Language
English (US)
Español
Chinese
French (France)
Client Intake Form TAX YEAR 2023
Welcome to Easy Tax Co! As a new or returning client please complete the intake form. The information you provide will be encrypted to protect your personal information. If you have questions or problems using this app call or text 312-259-4839 for support.
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Email
example@example.com
Phone Number
*
Please enter a valid phone number.
What is your filing status?
Single
Head of Household (If you are claiming dependents and not married)
Married Filing Jointly
Married Filing Separately (You are still married but have separated your finances)
Qualifying Widow(er)/Qualifying Surviving Spouse
Name of Spouse (If Legally Married)
First Name
Last Name
Spouse Date of Birth
-
Month
-
Day
Year
Date
SSN - Social Security Number or ITIN - Individual Taxpayer Identification Number
*
Spouse SSN - Social Security Number or ITIN - Individual Taxpayer Identification Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Select the Tax Year you want to file
*
2021
2022
2023 (Current Tax Year Deadline is 4/15/2024)
Amend Prior Year(s)
Did you file your 2022 Income Tax Return last year?
*
Yes
No
If you answered yes, Do you have a copy of your 2022 Tax Return?
*
Yes
No
What is your 2022 AGI (Adjusted Gross Income) Line 11 on 1040 Form - Optional
Upload your Federal IRS IP Pin and or State Pin - If applicable
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Did you Receive a Federal or State Refund for 2022?
*
Received Federal
Received State
Didn’t receive a Federal Refund for 2021 - owe a tax obligation.
Didn’t receive a State Refund for 2021 - owe a tax obligation.
Unique tax situation - requires a conversation
Did you, your spouse, or a dependent have insurance under the Affordable Care Act in 2023? *If so, select Yes – you must report Form 1095-A for the IRS to accept your return. If you did not have an Affordable Care Act insurance plan, select No.
Yes
No
What is your current income status?
*
Employed - W-2 Form
Contractor - 1099 or 1099 Misc Form
Self Employed - Schedule C Form
Business Owner - Schedule C Form
Retired - 1099R or Social Security Retirement Form
Dividend 1099 - DIV or Interest Income 1099-INT Form
Business Owner - S Corp or C Corp 1120 Form
Other Income - Form not listed
Do you have Dependents?
*
Yes
No
Name of 1st Dependent
First Name
Last Name
SSN or ITIN 1st Dependent
Date of Birth 1st Dependent
-
Month
-
Day
Year
Date
Name of 2nd Dependent
First Name
Last Name
SSN or ITIN 2nd Dependent
Date of Birth 2nd Dependent
-
Month
-
Day
Year
Date
Name of 3rd Dependent
First Name
Last Name
SSN or ITIN 3rd Dependent
Date of Birth 3rd Dependent
-
Month
-
Day
Year
Date
Name of 4th Dependent
First Name
Last Name
SSN or ITIN 4th Dependent
Date of Birth 4th Dependent
-
Month
-
Day
Year
Date
Can you and your dependents be claimed by another person?
*
Yes
No
Take Photo -OR- Upload Your I.D and Social Security Card (Front and Back)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Take Photo -OR- Upload Your SPOUSE I.D and Social Security Card (Front and Back)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Take Photo -OR- Upload I.D or Social Security Card and Birth Certificate for your dependents. IRS Requires this documentation
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Take Photo -OR- Upload Proof of residency for you and your dependents. (Lease, Medical Insurance, School Records, Foodstamp Verification, Mail)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Take Photo -OR- Upload W-2, Self Employed Income, 1099 Forms, Business Income and or any other documents related to your income.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Take Photo -OR- Upload out of pocket expenses related to income W-2, Self Employed Income, 1099 Forms and Business Income. (work related expenses, self employed expenses: receipts, ledger, bank statements etc.)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Take Photo -OR- Upload a copy of your 2021 Tax Return or Prior Year Return(s) *Optional
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Business EIN -Employer Identification Number
Business Description or NAICS Code
Take Photo -OR- Upload a copy of your 2023 1095-A Form
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Are you interested in the Taxpayer Advanced Loan up to $6,000 if eligible?
Yes
No
Would you like the tax preparation fees deducted from your refund if eligible?
Yes
No
If you want your refund paid via ACH Direct Deposit Take Photo -OR- Upload your banking institution information: Bank Name, Routing and Account information.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Name listed on Bank Account
First Name
Last Name
If you do not have a bank account would you like a pre-paid debit card provided by Easy Tax Co?
Yes
No
Save
Submit
Should be Empty: