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报税客户信息表 Tax Preparation Client Intake Form
个人报税 Individual Tax Filing
您是老顾客还是新顾客？Are you an old or new client?
Please Select
老顾客 Old client
新顾客 New client
报税类型 Filing Status
单身报税 Single
一家之主报税 Head of Household
已婚分开报税 Married Filing Separat
已婚联合报税 Married Filing Joint
丧偶报税 Qualifying Widower
报税人信息 Taxpayer Information
姓名 Name
名 First Name
姓 Last Name
社会安全号 SSN
出生日期 Date of Birth
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Month
-
Day
Year
Date
电话号码 Phone Number
Please enter a valid phone number.
邮箱 Email
example@example.com
微信 Wechat
地址 Address
街道地址 Street Address
街道地址 2 Street Address Line 2
城市 City
州 State / Province
邮编 Postal / Zip Code
职业 Occupation
您的签证类型？What is your visa type?
绿卡 Green Card
工作签证 H1B
跨国公司经理人 L1
公民 US CITIZEN
留学生 F1
Other
请说明持有签证类型以及开始的日期? What kind of visa you hold and what the start date ?
您是全日制学生吗？Are you a full-time student?
Yes
No
您是否完全且永久残疾？Are you totally and permanently disabled?
Yes
No
您是法定盲人吗？Are you legally blind?
Yes
No
配偶信息 Spouse Information
姓名 Name
名 First Name
姓 Last Name
社会安全号 SSN
出生日期 Date of Birth
-
Month
-
Day
Year
Date
电话号码 Phone Number
Please enter a valid phone number.
邮箱 Email
example@example.com
微信 wechat
地址 Address
街道地址 Street Address
街道地址2 Street Address Line 2
城市 City
州 State / Province
邮编 Postal / Zip Code
职业 Occupation
他们是全日制学生吗？Are they a full-time student?
Yes
No
请说明持有签证类型以及开始的日期? What kind of visa you hold and what the start date ?
他们是否彻底且永久地残疾了？Are they totally and permanently disabled?
Yes
No
他们是法定盲人吗？Are they legally blind?
Yes
No
他们是您的受抚养人吗？Are they your dependent?
Yes
No
受抚养人 Dependents
在此输入您的受抚养人信息 Enter your dependents here
姓名 Name
出生日期 Date of Birth
与您的关系 Relationship
社会安全号 SSN
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您、您的配偶和您的受抚养人去年 12 个月内是否有健康保险？如果有，谁来承保？Does you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it?
是/否 Yes/No
雇主 Employer
配偶保险 Spouse Ins
交易/市场 Exchange/ Marketplace
直接与保险公司联系Direct with Insurer
医疗保险 Medicare
医疗补助 Medicaid
报税人 Taxpayer
Yes
No
配偶 Spouse
Yes
No
受抚养人1 Dependent 1
Yes
No
受抚养人2 Dependent 2
Yes
No
受抚养人3 Dependent 3
Yes
No
受抚养人4 Dependent 4
Yes
No
受抚养人5 Dependent 5
Yes
No
税务相关问题 Tax Related Questions
2024 年就业情况 Employment Status
受雇 Employed
失业 Unemployed
自雇 Self-employed
您是否有w2 收入或者1099-NEC 自雇收入？ 金额是？请上传w2表或者1099-NEC 表， Do you have w2 or 1099-Nec income ? If yes, please put in amount and upload the form
您是否有利息收入？如有请告知金额并上传1099-INT 表。 Do you have any interest income? If yes, please upload 1099-INT
您是否向 401k 或其他税前账户供款？如有请上传证明 Are you contributing to 401k or other pre-tax account? If yes, please upload proof
Yes
No
您的受抚养人有学费支出吗？如有请上传1098-T 表 Does your dependents have tuition expenses? If Yes, please upload form 1098-T
Yes
No
您有任何托儿费用吗？如有请上传收据需要学托儿所的名称，地址，电话以及税号和金额 Do you have any expenses for child care? If Yes, please upload receipt from daycare
Yes
No
您是否对房屋进行了能源星级改造？Do you have energy star rated improvements to your home? 如有请上传收据。 If Yes, please upload receipt from provider
窗户 Windows
门 Doors
炉灶 Furnace
Other
您目前是租房吗？Are you currently renting?
Yes
No
如是，每月租金是多少？If yes, what is the monthly rental amount?
您有自己的房子吗？Do you have your own home? 如果有贷款请上传表1098. If have mortgage, please upload form
Yes
No
您是否有文件证明您缴纳了房产税？如果有请上传证明 Do you have documents that shows you paid for property taxes? If Yes, please upload proof
Yes
No
您有卖房收入吗？(如无请填0) 如有请上传最后的卖房表 Is there any income from selling the house? (If no, please fill in 0) If Yes, please upload final statement
您在该住所居住了多久？How long have you lived at the property?
