Gemini Client In-Take Form

Client In-Take Form

We understand there are a multitude of professional tax preparation service providers and are elated you have chosen us to patronize. We hope this will be the beginning of a long and mutually beneficial relationship. Please answer all fields truthfully and accurately to the best of your knowledge for an efficient virtual experience.
ATTENTION - PLEASE READ

In order to provide you a with a tax estimate or file your taxes, it is required by law, for you to sign the nessesary disclosures thus giving permission to use and disclosure your tax information to whom we have entered into arrangements. Such as but not inclusive with certain financial institutions and their partners regarding the provision of bank accounts, refund settlement products, card services, and/or related banking services. To determine whether these services may be of interest to you, we will need to use your tax return information.

If you sign this form below, you authorize us to use your 2023 tax return for this designated purpose.

PLEASE BE ADVISED THERE IS TWO DIFFERENT CONSENT FORMS, THE FORMS MAY LOOK SIMILAR, BUT PLEASE REVIEW AND COMPLETE BOTH TO CONTINUE AND COMPLETE SUBMITING YOUR INFORMATION.

CONSENT TO USE OF TAX RETURN INFORMATION

Federal law requires this consent form to be provided to you. Unless authorized by law, we cannot use, without your consent, your tax return information for purposes other than the preparation and filing of your tax return.

You are not required to complete this form. If we obtain your signature on this form by conditioning our services on your consent, your consent will not be valid. Your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year.

For your convenience, we have entered into arrangements with certain financial institutions and their partners regarding the provision of bank accounts, refund settlement products, card services, and/or related banking services. To determine whether these services may be of interest to you, we will need to use your tax return information.

If you sign this form and check the box below, you authorize us to use your 2025 Tax Return for the designated purpose.
I authorize Gemini Financial Solutions & Tax to use my entire 2025 Tax Return and information collected during the preparation of my taxes to ensure that any refund settlement products and related banking services that I obtain or apply for can be issued, processed, underwritten, and serviced.

The foregoing activities and related services may be performed by one of the following companies and/or their affiliates: Santa Barbara TPG.
Taxpayer’s Signature    Signature*   Date*
Taxpayer’s Name (print):    First Name*   Last Name*
Spouse’s Signature:   Signature   Date
Spouse's Name (print):   First Name   Last Name

If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by email at complaints@tigta.treas.gov

CONSENT TO DISCLOSURE OF TAX RETURN INFORMATION

Federal law requires this consent form to be provided to you. Unless authorized by law, we cannot disclose, without your consent, your tax return information to third parties for purposes other than the preparation and filing of your tax return. If you consent to the disclosure of your tax return information, Federal law may not protect your tax return information from further use or distribution.

You are not required to complete this form. Because our ability to disclose your tax return information to another institution affects the service that we provide to you, we may change the terms of service that we provide to you if you do not sign this form. If you agree to the disclosure of your tax return information, your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year.

You have indicated that you are interested in obtaining a bank account, refund settlement product, card service, and/or related banking services. These products are made available through arrangements that we have with financial institutions and their partners. To apply for and obtain any of these products or services, we may forward your information to these companies and/or their affiliates.
If you sign this form and check the box below, you authorize us to disclose your 2025 Tax Return for the designated purpose.

I authorize Gemini Financial Solutions & Tax to disclose my entire 2025 Tax Return and information collected during the preparation of my taxes to ensure that any refund settlement products, and related banking services that I obtain or apply for can be issued, processed, underwritten, and serviced. The foregoing activities and related services may be performed by one of the following companies and/or their affiliates: Santa Barbara TPG.
Taxpayer’s Signature:     Signature*   Date*
Taxpayer’s Name (print):   First Name*   Last Name*
Spouse’s Signature:    Signature   Date
Spouse's Name (print):       First Name   Last Name

If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by email at complaints@tigta.treas.gov

Due Diligence

The United States Congress, in response to significant tax fraud arising from the decision to distribute federal social welfare program benefits through tax returns, has imposed new, extensive due diligence requirements on paid tax return preparers whose clients claim certain tax credits. These new requirements, combined with the already stringent measures previously implemented by the Internal Revenue Service (IRS), compel tax preparers to rigorously question and verify their clients' eligibility for credits such as the Earned Income Credit (EIC), Child Tax Credit (CTC), Additional Child Tax Credit (ACTC), and Head of Household (HOH) status. If you intend to claim the Earned Income Credit (EIC), Child Tax Credit (CTC), Additional Child Tax Credit (ACTC), Head of Household (HOH) status, and/or the American Opportunity Credit (AOC) on your 2023 tax return, please complete this questionnaire.
Does any one else live in the home that is not listed above?*

Yes (Please answer the following question.)No
Please advise who else lives in the home and the relationship to the taxpayer. *
If claiming dependents, are you the custodial parent or the non-custodial parent who received Form 8332 (Release/Revocation of Claim to Exemption for Child by Custodial Parent) from the custodial parent to release the qualifying credits?*

YesNo
If claiming dependents, did they reside/live in your home for more than half of the year? (If you are not claiming dependents, please enter N/A in the box below.)*
If claiming dependent children, please advise the location of the other parent. (If you are not claiming dependents place an N/A in the box below.)*
If claiming dependent child(ren) who are not your biological child(ren), please advise why the parents are not claiming the child(ren). (If you are not claiming dependents place an N/A in the box below.)*
In the event the IRS ask for supporting documents to support the claim of Head of Household, Earned Income Credit, and/or Child Tax Credit. Will you be able to provided the required documents? (You can submit the documents below)*

YESNO
LEASE OR UTILITY BILL:

Cancelof
Has the IRS disallowed or reduced a Earned Income Credit, Child Tax Credit, Additional Child Tax Credit, or American Opportunity Credit claimed by you and/or spouse on a past tax return?*

YesNo
Income/Expenses

Please make sure you answer all questions accurately and truthful.

