CLIENT INTAKE FORM

CLIENT INTAKE FORM
Taxpayers Email*
example@example.com
Taxpayers Name*

First NameLast Name
Taxpayer's SSN*
Taxpayer's Date of Birth*
Example: 01/01/2001
Taxpayer's Phone Number*
Example: xxx-xxx-xxxx
Taxpayer's Job Title
Spouse

First NameLast 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
Spouse's Job Title
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How many dependents are you claiming?*
Dependent #1

First NameLast Name
Dependent #1 Date of Birth
01/01/2001
Dependent #1 SSN
How many months did Dependent #1 live with you in 2024? (If all year, enter 12)
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.)?
How many months did Dependent #2 live with you in 2024? (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
How many months did Dependent #3 live with you in 2024? (If all year, enter 12)
What is Dependent #3's Relationship to you (son, daughter, etc.)?
Were you or any of your dependents in college in 2024?

YesNo
Are there any dependents in daycare? If yes, please upload the form you received from your daycare provider.

YesNo
Are you trying to buy a new home within the next 2 years?*

YesNo
Are you interested in Credit Repair*

YesNo
Are you self employed?*

YesNo
What is your marital status as of December*

Single (Not Married)Married living with SpouseMarried not living with spouse
Did you and your spouse live apart during the year?*

YesNoNot Applicable
If yes, did you live together at any time after June 30, 2019?*

YesNoNot Applicable
Did you support a child or family member for more than 6 months out of the year?*

YesNo
Did you pay over half the expenses of maintaining your residence for the entire year?*

YesNo
Are you on any Government Assistance*

YesNoNot Applicable
Can someone else claim you as a dependent?

YesNo
Did you have health insurance in 2024 through the marketplace?

YesNo
Did you trade any Virtual Currency

YesNo
CLIENT NON-PAYMENT/OFFSET CLAUSE

At Zero Fuss Deals, we are committed to assisting all our clients with their tax-related needs. However, we understand that unforeseen circumstances may arise. If your tax refund is offset by the IRS, student loans, child support, or if your check is mailed to you, you are still responsible for paying the fees associated with the preparation and filing of your tax return.

By signing this agreement, you acknowledge that failure to make full payment within 90 days will result in legal action being pursued to resolve the outstanding balance.
Primary Taxpayer's Signature

Clear
Date

MonthDayYear
Date
I hereby authorize Zero Fuss Taxes to prepare all necessary forms related to my tax return, apply for and secure Refund Anticipation Checks (RACs) and Refund Anticipation Loans (RALs) on my behalf, and to sign and electronically file my tax return. I acknowledge and accept full responsibility for the accuracy of the information provided on this form. I understand that ZFD Consulting LLC, along with its affiliates, will not be held liable for any misrepresentation or false claims related to my tax return.
Primary Taxpayer's Signature

Clear
Date

MonthDayYear
Date
Spouse's Signature (If no spouse, leave blank)

Clear
Date

MonthDayYear
Date
TAXPAYER DRIVERS LICENSES

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SPOUSE DRIVERS LICENSES

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