Clone of Client Intake Form 2026

Returning Clients!!!

If you are a returning client you don't have to upload social security cards or birth certificates for dependents!!! If you are adding new dependent(s) please upload required documents!!!
How did you hear about us?
If someone referred you, please type his or her name here.
Tax Payers Name

First NameLast Name
Filing Status
HEAD OF HOUSEHOLD FILERS MUST PRESENT ONE OF THE FOLLOWING TO FILE THIS STATUS. PICK ONE OF THE 3 OPTIONS THAT YOU WILL SUBMIT TO BE APPROVED TO FILE HEAD OF HOUSEHOLD.
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Taxpayer's Phone Number
Example: xxx-xxx-xxxx
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Taxpayer's Driver's License

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Taxpayer's Social Security Card(s)

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Taxpayer's Date of Birth
Example: 01/01/2001
Taxpayer's SSN
Example: xxx-xx-xxxx
Taxpayer's Email Address
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
Are you self employed?
Do you have a side hustle? includes: Babysitting, selling plates, Uber, doordash, make-up & etc
Taxpayer's W-2/ 1099'S,1099k

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Did you support a child or family member for more than 6 months out of the year?
How many dependents are you claiming?
Dependent(s ) Social Security Card(s)

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Dependent(s) Birth Certificate(s)

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Proof of Residency For Dependent(s) Example: Records for school or childcare enrollment , government benefits, medical care showing your address and address of the dependent(s)

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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.)?
Dependent #2

First NameLast Name
Dependent #2 Date of Birth
Example: 01/01/2001
Dependent #2 SSN
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
Dependent's #3 SSN
What is Dependent #3's Relationship to you (son, daughter, etc.)?
Dependent #4

First NameLast 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.)?
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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Do you have health insurance through marketplace if so upload form 1095A?

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Did you have health insurance in 2025?
If you own your house, have you received form 1098 from your mortgage lender?
If you have your 1098 form, upload here.

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Were you or any of your dependents in college in 2025?
If you have a 1098-T form, upload it here.

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Do you owe debt to any Government Agency; such as IRS, Student Loans, Child Support etc?
Do you receive unemployment benefits?
Do you have a Identity Protection Pin (Ip Pin)? if so upload below

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Are you interested in ADVANCE LOAN? (APPROVAL IS BASED ON BANK)
How would you like to receive your tax refund?
Which type of account would you like your refund deposited into?

Other
Bank Account Number
Routing Number
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CLIENT NON PAYMENT/OFFSET CLAUSE

At Gipson Tax Service, 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.
I am giving Gipson Tax Service permission to prepare all forms related to my tax return; to file on my behalf; and file my taxes electronically. I take full responsibility for the accuracy of this form and understand that Gipson Tax Service and/or associated affiliates hold no responsibility for any misrepresentation or false claims.
Primary Taxpayer's Signature
Date

MonthDayYear
Date
Should be Empty:

Returning Clients!!!

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