Tax Refund Details
Would you like to pay your tax preparation fees out of your refund?*
Please select your refund disbursement option:*
If requesting a checks please note there is a $36 fee
Would you like to apply for a Advance on your refund? *
* Conditions apply, subject to bank approval. **Advances are available until Februrary 28th
Do you receive your 2024 Tax Refund? *
Do you owe any delinquent balances with any State or Government Agencies. (Please answer honestly, so you may receive the proper assistance)*

IRS - Back TaxesChild SupportStudent LoansState TaxesOtherNot Applicable
I authorize and grant full written and verbal permission to Gemini Financial Solutions & Tax and its employees/agents/representatives to contact the American Offset Debt Line/Treasury Offset Program on my behalf. This is to determine if I have any non-tax debt that may offset my current tax return. The contact number for the Offset Debt Line is 1-800-304-3107.

Signature*
If you have selected Direct Deposit as your refund disbursement option, please fill in information below:

Bank Name:   Type a label
Bank Routing Number:
Bank Account Number:

I certify, the banking information I have entered above is the correct banking information I wish to have my tax refund deposited.

In addition, I understand that once the tax return has been transmitted to and accepted by the IRS, no changes can be made to the bank payout options.

  Signature*

PLEASE UPLOAD A VALID UNEXPIRED ID FOR TAXPAYER:*

Cancelof
PLEASE UPLOAD A VALID UNEXPIRED ID FOR SPOUSE:

Cancelof
PLEASE UPLOAD A VALID SOCIAL SECURITY CARD FOR TAXPAYER:*

Cancelof
PLEASE UPLOAD A VALID SOCIAL SECURITY CARD FOR SPOUSE:

Cancelof
PLEASE UPLOAD A SELFIE PHOTOGRAPH OF YOURSELF:*

Cancelof
PLEASE UPLOAD A SELFIE PHOTOGRAPH OF SPOUSE:

Cancelof
UPLOAD ALL REQUIRED TAX DOCUMENTS:

Cancelof
IF UNABLE TO UPLOAD ALL DOCUMENTS SEND VIA EMAIL TO INFO@GEMINITAXES.COM PLEASE INCLUDE YOUR FIRST & LAST NAME AND LAST 4 OF SOCIAL IN THE SUBJECT LINE
By signing below, I certify that all information I have provided is true, correct, and complete to the best of my knowledge. Based on this information, I understand that Gemini Financial Solutions & Tax and its agents are not responsible for any delays in my refund caused by incorrect information (e.g., social security numbers, names, or dates of birth) provided by the taxpayer. I request that my tax return be prepared based on the information I have provided. *

Clear

WHAT TO EXPECT AFTER SUBMITTING FORM...

***TAKE A PICTURE AND SAVE THIS INFORMATION***
Once you have completed the intake and submitted all necessary documents. I will receive a instant email notification of your submission.

In order to be placed on the waiting list YOU MUST HAVE ALL REQUIRED DOCUMENTS & INFORMATION SUBMITTED.

If you are missing anything, you will receive an email notifying you of the necessary documents. You will not be placed in line to be serviced until I have received eveything required to complete the return.

Once I have completed the return, you will be contacted in order to go over details of your tax return.

Once I have your consent to file, I will send you the Customer Portal for your signature. You will need to create a login for access. Once the return is signed we will submit to the IRS, and a copy will be place in the customer portal. Please download a copy for your own records.

Please note the IRS generally takes 21 business days to process a return. If the return has EITC or CTC on the return the IRS will not process until AFTER February 15th.

If you have any additional questions my contact information is

Gina Taylor

2231 Singleton Blvd Ste 103

Dallas, Texas 75212

Office Hours:

Monday - Thursday 10 am -7 pm

Friday & Saturday 10 am - 3 pm

Email: info@geminitaxes.com

Phone number: 214.769.2842

(If you text or email please always provide your full name)
HOW DID YOU HEAR ABOUT GINA TAYLOR
IF REFERRED BY A FRIEND, PLEASE ADVISE NAME AND PHONE NUMBER.
Should be Empty:

	DEPENDENT 1	DEPENDENT 2	DEPENDENT 3	DEPENDENT 4
DEPENDENT NAME AS LISTED WITH SOCIAL SECURITY (INCLUDE SUFFIX)
SOCIAL SECURITY NUMBER (XXX-XX-XXXX)
DATE OF BIRTH (MM/DD/YYYY)
RELATIONSHIP TO TAXPAYER
MONTHS LIVED IN HOME? (EX. 12 MONTHS)
FULL TIME STUDENT?

Client In-Take Form

CLIENT INTAKE FORM

CHILD/DEPENDENT CARE EXPENSES

Due Diligence

Income/Expenses

Tax Refund Details

WHAT TO EXPECT AFTER SUBMITTING FORM...