几个月 # of months
您卖出过股票吗？如有请上传1099B 表或者1042S Did you sell any stock? If Yes, please upload form 1099B or 1042S
Yes
No
您从 401 账户中取钱了吗？如有请上传1099R Did you take money from your 401? If Yes, please upload form 1099R
Yes
No
您交纳车辆税了吗？如有请告知金额，如无请填0. Did you pay your vehicle tax? If yes, please inform the amount, if no, please fill in 0.
您有抵押贷款利息吗？Do you have mortgage interest?
Yes
No
您是身份盗窃的受害者吗？Are you a victim of identity theft?
Yes
No
您去年收到过州退税吗？如有请告知金额，如无请填0. Did you receive a state refund last year? If yes, please inform the amount, if no, please fill in 0.
您是否已在美国成立公司或是任何美国公司的股东？Whether you have established a company in the U.S. or are a shareholder of any U.S. company?
Yes
No
如是，请列出每个美国公司的名字，公司成立日期，是否已报税？If yes, please list the name of each U.S. company, the date of incorporation, and whether it has filed taxes?
费用 Expenses
请仅填写当年的信息 Please fill-up the information within the current year only.
一般费用 General Expenses
金额 Amount
医疗费用 Medical Expenses
牙医费用 Dental Expenses
已付保险费 Insurance Premiums paid
Long Term Care Premiums
长期护理保险费 Prescription Drugs and Medications
住房抵押贷款 Home Mortgage
投资利息 Investment Interest
现金捐款 Cash Contributions
非现金捐款 Non-Cash Contributions
未报销的业务费用 Unreimbursed Business Expenses
工会会费 Union Dues
报税费用 Tax Preparation Fees
投资费用 Investment Expenses
费用总计 Total Expenses
海外与其他流动资产 Overseas And Other Current Assets
您需要申报多少个海外账户？How many overseas accounts do you need to declare? (Please fill in 0 if none)
请在此输入您当年海外银行账户信息 Please enter your overseas bank account information for the year here
持户人 Account holder
是否与其他人/通过公司共同拥有账户 Do you own the account jointly with other people/through a company?
银行名或金融机构名称 Name of bank or financial institution
银行或金融机构地址 Bank or financial institution address
账号
Account number
币种Currency
账户全年最高余额 Maximum account balance for the year
账户类型(储蓄，证券，基金，保险)Account type (savings, securities, fund, insurance)
利息收入金额Interest income amount
股息收入金额Dividend income amount
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海外公司 Overseas Companies
您有多少家海外公司持有 10% 以上的股份？ 如果没有，请填写 0 How many overseas companies hold more than 10% of the shares? (If none, please fill in 0)
公司名称 Company Name
公司成立日期 Date of Incorporation
公司地址 Company Address
持股人名字 (只限移民家庭内) Name of Shareholder (only for immigrant families)
本人和家人占公司股份百分比 The percentage of company shares held by the taxpayer and the family
是否有公司有营业执照？Does the company have the business license?
Yes
No
是否有税务登记证？Does the company have the Tax Registration Certificate?
Yes
No
是否有2024年12月31日资产负债表？需包括年初数字和年末数字 Is there a Balance Sheet as of December 31, 2024? Need to include both beginning and end of year figures
Yes
No
是否有2024年1-12月损益合总表？Is there a Profit & Loss Statement from January to December 2024?
Yes
No
总损益表内销售费用，管理费用，财务费用里各分类费用金额 The amount of each category of expenses in the total income statement, including sales expenses, administrative expenses, and financial expenses
2024年是否有增资？Will there be capital increase in 2024?
2024年是否有股权变更？Will there be any equity changes in 2024?
有无公司银行账户签字权(以本人或公司名义开的公司银行账户)？Do you have the signing authority for the company bank account (a company bank account opened in your own name or in the company's name)?
Yes
No
有无其他股东具有美国绿卡或公民？Are there any other shareholders who have U.S. green cards or citizenship?
