2025-Military Client Intake Form

🪖1. TAXPAYER INFORMATION
What tax year are you requesting to file?*
Choose the filing status that best matches your situation on December 31 of the tax year.*
Full Legal Name*

First NameLast Name
SSN*
Please enter a valid phone number.
Taxpayers Driver’s License / State ID Information*
Do you have an IRS Identity Protection PIN (IP PIN)?*

YesNo
What is your IRS Identity Protection PIN (IP PIN)?
An IP PIN is a 6-digit number assigned by the IRS each calendar year to help protect your tax account from identity theft.
Date of Birth*

MonthDayYear
Date
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Current Mailing Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Are you Active Duty, Reservist, or Veteran?*
Branch of Service*
Rank / Pay Grade*
Date Entered Service*

MonthDayYear
Date
Date Separated (if applicable)

MonthDayYear
Date
Reservist / National Guard Travel Information*
Do you have Unreimbursed Employee Expenses during the tax year?*

YesNo
Other Unreimbursed Employee Expenses*
Upload Your Unreimbursed Employee Expenses*

Cancelof
Were you deployed during the tax year?*

YesNo
Where were you deployed?
Were you in a combat zone receiving combat pay?*

YesNo
Were you stationed overseas during the year?*

YesNo
Duty Station as of December 31 of the tax year*
Home of Record (State) on LES*
Current State of Residence*
Did you or your spouse move / PCS during the tax year?*

YesNo
Did YOU get promoted during the tax year?*

YesNo
From what state did you move?*
What is your new duty station / residence state?*
What state(s) do YOU claim for Military Spouse Relief Residency Act (MSRRA) purposes?
Upload YOUR most two recent Leave & Earnings Statement (LES) and any relevant Military Orders*

Cancelof
Did you receive a military W-2?*

YesNo
Did you receive other W-2s from civilian jobs?*

YesNo
Upload all W-2s military & civilan jobs.*

Cancelof
Did you receive bonus, hazard, or special duty pay?*

YesNo
Did you receive VA Disability Compensation?*

YesNo
Did you have 1099 income (contract work, side jobs, or business)?*

YesNo
💰Profit & Loss Statement (Income & Expenses Summary)

Enter your total business income and expenses for the tax year. This section applies to self-employed individuals, freelancers, and independent contractors who receive Form 1099-NEC or 1099-MISC. Include all income from your trade or business and list ordinary and necessary business expenses you paid during the year to operate your business.
Profit & Loss Statement (Business Income & Expenses)*
Business Expense Categories*
Vehicle for Business Use (per vehicle)

Standard Mileage Method — You claim a set rate per business mile driven (for 2024 = 67¢ per mile). This covers gas, oil, maintenance, depreciation, and insurance automatically. ✅ Easiest to track (only need total business miles). 🚫 Cannot use if you’ve claimed depreciation or Section 179 on this same vehicle before.Actual Expense Method — You deduct the business % of all actual vehicle costs (fuel, maintenance, insurance, lease, etc.). ✅ More detailed, may give a higher deduction. 🚫 Requires accurate receipts and a calculated business-use percentage.
Vehicle Mileage Method (“Standard Mileage”)*
Vehicle Actual Expense Method*
Upload 1099s, expense reports, receipts, and or bookkeeping summaries

Cancelof
Are you contributing to a TSP (Thrift Savings Plan) or other retirement account?*

YesNo
🪖2. SPOUSE INFORMATION
Spouse Full Name*

First NameLast Name
Spouse SSN*
Please enter a valid phone number.
Spouse Driver’s License / State ID Information*
Does your SPOUSE have an IRS Identity Protection PIN (IP PIN)?*

YesNo
What is your SPOUSE IRS Identity Protection PIN (IP PIN)?
An IP PIN is a 6-digit number assigned by the IRS each calendar year to help protect your tax account from identity theft.
Spouse Date of Birth*

MonthDayYear
Date
Are you married to a service member?*

YesNo
Is your spouse Active Duty, Reservist, or Veteran?*
Spouse Branch of Service*
Spouse Rank / Pay Grade*
Date Entered Service*

MonthDayYear
Date
Date Separated (if applicable)

MonthDayYear
Date
Reservist / National Guard Travel Information*
Does your Spouse have Unreimbursed Employee Expenses during the tax year?*

YesNo
Other Unreimbursed Employee Expenses*
Upload Spouse’s Unreimbursed Employee Expenses*

Cancelof
Did your spouse get promoted during the tax year?*

YesNo
Was your spouse deployed during the tax year?*

YesNo
Spouse Deployment location(s)
Was the Spouse deployed to a combat zone?*

YesNo
Was your spouse stationed overseas during the year?*

YesNo
Spouse’s Home of Record (State)*
Spouse’s Current State of Residence*
What state(s) does SPOUSE claim for Military Spouse Relief Residency Act (MSRRA) purposes?
Upload Spouse’s most two recent Leave & Earnings Statement (LES) and any relevant Military Orders*

