Tax Client Intake Form

Tax Client Intake Form
This is an all-in-one intake form, so not every section will apply to every client.

Please feel free to skip any fields that do not apply to you, or that we can pull directly from your uploaded documents.

This form does not have to be done in one sitting. You can save your progress at any time and continue later (scroll to the bottom, press "Save", then use either of the "Copy link" or "Enter email address" options). If you prematurely submit the form, not to worry, you will receive an email with an "Edit submission" link.
What tax year is being filed? (Skip this question if you are filing the most recent tax year)
Filing Status
Taxpayer Name

First NameMiddle NameLast NameSuffix
Driver License

Driver License #Expiration DateIssue DateState
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Occupation
SSN
Spouse Name

First NameMiddle NameLast NameSuffix
Driver License

Driver License #Expiration DateIssue DateState
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Occupation
SSN
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Provide banking info for Direct Deposit or Direct Debit

Bank NameRouting NumberAccount Number
Bank Account Type
If you own a business (Corporation, Partnership, LLC), provide your business banking info for Direct Deposit or Direct Debit

Bank NameRouting NumberAccount Number
Business Bank Account Type
IMPORTANT: If you own a Single-Member LLC, you must have a dedicated business bank account (separate from your personal accounts).
Did you pay any Federal and/or State quarterly estimated taxes or apply any of your prior year tax refund (not referring to payroll tax withholdings or what you paid with your prior year tax filing)?
Provide amounts and dates of Quarterly Estimated Tax Payments (be sure to specify Federal or State for each payment)
Was there any Paid Family Leave (Maternity and/or Paternity Leave) included in your W2?
Did Taxpayer perform a Backdoor Roth IRA conversion (not to be confused with a Mega Backdoor Roth Conversion via your Employer)?
Provide Date of Conversion to Roth

MonthDayYear
Date
Did Spouse perform a Backdoor Roth IRA conversion (not to be confused with a Mega Backdoor Roth Conversion via your Employer)?
Provide Date of Conversion to Roth

MonthDayYear
Date
Do you have an HSA in which you invest into index or mutual funds?
If Yes to the above, then provide amount of dividends and/or interest earned (these are taxable in the state of CA and NJ)
HSA Dividends/Interest Earned in the year
Select all that apply:

Dependent Information (part 1)

Rows	First Name (required) and Middle Initial (optional)	Last Name	SSN	Date of Birth	Relationship
1
2
3
4
5
6

Dependent Information (part 2)

Rows	Check box if child has opened a Trump Account	Check box if you would like to open a Trump Account (and have not already done so)	Check box if pilot program election has already been made	Check box if you would like to make the pilot program election (and have not already done so)
1
2
3
4
5
6

Day Care Provider for Children

Rows	Provider Name	TAX ID	Address	Amount Paid	Phone Number
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5
Dependent 6

Did you superfund a Qualified Tuition Plan (Sec 529)?
Amount of Superfunded Contribution

Do you receive compensation in the form of equity? Check all that apply:
Do you sell your equity-based compensation through E*TRADE/Morgan Stanley?
Number of ISOs Exercised
ISO Exercise Date

MonthDayYear
Date
ISO FMV When Exercised
ISO Strike/Exercise Price
Number of ISOs Sold (if different)
ISO Sale Date

MonthDayYear
Date
If multiple batches of ISOs were exercised and sold, please provide a summary of your ISO exercise/sale history:

Insurance Premiums (don't include premiums paid through your employer since those are already pretax)
Doctor, Dentist, Vision, Prescriptions
LT Care Insurance
Hospital, Ambulance
Mortgage Interest (provide 1098)
Mortgage Interest (provide 1098)
Property Tax (provide statements)
Property Tax (provide statements)
Vehicle License Fee (Tax portion only)
Prepaid Interest on Refinance of Home
Medicare Insurance Premiums (not payroll tax)
Cash Charitable Contributions (upload Tax ID and name of organization)
Non-cash donation (upload Tax ID and name of organization as well as Cost basis and FMV)
Did you install Solar electric generation or Qualified Energy property that meets Government energy standards during the tax year?
Did you purchase an all electric vehicle during the tax year?
If you purchased an electric vehicle, did you receive a Clean Vehicle Seller Report (Form 15400) and/or IRS Notice CP99A?
If yes, then provide description of energy property or vehicle, VIN, date purchased, and cost.

