Client Intake Form

  • Client Intake Form

  • Thank you for taking time to complete your 2022 Client Intake Questionnaire. For new clients, this information is critical to ensure we accurately file your tax return. For existing clients, we kindly request you provide this information again to ensure our records are 100% accurate and up to date.

  • IMPORTANT: UPON COMPLETION OF ALL APPLICABLE PARTS OF THIS FORM YOU MUST CLICK THE "SUBMIT" BUTTON AT THE END OF THE FORM TO SEND THIS INFO TO OUR OFFICE. CLOSING YOUR BROWSER BEFORE CLICKING THE "SUBMIT" BUTTON WILL DELETE ALL INFO WITHOUT SENDING IT TO US. IT SHOULD BE NOTED THAT UPON CLICKING THE SUBMIT BUTTON YOU WILL GET A CONFIRMATION EMAIL THAT WE RECEIVED YOUR INFO.

  • How did you hear about us or who referred you? If existing client leave blank
     

  • Years needing to file?
  • Taxpayer Date of Birth*
     - -
  • Format: (000) 000-0000.
  • Do you agree to receive communications by text messages?*
  • Were you previously issued an Identity Protection Pin (IP PIN) by the IRS?*
  • Can another taxpayer claim you as a dependent on their tax return?*
  • At anytime during 2022 did you receive, sell, exchange, or otherwise acquire any financial interest in any virtual currency?*
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  • Spouse Information

    If this does not apply to you scroll down and click next.
  • Are you Married Filing Joint or Married Filing Separate?*
  • Spouse Date of Birth
     - -
  • Format: (000) 000-0000.
  • Were your spouse previously issued an Identity Protection Pin (IP PIN) by the IRS?
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  • Dependent Information

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  • Are you claiming any dependents?*
  • Dependent 1 Date of Birth
     - -
  • Was dependent 1 permanently and totally disabled?
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  • Dependent 2 Date of Birth
     - -
  • Was dependent 2 permanently and totally disabled in?
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  • Dependent 3 Date of Birth
     - -
  • Was dependent 3 permanently and totally disabled?
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  • Dependent 4 Date of Birth
     - -
  • Was dependent 4 permanently and totally disabled?
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  • Did you pay daycare or someone to watch your dependents in order to work or go to school in 2022?
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  • Did you receive any advance child tax credit payments? (This was payments made to you from July 2021 until December 2021 if you did not opt out.)*
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  • Did you, your spouse, or any dependents attend college in 2022?*
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  • Did you, your spouse, or any dependents received health insurance through the Marketplace in 2022?*
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  • Did you or your spouse receive unemployment benefits in 2021?*
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  • Did you make any mortgage payments in 2022?*
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  • Did you or your spouse make payments on student loans in 2022?*
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  • Did you or your spouse pay any medical or dental expenses in 2022? (This does not include insurance premiums)*
  • Did you or your spouse own any rental properties?*
  • Did you or your spouse receive any gambling winnings in 2022?*
  • Did you or your spouse receive any social security benefits in 2022*
  • Did you or your spouse make any charitable contributions in 2022? (Goodwill, Salvation Army, local charity, church etc.)*
  • Did you or your spouse receive any earnings from interest or dividends in 2022?*
  • Did you or your spouse withdraw money from your 401k or IRA in 2022?*
  • Did you work as an independent contractor, gig worker, or freelancer? (Uber, Instacart, TaskRabbit, etc.)
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  • Business Owner Data Sheet

    If this does not apply to you scroll down and click next
  • Are you self-employed or own a business?*
  • Did you missing any days operating your business due to Covid-19?

  • Business Expense

    Complete to the best of your ability. In each field enter the approximate amount you spent in each category.
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  • Did you receive any of the following grants/loans:
  • If you received the ppp loan was this forgiven?
  • Do you or your spouse owe debt to any government agency such as: IRS, Student Loans, Child Support etc.?*
  • Would you like to apply for a refund advance up to $6,000? (ends on 2/28/2023)*
  • Would you like to add Audit Protection Plus to this return?*
  • Are you interested in credit repair and taking advantage of a bundle deal?*
  • How would you like to receive your tax refund?*
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  • If you have any questions do not hesitate to contact our office at 682-235-3212 or email us at info@lafrancoisenterprises.com

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