Cancelof
Did your Spouse receive a military W-2?*

YesNo
Did your Spouse receive other W-2s from civilian jobs?*

YesNo
Upload all your Spouse W-2s military & civilan jobs.*

Cancelof
Did your Spouse receive bonus, hazard, or special duty pay?*

YesNo
Did your Spouse receive VA Disability Compensation?*

YesNo
Did your Spouse have 1099 income (contract work, side jobs, or business)?*

YesNo
💰Spouse Profit & Loss Statement (Income & Expenses Summary)

Enter your total business income and expenses for the tax year. This section applies to self-employed individuals, freelancers, and independent contractors who receive Form 1099-NEC or 1099-MISC. Include all income from your trade or business and list ordinary and necessary business expenses you paid during the year to operate your business.
Spouse Profit & Loss Statement (Business Income & Expenses)*
Spouse Business Expense Categories*
Spouse Vehicle for Business Use (per vehicle)

Standard Mileage Method — You claim a set rate per business mile driven (for 2024 = 67¢ per mile). This covers gas, oil, maintenance, depreciation, and insurance automatically. ✅ Easiest to track (only need total business miles). 🚫 Cannot use if you’ve claimed depreciation or Section 179 on this same vehicle before.Actual Expense Method — You deduct the business % of all actual vehicle costs (fuel, maintenance, insurance, lease, etc.). ✅ More detailed, may give a higher deduction. 🚫 Requires accurate receipts and a calculated business-use percentage.
Spouse Vehicle Mileage Method (“Standard Mileage”)*
Spouse Vehicle Actual Expense Method*
Upload Your Spouse 1099s, expense reports, receipts, and or bookkeeping summaries

Cancelof
Did YOU or SPOUSE have Unemployment 1099G income?)?*

YesNo
🧩3. Unemployment Income

Report any unemployment compensation you or your spouse received during the tax year. The IRS issues Form 1099-G for these payments. Include both federal and state unemployment benefits, even if taxes were withheld.
Unemployment Income*
Upload Form 1099-G or Unemployment Payment Statement(s):

Cancelof
Did you or your spouse receive other 1099 Income & Retirement Distribution income during the tax year? (Proof of income or benefits for adult dependents 1099-K, 1099-DIV, 1099-INT, 1099-R (retirement), SSA-1099 (Social Security), and any other 1099 type not mentioned.)*

YesNo
💵4. 1099 Income & Retirement Distsribution Information

List all 1099 income forms received by you and/or your spouse during the tax year. Indicate who the form belongs to and, if applicable, whether any retirement distributions were taken before age 59½. You’ll upload the actual 1099 forms in the next section for verification.
1099 Summary*
Upload all 1099 forms and retirement/rollover proofs:

Cancelof
Is Your Spouse contributing to a TSP (Thrift Savings Plan) or other retirement account?*

YesNo
👨‍👩‍👧‍👦 5. DEPENDENTS

List all dependents (children or qualifying relatives) you plan to claim on your tax return. Include their full legal names, dates of birth, relationship to you, months lived with you, and support information
Do you have dependents you’ll be claiming on your tax return?*

YesNo
How Many Dependent(s) (NOT parents/adult relatives) will you be claiming on your tax return?
Dependent(s) (NOT parents/adult relatives) details*
Did you pay childcare expenses for this dependent (under age 13)?*

YesNo
Childcare Provider Details*
Do you provide over 50% support for a parent or adult relative?*

YesNo
Dependent (s) Over 50% of Support for a Parent or Adult Relative Support Details *
Upload Dependent Verification Documents - Examples of acceptable documents: Birth certificate or adoption papers (to prove relationship) • School or medical records showing the dependent’s address (to prove residency) • Lease, rent receipts, or bills showing you provided more than half their support • Proof of income or benefits for adult dependents

Cancelof
Are you or your spouse enrolled in college at least part-time?*
(6 or more credit hours per semester)
📕6. Education Expenses & Student Enrollment (AOTC Eligibility)

Used to determine if you, your spouse, or your dependent qualifies for the education credit
AOTC Student Information (per student)*
Upload 1098-T, proof of enrollment & expenses:

Cancelof
💡7. Additional Deductions & Tax Credits
Did you pay medical expenses not covered by TRICARE?*

YesNo
Did you donate to charities?*

YesNo
Are you a homeowner (mortgage interest, property taxes)?*

YesNo
Are you a business owner/employer with veterans on payroll (for WOTC credit)?*

YesNo
Upload valid Military ID (front only)*

Cancelof
Upload any additional 1099s, W-2s, or documents relevant to this year

Cancelof
Upload any mortgage and property tax statements

Cancelof
Did you own or rent out any real estate or receive rental income this year?*