Did you (or your spouse, if applicable) receive tips?
Did you (or your spouse, if applicable) receive overtime compensation?
Did you secure a loan for a new vehicle purchased after December 31st, 2024?
Was the vehicle used for business purposes at any time?
Name(s) listed on the loan (if both you and your spouse are listed, provide who is listed first)
VIN
Loan Origination Date

MonthDayYear
Date
Outstanding Principal on Origination Date or Beginning of Year (whichever is earlier)
Total Vehicle Loan Interest Paid During the Year

Do not use this section if your unreimbursed expenses as an employee are less than 2% of your adjusted gross income. Otherwise, enter expenses below:
List types and total amounts of unreimbursed expenses

Did you sell any real estate during the year? If so, was it a primary residence, rental property, or both at one time or another?
If the property you sold was both a primary residence and rental property at one time or another, please provide dates and descriptions below:
Purchase Price
Dollar amount of Improvements over the years:
Closing Costs at time of Purchase
Sale Price
Closing Costs at time of Sale
CA FTB Withholding Payment
Date of Purchase

MonthDayYear
Date
Date of Sale

MonthDayYear
Date
Date it began as Primary Residence

MonthDayYear
Date
Date it became a Rental Property

MonthDayYear
Date
Foreign Tax Paid on Sale of Property (if rental was international)

If you have more than 2 rental properties, please submit an additional client intake form with just this section completed again.

If this is a rental property's first year being rented, upload the ALTA settlement statement or Closing Disclosure (even if the property was purchased in a prior year).

If a rental property's mortgage was refinanced during the year, upload a Closing Disclosure or other official statement showing the refinancing costs.
Rental 1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Rental 2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Number of Days Rented or advertised for Rent 1
Number of Days Rented or advertised for Rent 2
Number of Personal Days 1
Number of Personal Days 2
Date it originally became a Rental 1

MonthDayYear
Date
Date it originally became a Rental 2

MonthDayYear
Date
If you have a Profit and Loss report, Income Statement, or any other summary of revenue and expenses, please upload a copy to your client portal.
Rental 1 Income
Rental 2 Income
Advertising 1
Advertising 2
Cleaning & Maintenance 1
Cleaning & Maintenance 2
Insurance 1
Insurance 2
Legal and Professional 1 (which can include allocated portion of last year's tax prep fees)
Legal and Professional 2 (which can include allocated portion of last year's tax prep fees)
Management Fees 1
Management Fees 2
Repairs 1
Repairs 2
Mortgage Interest 1
Mortgage Interest 2
Supplies and Hardware 1
Supplies and Hardware 2
Property Tax 1
Property Tax 2
Utilities 1
Utilities 2
HOA 1
HOA 2
Other rental expenses not listed above (please specify types, total amounts, and whether expense is for Rental 1 or Rental 2)
For Capital Improvements, include date put into service
If you rented out a room or two in your primary residence, please provide details so we can properly calculate deductible expenses proportionately. How many rooms were rented? How many total rooms? Square footage of area rented vs. Square footage of entire home?
Provide Make, Model, and Year of Business Vehicle(s) Used for Rental Property Activities (if any)
Date Vehicle 1 Was First Used For Rental Property Activities

MonthDayYear
Date
Date Vehicle 2 Was First Used For Rental Property Activities

MonthDayYear
Date

Vehicle Mileage and Expenses (if used for rental property activities)

Rows	Vehicle 1	Vehicle 2
Business Mileage
Commuting Mileage
Personal Mileage
Gas or Fuel
Auto Insurance
Registration (do not include tax portion of Vehicle License Fee)
Parking and Tolls
Maintenance and Repairs
Purchase Price (only if using actual expense method)
Loan Interest
Lease Payments

