Prestige Tax Client Intake Form

CLIENT INTAKE FORM
Thank You for taking the time to complete your Client Intake Form.

This information is critical to ensure your tax return is filed accurately. Please take your time and review all information before you submit. Please note that if documents are missing or information is incorrect this will result in a delay in processing your return.

This intake form will take 20- 30 minutes to complete.

Please upload all documents required. Note that is is best to wait until you have ALL of your documents before submitting this form.

Please complete this form in its ENTIRETY and click SUBMIT when finished.

If you have any questions while completing this form, please reach out to your Tax Preparer for assistance!

Thank you for business and we look forward to working with you!
Taxpayer Information
How did you hear about us?*

FacebookInstagramReferralOther
If someone referred you, please type his or her name here:
Tax Preparer Name*
Taxpayer Name*

First NameLast Name
Taxpayer Phone Number*
Example: xxx-xxx-xxxx
Taxpayer Job Title*
Taxpayer Email Address*
example@example.com
Taxpayer Date of Birth*
Example: 01/01/2001
Taxpayer SSN*
Example: xxx-xx-xxxx
Taxpayer Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you Married and Filing Taxes Jointly with your Spouse?*

YesNo

Spouse Information
Spouse Name (Only enter spouse information if Married Filing Jointly)

First NameLast Name
Spouse Phone Number
Example: xxx-xxx-xxxx
Spouse Job Title
example@example.com
Spouse Email Address
Example: example@example.com
Spouse Date of Birth
Example: 01/01/2001
Spouse SSN
Example: xxx-xx-xxxx

Dependent Information
How many dependents are you claiming?*
Complete Dependent Information for Each Dependent Below
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 2023? (If all year, enter 12)
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.)?
How many months did Dependent #2 live with you in 2023? (If all year, enter 12)
Dependent #3

First NameLast Name
Dependent #3's Date of Birth
01/01/2001
Dependent #3s SSN
Example: xxx-xx-xxxx
What is Dependent #3's Relationship to you (son, daughter, etc.)?
How many months did Dependent #3 live with you in 2023? (If all year, enter 12)
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.)?
How many months did Dependent #4 live with you in 2023? (If all year, enter 12)
Dependent #5

First NameLast 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 2023? (If all year, enter 12)
Upload a copy of Dependent(s) SSN Card & Birth Certificate here:

Cancelof
Did you pay any child/dependent care expenses for a child under 13 years old or costs to care for a handicapped individual?

YesNo
If yes, please upload the form(s) you received from your daycare or healthcare provider here:

Cancelof
Did you receive dependent care benefits from your employer in 2023?

YesNo
Are you able to provide Proof of Residency for each Dependent you are claiming to validate that each dependent resided with you for at least 6 months in 2023?
Valid Proof of Residency includes a lease with dependents name listed, schools records, medical records, or letter from government agency with address that matches taxpayer's address.
If yes, upload Proof of Residency document(s) here:

Cancelof

End
Filing Questions
Were you previously issued an Identity Protection Pin (IPPIN) by the IRS?*

YesNo
If yes, enter your IPPIN here:
Are you interested in AUDIT PROTECTION?*

YesNo
Are you interested in a Refund Advance Loan?*
A refund advance loan is a short-term loan that is taken out against your tax refund. If you’re approved, you’ll receive your loan money before the IRS processes your tax return—and sometimes as soon as the day you file your taxes. Usually, you only get a loan for part of your tax refund. It’s unlikely you’ll be approved for a loan for your entire tax refund. There are fees associated with these loans. If you select, yes, your tax preparer will provide you will more details.
How would you like to receive your tax refund?*

Direct DepositCheck via mail
If Direct Deposit, which type of account would you like your refund deposited into?
NOTE: It is very important that you provide bank account information for an account you plan to have open long term. Once bank information is submitted on your return, we are unable to change the information. In the case that the account is no longer active at the time of refund disbursement, the IRS will mail out a check on the address listed on your tax return. This can delay your tax return significantly!
Name of Bank
Routing Number
Bank Account Number
Upload Proof of Bank Account

Examples of Proof include Direct Deposit Form or screen shot of banking info from bank app
Cancelof
Acknowledgement & Consent
CLIENT NON-PAYMENT/OFFSET CLAUSE

At Prestige Tax & Financial Services, 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.

By signing this agreement you acknowledge that if payment is not made in full within 30 days legal actions will be sought to resolve payment.
ACKNOWLEDGEMENT & CONSENT

By signing this agreement, I am giving Prestige Tax & Financial Services LLC permission to prepare all forms related to my tax return. To apply for and secure RAC's and RAL's on my behalf, sign all necessary forms and file my taxes electronically. I acknowledge that all information provided is accurate and true. I take full responsibility for the accuracy of this form and understand that by signing this agreement Prestige Tax & Financial Services LLC and/or associated affiliates hold no responsibility for any misrepresentation or false claims. I also confirm that I can provide all documentation associated with my tax return and proof of eligibility of any credits or deductions if requested by the IRS.
REMINDER

Note that we are unable to complete your tax return without this form being completed in its entirety and all supporitng documentation has been received.

Before submitting this form, please ensure you have answered all applicable questions and uploaded all applicable forms, if you are unable to upload all forms at this time, please take note of which forms you require based on the questions for which you answered "yes", gather your documents and come back to complete the form or email directly to your tax preparer as soon as possible.
Primary Taxpayer's Signature

Clear
Date

MonthDayYear
Date
Spouse's Signature (if applicable)

Clear
Date

MonthDayYear
Date
Email Address (PDF) Jotform
example@example.com
Should be Empty:

CLIENT INTAKE FORM

Taxpayer Information

Dependent Information

Income

Housing Information:

Health Information

Retirement Information

Education

Miscellaneous Information

Itemized Deductions

Filing Questions

Acknowledgement & Consent