YesNo
🏠8. Real Estate Property Information

Enter information for each rental or investment property you owned during the tax year. Include income, expenses, and days used personally vs. rented. Accurate details ensure proper depreciation, passive-loss limits, and Schedule E reporting.
Rental Property Information*
Upload Mortgage Statements / Property Tax Bills / Closing Statements (If New Property and Expenses)

Cancelof
Did you have any farm income or farm-related expenses during the tax year?*

YesNo
🌾9. Farm Income & Expense Report

Enter detailed information about your farm income and expenses for the tax year. Include income from crop and livestock sales, government payments, and all ordinary and necessary farm-related expenses. Accurate reporting ensures your Schedule F is prepared correctly and that you receive all available agricultural deductions.
Farm Income & Expense *
Upload Supporting Farm Documents (1099-PATR, 1099-G, or Loan Statements)

Cancelof
Did you or your farm operation purchase and use any off-highway fuel (gasoline, diesel, or kerosene) for farming purposes during the tax year*

YesNo
If yes, upload fuel receipts, invoices, or summaries showing total gallons purchased for farm use (tractors, combines, irrigation pumps, etc.). This information is used to determine eligibility for a fuel tax credit under Form 4136

Cancelof
Did you have any gambling winnings or online betting income during the tax year?*

YesNo
🎰10. Gambling Income & Winnings

Include all gambling winnings, including those from casinos, lotteries, sports betting, raffles, and online platforms. The IRS receives copies of your Form W-2G for winnings of $600 or more (depending on the type of game). Upload supporting forms and statements below.
Form W-2G or Online Account Statement*
Upload Copy of Form W-2G or Online Account Statement (if applicable)

Cancelof
Do you have copies of your prior year tax returns available to upload?*

YesNo
📂11. Prior Year Tax Returns Upload

Prior Year Tax Returns Upload: If available, upload copies of your prior year tax returns. These help verify carryovers, depreciation schedules, business assets, and filing consistency. Providing past returns ensures your new return is prepared accurately and efficiently
Upload Prior Year Tax Returns

Cancelof
Would you like your tax preparation fees and bank processing costs to be deducted directly from your tax refund?*

YesNo
🏦12. Bank Products

Choose how you would like your tax refund and services to be processed. Tax Soldier LLC offers secure refund-transfer bank products that allow your tax preparation fees and related costs to be deducted directly from your refund once released by the IRS. You may also choose optional add-on protections or cash advance programs.
Which of the following bank products would you like to include? Multiple selections optional

Opt-in to Identity Theft Protection for an additional fee.Opt-in to Audit Protection for an additional fee.Apply for a Pre-Season Cash Advance (deducted from refund).Apply for an In-Season Cash Advance (deducted from refund).None of the above.
💰13. REFUND METHOD:

Select your preferred method to receive your tax refund. Verify all banking details carefully to prevent delays or misdirected deposits. All refund checks are issued directly from the Tax Bank associated with your filed return. Upload a screenshot for account verification to ensure accuracy and compliance.
Direct Deposit Information*
Please upload a clear screenshot or photo of your bank account information showing: • Bank name • Full routing number• Full account number. This information is required to verify your direct deposit details and/or authorize applicable drafts for tax preparation fees.*

Cancelof
🪖 14. Power of Attorney for Deployed Service Members

Attach a signed copy of IRS Form 2848 authorizing you to sign your spouse’s tax return while they are deployed or on active duty.
Are you signing this tax return on behalf of your spouse due to their deployment or military duty assignment?*

YesNo
Upload SIGNED & DATED Power of Attorney (Form 2848)*

IRS regulations require a valid Form 2848 when one spouse signs a joint tax return on behalf of the other due to deployment or other absence. The form must include both the taxpayer’s and the representative’s signatures.
Cancelof
📋 15. Agreements, Authorizations & Attestations

(Applies to all clients of Tax Soldier LLC)
1. Truthfulness & Accuracy
I attest that all information provided to Tax Soldier LLC is true, correct, and complete to the best of my knowledge. I understand that knowingly submitting false or incomplete information is a violation of federal law (IRC § 7206) and may result in penalties or prosecution.
I agree to promptly provide all documents requested to verify income, dependents, or deductions.

💼 2. Responsibility for Return Review
I understand that Tax Soldier LLC prepares returns based solely on the information I provide.
Before filing, I will review my return for accuracy.
If I fail to review or sign my return after preparation, abandon services, or become unresponsive, I authorize Tax Soldier LLC to charge a $199 administrative fee for time and labor.