If you have multiple businesses, please submit an additional client intake form with just this section completed again for each business.
Employer Identification Number
Business Name (if a separate business name is used)
Principal Business Activity
Secretary of State Number (LLC's only)
LLC Registration Date
If you have a Profit and Loss report, Income Statement, or any other summary of revenue and expenses, please upload a copy to your client portal.
Revenue/Sales
Advertising
Commissions and Fees
Contract Labor
Dues and Subscriptions
Business Meals
Insurance (not health)
Interest
Internet/Data
Legal and Professional (which can include allocated portion of last year's tax prep fees)
Licenses
Office Expense
Rent
Repairs
Supplies
Telephone
Utilities
Employee Wages (W-2)
Employer Portion of Payroll Taxes
Professional Licenses
Continuing Education
Travel
Other business expenses not listed above (please specify types and total amounts)
Self Employed Health Insurance - only if you are not covered by or do not have the ability to obtain health insurance through an employer (Taxpayer or Spouse)
(Single-Member LLCs only) Did the business make any quarterly estimated tax payments to the state? If so, provide amounts and dates of payments below:
If taking business use of home office, please select your preferred method:
Square Footage of Home Strictly Used for Business
Square Footage of Entire Home
Annual Rent Expense of Home (if not a homeowner)
Annual Property Tax (if homeowner)
Annual Mortgage Interest (if homeowner)
Annual Homeowners or Renters Insurance Premiums
Annual Home Utilities Expense (including internet and phone)
Annual Maintenance and Repairs Expense of Home
Other home expenses not listed above (please specify types and total amounts)
Provide Make, Model, and Year of Business Vehicle(s)
Date Business Vehicle 1 Was Put Into Service

MonthDayYear
Date
Date Business Vehicle 2 Was Put Into Service

MonthDayYear
Date

Business Vehicle Mileage and Expenses

Rows	Vehicle 1	Vehicle 2
Business Mileage
Commuting Mileage
Personal Mileage
Gas or Fuel
Auto Insurance
Registration (do not include tax portion of Vehicle License Fee)
Parking and Tolls
Maintenance and Repairs
Purchase Price (only if using actual expense method)
Loan Interest
Lease Payments

Entity Structure
Entity Information (part 1)

Name of BusinessPhoneEIN (Employer ID Number)
Entity Information (part 2)

EmailDesignated Partner/Shareholder
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Principal Business Activity
Principal Product or Service
Business Code
Method of Accounting
State of Incorporation
State ID Number
Date Formed or Incorporated

YearMonthDay
Date
If S-Corporation, Effective Date of Election

YearMonthDay
Date
If an S-Corporation, are Shareholders/Officers paid a reasonable salary?
List amount of distributions/draws taken by shareholders (Not W2 wages)
List amount of contributions made by shareholders (and if noncash, include description of property)

Principal Shareholders or Partners or LLC Members

Rows	Name	Tax ID Number/SSN	Address	Ownership %
1
2
3
4

Did the Shareholder or the Entity make any Federal or State quarterly estimated tax payments? If so, provide amounts and dates of payments below:

Even if you have responded to all questions above, we still need you to upload all tax forms and supporting documents to your SmartVault Secure Client Portal at bayareacpa.smartvault.com

If applicable, upload the following to the Client Source Documents Folder:

(Common forms are outlined in red. Please upload all forms that apply, as well as any tax forms you received that may not be listed below)

Driver Licenses

Prior Year Tax Return (if not completed by this office)

W-2, Employment Wages

1095-A, Health Insurance Marketplace Statement

1098, Mortgage Interest and Property Tax Statements

1098-E, Student Loan Interest

1098-T, Tuituion

K-1 and supplemental statement

1098-C, Donations of Vehicles

1098-F, Fines and Penalties

1098-MA, Mortgage Assistance

1098-Q, Qualifying Longevity Annuity

1099-A, Acquisition or Abandonment of Secured Property

1099-B, Proceeds From Broker and Barter Exchange Transactions

1099-C, Cancellation of Debt

1099-CAP, Changes in Corporate Control and Capital Structure

1099-DIV, Dividends and Distributions

1099-G, Certain Government Payments

1099-H, Health Coverage Tax Credit (HCTC) Advance Payments

1099-INT, Interest Income

1099-S, Proceeds from Real Estate Transactions

1099-K, Merchant Card and Third Party Network Payments

1099-LTC, Long-Term Care and Accelerated Death Benefits

1099-NEC, Non Employee Compensation

1099-MISC, Miscellaneous Income

1099-OID, Original Issue Discount

1099-PATR, Taxable Distributions Received From Cooperatives

1099-Q, Payments From Qualified Education Programs (Under Sections 529 and 530)

1099-R, Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.

1099-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA

5498 - Brokerage Account Annual Statement

Supplemental Stock Transaction Documentation for Adjusted Cost basis

*If you are a Business Client or Self-Employed/Sole-Proprietor, we will need your Profit & Loss Statement and Balance Sheet as of 12/31*
Please provide additional comments about your situation that you'd like our office to know.
Please let us know via email when you have uploaded all your current year tax documents, prior year tax filing, driver licenses, and any other documentation you need us to look at.
Signature
Signature
Date

MonthDayYear
Date
Date

MonthDayYear
Date

Should be Empty: