Tax Intake Form

CLIENT FORM

Www.BAGLADYTAXES.com / Office Contact (682)218-2870 / BagLadyTaxes@gmail.com
How did you hear about us?
Tax Payers Name

First NameLast Name
Email
example@example.com
Taxpayer's Phone Number
Example: xxx-xxx-xxxx
If someone referred you, please type his or her name here.
Taxpayer's Job Title
Taxpayer's Date of Birth
Example: 01/01/2001
Taxpayer's SSN
Example: xxx-xx-xxxx
Spouse's Full Name
First Name
Spouse's SSN
Example: xxx-xx-xxxx
Spouse's Date of Birth
Example: 01/01/2001
Spouse's Phone Number
Example: xxx-xxx-xxxx
Spouse's Email Address
Example: example@example.com
Spouse's Job Title
example@example.com
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you self employed?
Did you and your spouse live apart during the year?
What is your marital status as of December
Did you pay over half the expenses of maintaining your residence for the entire year?
Filing Status
Did you support a child or family member for more than 6 months out of the year?
Are you on any Government Assistance
Tax Year you are Filing?
How many dependents are you claiming?
Dependent #1

First NameLast Name
Dependent #1 Date of Birth
01/01/2001
Dependent #1 SSN
What is Dependent #1's Relationship to you (son, daughter, etc.)?
How many months did Dependent #1 live with you in 2025? (If all year, enter 12)
Dependent #2

First NameLast Name
Dependent #2 Date of Birth
Example: 01/01/2001
Dependent #2 SSN
How many months did Dependent #2 live with you in 2024? (If all year, enter 12)
What is Dependent #2's Relationship to you (son, daughter, etc.)?
Dependent #3

First NameLast Name
Dependent #3's Date of Birth
01/01/2001
How many months did Dependent #3 live with you in 2025? (If all year, enter 12)
Dependent #3s SSN
Example: xxx-xx-xxxx
What is Dependent #3's Relationship to you (son, daughter, etc.)?
Dependent #4's First Name
First Name
Dependent #4's Last Name
Last Name
Dependent #4's Date of Birth
01/01/2001
Dependent #4's SSN
Example: xxx-xx-xxxx
What is Dependent #4's Relationship to you (son, daughter, etc.)?
How many months did Dependent #4 live with you in 2025? (If all year, enter 12)
Dependent #5's First Name
First Name
Dependent #5's Last Name
Last Name
Dependent #5's Date of Birth
01/01/2001
Dependent #5's SSN
Example: xxx-xx-xxxx
What is Dependent #5's Relationship to you (son, daughter, etc.)?
How many months did Dependent #5 live with you in 2024? (If all year, enter 12)
Are there any dependents in daycare? If yes, please upload the form you received from your daycare provider.
Upload a copy of your daycare form here.

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How would you like to receive your tax refund?
Name of Bank
Which type of account would you like your refund deposited into?

Other
Routing Number
Bank Account Number
Can someone else claim you as a dependent?
Did you have health insurance in 2025?
Did you have health insurance for the entire year?
Who was your insurance cover through in 2025?
Was your insurance through your employer?
Was your insurance through Medicaid?
Was your insurance through the Affordable Care Act (The Marketplace)?
Did your dependents have health insurance for the entire year?
Was YOUR DEPENDENTS' insurance through your employer?
Who was your Dependents insured with in 2025?
Upload Taxpayer & Dependent(s)Insurance Documents

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Was YOUR DEPENDENTS' insurance through Medicaid?
Was YOUR DEPENDENTS' insurance through the Affordable Care Act (The Marketplace)?
Have you ever been denied the Earned Tax Credit (EITC)?
Were you or any of your dependents in college in 2025?
Do you have a 1098-T Form for either you or your dependents?
If you have a 1098-T form, upload it here.

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Are you Interested in the tax Advance Loan?
Are you interested in AUDIT PROTECTION?
DOES ANYONE ON THE RETURN HAVE AN IDENTITY PROTECTION PIN? IPPIN
MY TRUSTED TAX PREPARER WAS
CLIENT NON PAYMENT/OFFSET CLAUSE

At All Things BAG LADY TAXES, we strive to assist all of our clients in their tax needs, however we understand that situations arise. If your refund is offset by the IRS, student loans, child support or your check is mailed, you are still obligated to pay our company the fees associated with filing your tax return.
Primary Taxpayer's Signature
Date

MonthDayYear
Date
ADDITIONAL SERVICES

At All Things BAG LADY TAXES, we do more than just taxes. Please check below if you would be interested in any of the additional services we provide. We will schedule a time to speak with you at a later time.
SELECT THE INTERESTED SERVICE
Date

MonthDayYear
Date
Taxpayer's Driver's License

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Taxpayer's and Dependent(s ) Social Security Card(s)

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Taxpayer's W-2/ 1099'S

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House Bill/Proof of Residency

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Should be Empty:

CLIENT FORM