💰 3. Fees, Amendments & Audit Assistance
$199 — Non-review / abandoned return fee
$299 — Audit Assistance Fee (if Audit Protection not purchased) Federal & State are seperate fees
$399 — Client-caused Amendment Fee
Errors made by Tax Soldier LLC will be corrected or amended at no additional charge.

⚖️ 4. Refund Offsets
If my refund is seized or reduced by the IRS or a state agency for debt obligations, I remain responsible for paying all preparation fees in full within 30 days of notice.

🔐 5. Data Protection & Privacy
Tax Soldier LLC maintains all client information on encrypted, IRS-compliant networks.
Information will never be disclosed to third parties without written consent except as required by law.
Clients should transmit sensitive data only through secure channels.

🧾 6. IRS Correspondence
I agree to deliver all IRS or state correspondence related to my return to Tax Soldier LLC immediately to ensure timely response and maximum support.

🪙 7. Payment Authorization (ACH / Card)
I authorize Tax Soldier LLC to collect payment for agreed-upon services through:

ACH debit to my designated bank account; and/or
charge to my debit/credit card provided below.
Card / Account Information

⚠️ Compliance & Security Disclaimer (For Template Distribution)
🔒 This form template is designed for professional tax preparers and firms. It includes ACH authorization language for legal and compliance purposes; however, this template does not directly collect or transmit any financial data such as full routing or account numbers, credit/debit card details, or banking credentials.

To remain compliant with IRS Publication 4557, NACHA, and PCI DSS regulations, each tax professional or firm using this template must connect their own secure, PCI-compliant payment processor (e.g., Stripe, Square, Authorize.Net, EPS Financial, or bank-issued ACH platform) for actual payment processing.

Any placeholders for banking or card information (e.g., last four digits, bank name, or ZIP code) are included for verification and identification purposes only and are not intended for full account data entry.

By using this form, you agree to implement your own compliant payment collection process and hold Tax Soldier LLC harmless for any misuse or misconfiguration of payment fields or unauthorized data collection.

🔁 8. Recurring Authorization Notice
This authorization remains in effect for future tax seasons and related services until I revoke it in writing.
I authorize Tax Soldier LLC to process recurring payments for future tax preparation, amendment, or audit-assistance fees using the most recent payment method on file.
I may cancel recurring authorization at any time by written notice, allowing at least 5 business days before the next scheduled debit.

🧑🏽‍💼 9. Professional Conduct & Social-Media Representation
I agree to maintain professionalism when communicating about Tax Soldier LLC.
Posting or sharing false, defamatory, or misleading statements on any platform constitutes breach of this agreement and may result in legal action.
Concerns or complaints must be addressed directly with Tax Soldier LLC for resolution.

🪖 10. Legal & Compliance Disclaimers
Tax Soldier LLC is not liable for penalties or interest caused by incomplete, late, or false information provided by the client.
Refund amounts are estimates until verified by the IRS or state.
All returns are subject to IRS review.
Client acknowledges receipt of all required disclosures under IRS Circular 230 and Form 8879 authorization procedures.

✍🏽 11. Client Acknowledgment & Signature
By signing below, I confirm that I have read, understand, and agree to all statements, authorizations, and attestations in this document.

I authorize Tax Soldier LLC to:

Prepare and e-file my tax returns;
Deduct agreed fees from my refund or process ACH/card payments;
Retain copies of records per IRS requirements; and
Provide audit or amendment services per selected options.
Primary Taxpayer Signature & Acknowledgment (for Individual & Joint Filers) Client Signature & Acknowledgment (for Individual & Joint Filers)*

Powered by Jotform SignClear
Spouse Signature & Acknowledgment (for Individual & Joint Filers) Client Signature & Acknowledgment (for Individual & Joint Filers)

Powered by Jotform SignClear
Primary Taxpayer Date Signed

MonthDayYear
Date
Spouse Date Signed

MonthDayYear
Date
© 2025 Blessed Services Mobile Notary & Tax Preparation™

For use by the original purchaser only.
Unauthorized distribution or resale is prohibited
Should be Empty:

🪖1. TAXPAYER INFORMATION

💰Profit & Loss Statement (Income & Expenses Summary)

🪖2. SPOUSE INFORMATION

💰Spouse Profit & Loss Statement (Income & Expenses Summary)

🧩3. Unemployment Income

💵4. 1099 Income & Retirement Distsribution Information

👨‍👩‍👧‍👦 5. DEPENDENTS

📕6. Education Expenses & Student Enrollment (AOTC Eligibility)

💡7. Additional Deductions & Tax Credits

🏠8. Real Estate Property Information

🌾9. Farm Income & Expense Report

🎰10. Gambling Income & Winnings

📂11. Prior Year Tax Returns Upload

🏦12. Bank Products

💰13. REFUND METHOD:

🪖 14. Power of Attorney for Deployed Service Members

📋 15. Agreements, Authorizations & Attestations