Tax Client Intake Form

Tax Client Intake Form

Robinson Tax & Accounting Services
Taxpayer Information
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Tax Year
Did you file with us last year?
Marital Status
Filing Status
Social Security Number
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Are you a U.S. Citizen or green card holder?
Occupation
Are you filing an eligible spouse on your return?
Are you a full-time student?
Are you totally and permanently disabled?
Are you legally blind?
Are you eligible to be claimed as a dependent by any other person(s)?
Do you have a Tax ID PIN?
Proof Of ID: Drivers License, Passport, ID Card

Cancelof
Tax ID PIN

Cancelof
Spouse & Dependents Information
Spouse Name

First NameLast Name
Spouse Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Spouse's Social Security #
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Is your spouse a full-time student?
Is your spouse totally and permanently disabled?
Is this individual a dependent of another?
Are you claiming any dependents?
Dependent Information
Dependent 1 Name, Dependent 1 Social Security #, Dependent 1 Date of Birth, Dependent 1 Relationship:
Dependent 1 Birth Certificate(s)

Cancelof
Dependent 1 Social Security Card(s)

Cancelof
Dependent 1 Report Card(s)

Cancelof
Dependent 2 Name, Dependent 2 Social Security #, Dependent 2 Date of Birth, Dependent 2 Relationship:
Dependent 2 Birth Certificate(s)

Cancelof
Dependent 2 Social Security Card(s)

Cancelof
Dependent 2 Report Card(s)

Cancelof
Dependent 3 Name, Dependent 3 Social Security #, Dependent 3 Date of Birth, Dependent 3 Relationship:
Dependent 3 Birth Certificate(s)

Cancelof
Dependent 3 Social Security Card(s)

Cancelof
Dependent 3 Report Card(s)

Cancelof
Dependent 4 Name, Dependent 4 Social Security #, Dependent 4 Date of Birth, Dependent 4 Relationship:
Dependent 4 Birth Certificate(s)

Cancelof
Dependent 4 Social Security Card(s)

Cancelof
Dependent 4 Report Card(s)

Cancelof
If any of your dependents are disabled list them here:
Tax Related Questions
Employment Status
Is this your first time opening a pre-tax account?
Does your dependents have tuition expenses?
Are you currently renting?
What is the monthly rental amount?
Do you own your home?
Do you have documents that show you paid for property taxes?
How long have you lived at the property?
Did you take money from your 401?
Do you have mortgage interest?
Do you have real estate tax?
Did you receive a federal tax last year?
Are you a victim of identity theft?
Income
Please select all forms of income in the current tax year:
Expense
Please select which other expenses pertain to you:

General Expenses

Rows	Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses

Total Expenses
Upload expense evidence here:

Cancelof
Did you have health insurance through the Marketplace?
Do you have expenses from a business?
Do you have receipts and documentation for the expenses?
Upload the documents of business expenses?

Cancelof
Upload Form 1095-A

Cancelof
Dependent(s) 1095-A Form

Cancelof
Driver License, Passport, ID Cards

Cancelof
Bank Information: Routing and Account Number

Cancelof
Would you like a tax advance?
Upload W2 Form

Cancelof
Additional Tax Documents

Cancelof
Authorization & Consent
- I confirmed that all information I entered here is accurate and true.
- I allow Robinson Tax & Accounting Services to capture my sensitive data like personal id, government id, social security number (SSN), and other information.
- I have read the terms and conditions and privacy policy of Robinson Tax & Accounting Services.
- By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Taxpayer Signature
Date Signed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Spouse Signature
Date Signed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Tax Client Intake Form

Taxpayer Information

Spouse & Dependents Information

Dependent Information

Tax Related Questions

Income

Expense

Authorization & Consent