海外收入 Overseas Income
有多少海外工资收入？(如果没有，请填写 0) How much overseas salary income?(Please fill in 0 if none)
海外税前薪资总收入 Total overseas pre-tax salary income
是否有海外薪资收入完税证明？如有请上传 Do you have a tax payment certificate for overseas salary income? If Yes, please upload
Yes
No
各类利息或股息收入 Various types of interest or dividend income
租金收入以及相关费用 Rental income and related expense
基金收入/亏损 Fund income/loss
所有分红 All dividends
自雇收入/亏损 Self-employment income/loss
买卖股票收入/亏损 Income/loss from buying and selling stocks
买卖房屋收入/亏损 Income/loss from buying and selling housesv
投资收入/亏损 Investment income/loss
海外赠与 Overseas Gifts
您是否收到过 100,000 美元以上的捐赠？(如果没有，请填写 0）Have you received a gift of more than 100,000 USD? (If not, please fill in 0)
请在此输入本人或家人收到的外国人赠与信息 Please enter the gift information received by you or your family from foreigners here
受赠(收款人)Donee (payee)
赠与方 Donor
与您的关系 Relationship
请注明：金钱/其他类型资产 Please specify: Money/other types of assets
每笔金额或价值
Amount or value of each
每笔赠与日期Date of each donation
赠与方式说明 (收款账户) Instructions on donation method (receiving account)
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请在此输入本人或家人赠与其他人的信息 Please enter the information you or your family members have given to others.
赠与方Donor
受赠人(收款人) Donee (payee)
与您的关系 Relationship
受赠人地址Donee's address
请注明：金钱/其他类型资产 Please specify: Money/other types of assets
每笔金额或价值
Amount or value of each
每笔赠与日期Date of each donation
赠与方式说明 (收款账户) Instructions on donation method (receiving account)
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房屋出租 Rental Income
请在此输入房屋出租相关信息，并上传所有支持文件 Please enter your rental information here and upload all supporting documents
房产一Property 1
房产二Property 2
房产三Property 3
房产四Property 4
房产五Property 5
房主 (个人 或公司名字)Owner (personal or company name)
地址 Address
购买日期Purchase Date
购买价格(如有，请提供房屋购买结算单)Purchase price (if any, please provide the house purchase settlement slip)
何时开始出租 (月/日/年)When will the rental start? (mm/dd/yyyy)
实际收到的房屋租金Actual rent received
房产税 Property Tax
物业管理费(HOA)Property Ownership Administration (HOA)
房屋贷款利息Housing loan interest
维修和维护费Repair and maintenance costs
清洁费Cleaning Fee
管理费/中介费Management fee/agency fee
银行费用Bank Fees
保险费 Insurance
水电费 Utilities
其他费用(请列明)Other expenses (please specify)
来美国机票和酒店Flights and hotels to the United States
净收入Net income
改造翻修费Renovation and renovation costs
新购装置或设备New equipment or devices
房屋出售 Houses For Sale
请在此输入房屋出售相关信息，并上传所有支持文件 Please enter your home sale information here and upload any supporting documents
房产一Property 1
房产二Property 2
房产三Property 3
房产四Property 4
房产五Property 5
房主 (个人 或公司名字)Owner (personal or company name)
地址 Address
购买日期Purchase Date
购买价格(请提供房屋购买结算单)Purchase price (please provide the house purchase settlement slip)
出售日期Sale Date
出售价格 (请提供房屋购买结算单)Selling price (please provide the house purchase settlement slip)
改造翻修费Renovation and renovation costs
新购装置或设备New equipment or devices
银行账户信息 (用于收退税/交税) U.S. Bank Account Information (For Tax Refund/Tax Payment)
银行名称 Bank Name
汇款路由编号 Routing Number
账户号码 Account Number
该银行账户类型是什么？What is this bank account type?
支票账户 Checking Account
储蓄账户 Saving Account
报税资料及付款提示 Tax Documents & Payment Reminder
上传资料请注册Taxaroo Portal 或发邮件到bizfile@clmybiz.com (注册链接为: https://client.taxaroo.com/invite/cltax) 注册完毕请将您的portal链接发来。 For documents upload , please register Taxaroo Portal or send email to bizfile@clmybiz.com (Register Link is https://client.taxaroo.com/invite/cltax) After register done, please send us your portal link
前一年是否有报税，请上传前一年税单 Did you file tax return for previous year? if yes, please upload tax return for the previous year.
您是否已支付报税费用，支付金额是？支付方式是？Did you pay tax filing fee? If yes, how much you paid? How you paid ?
确认与签名 Acknowledgment & Signature
我确认在此输入的所有信息均准确真实。I confirmed that all information I entered here is accurate and true.
我允许美迎会计事务所获取我的敏感数据，如个人身份证、政府身份证和其他信息。I allow C.L. Tax & Accounting Service Inc to capture my sensitive data like personal id, government id, and other information.
我已阅读美迎会计事务所的条款和条件以及隐私政策。I have read the terms and conditions and privacy policy of C.L. Tax & Accounting Service Inc.
通过在下方签名，您确认您已阅读并了解您在填写此纳税申报表时的责任以及我们的责任。By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
签署日期 Date Signed
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Month
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Day
Year
Date
报税人签名 Taxpayer Signature
签署日期 Date Signed
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Month
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Day
Year
Date
配偶签名 Spouse Signature
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