married):

Married Filing JointlyMarried Filing Separately

Individual Taxpayer Information
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Social Security Number:*
Preferred communication type*

PhoneE-mailText
I want to receive text messages from Accent Financial Services! By checking this box, I agree to receive updates, questions, and other information via text messages directly to my phone.*

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Privacy Policy

https://accentfinance.net/privacy-policy

Terms and Conditions

https://accentfinance.net/terms-and-conditions
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Photo ID: Acceptable government issued photo IDs include: Driver's License, Passport or Passport Card, Military ID, State ID, or Permanent Resident Card
Upload Photo ID

Cancelof
Filing Status Individual:

SingleHead of HouseholdQualifying Widow(er)

Refund
If you will be receiving a refund, will you want it by mail or direct deposit?*

MailDirect Deposit
Provide bank account you want used for IRS direct deposit purposes. (Note, if filing MFJ, it must be a joint account)

CheckingSavings
Checking Full Routing Number
Checking Full Account Number
Checking Full Routing Number (please enter again and verify number is correct)
Checking Full Account Number (please enter again and verify number is correct)
Savings Full Routing Number
Savings Full Account Number
Savings Full Routing Number (please enter again and verify number is correct)
Savings Full Account Number (please enter again and verify number is correct)

Dependent(s)

Digital Assets
At any time during 2022, did you (a) receive as a reward, award, or payment for property or services, or (b) sell, exchange, gift, or otherwise dispose of a digital asset (or a financial interest in a digital asset)?*

Schedule C
Do you have other income to report from last year? (This could qualify a Schedule C to be included on your tax return)*

LLC, Partnerships, S-Corporations, Trusts, or Estate Income
Did you have a LLC, Partnership, S-Corporation, Trust, or Estate Income during tax year?*

How did you hear about us?
How did you hear about us?*

Current customerYelpGoogleFacebookLinkedInNextdoorOther (please specify below)
Name of customer who referred you to our business
Other referral not listed above

Acknowledgment & Signature
- I confirmed that all information I entered here is accurate and true.
- I allow Accent Financial Services to capture my sensitive data like personal id, government id, social security number (SSN), and other information.
- I have read the terms and conditions and privacy policy of Accent Financial Services.
- By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Date Signed*

MonthDayYear
Date
Taxpayer Signature*

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Should be Empty:

	Federal Payments	State Payments
Applied from Prior Year
First Quarter (April 2023)
Second Quarter (June 2023)
Third Quarter (September 2023)
Fourth Quarter (January 2024)
Payment with Extension (April 2024)

Taxpayer Information