Client Intake Form

Type of client

What tax year taxes do you need filed?

2024

Filing status

If you have dependents, how many?

Name* This field is required.

First Name

Last Name

Email* This field is required.

example@example.com

Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Phone Number* This field is required.

Please enter a valid phone number.

WHAT IS YOUR SOCIAL

Which credit(s) applies to you?If you check any we need it uploaded

I paid daycare or a nanny to care for my child 13 years or younger while I worked or looked for work. I can get a statement with their EIN/SSN to provide a claim

I attended college and paid eligible expenses that can be proven with a 1098T

I paid charity/tithe to a community organization or religious institutions

I have energy and solar power expenses

I sold or purchased a home

I adopted a child or had a baby

I got separated/divorced paid or received alimony

I receive unemployment

I worked a job this year

I started a business this year

I have self employment work

I have marketplace insurance (if so we need 1095a uploaded)

I have a IRS PIN (if so we need the newest uploaded)

I have casino winnings and forms to upload

File UploadUNEXPIRED DRIVERS LICENSE OR ID FOR ALL ADULTS, SOCIAL CARDS FOR ANYONE ON THE RETURN

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

Signature

File UploadUPLOAD ADDITIONAL DOCUMENTS Please upload one or more files into the area. Uploads will accept LPG, PNG, and PDF files only. You can select multiple files to upload for each section by shift or Ctrl clicking files in the prompt.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

File UploadUPLOAD ANY ADDITIONAL FORMS IRS PIN, RECEIPTS, DAYCARE FORMS, ANY FORM THAT WILL HELP US COMPLETE A ACCURATE RETURN

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

How did you hear about Powers Tax & Insurance?We offer $25 referral!

How do you want to be contacted when we complete your return?* This field is required.

phone call

Text

Signature

Date

Client Intake Form