Gol Connections Client intake Form

Client Intake Form

Thank You for taking the time to complete your Client Intake Form. This information is critical to ensure your tax return is filed accurately. Please take your time and review all information before you submit. Please note that if documents are missing or information is incorrect this will result in a delay in processing your return.

This intake form will take 20- 30 minutes to complete.

Please complete this form in its ENTIRETY and click SUBMIT when finished. Upload all documents at the end of the form.

Please wait until you have ALL of your documents before submitting this form.

Note: If you are claiming any dependents, be sure to upload their Social Security Cards, Birth Certificates, and all items that show their address is the same as yours. (e.g. school records, medical records, doctor bills, Medicaid Statement, Social Services Records, or anything that shows your child's name and current address).

OUR RESPONSIBILITIES

Our work (whether consultation, tax return, tax plan or related product) is based on data you provide.

• We are not responsible to audit or verify the data that you give to us.
• We may ask for clarification of your data or additional information.
• We are not responsible to discover fraud or other irregularities, should any exist.
• We will work to find all the credits and deductions you are legally entitled to.

YOUR RESPONSIBILITIES

• To provide all the information required for a complete and accurate finished product.
• To provide this information in a timely manner.
• To retain, with the completed work, all the documents, cancelled checks and other data that form the basis of income and deductions since
you may later have to provide them to a taxing authority.
• To carefully review all work completed by our office before you sign. You have the final responsibility for anything submitted to a taxing
authority.
• You are responsible not to commit fraud.
• You are responsible to let us know if you received Child Tax Credit Payments in 2025, If you did not receive your stimulus payment 1, 2, and 3
payment, 1099k Form, and Unemployment 1099 Form.

PLEASE READ THROUGH ITS ENTIREITY.

DO NOT SUBMIT THIS FORM UNTIL YOU HAVE ALL SUPPORTING DOCUMENTS.

BE SURE ALL SUPPORTING DOCUMENTS ARE VALID & CURRENT.

BE SURE LEASE AND OTHER FORMS HAVE THE DEPENDENTS NAME ON THEM IF APPLICABLE.

How did you hear about us?
If someone referred you, please type his or her name here.
If you are filing multiple years you must complete a separate form for each year.
Which Tax Year Are You Filing For?*

20252024202320222021202020192018201720162015201420132012
Will this be an amended (corrected) return?

YesNo
Are you interested in applying for an advance loan?*

Date of Interview

MonthDayYear
Date
Interview Setting

In PersonVirtualTranslator Used
Taxpayer's Name*

First NameLast Name
Taxpayer's Social Security Number*
Example: xxx-xx-xxxx
Taxpayer's Date of Birth*
Example: 01/01/2001
Taxpayer's Job Title*
Taxpayer's Phone Number*
Example: (xxx)-xxx-xxxx
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Tax Payer Address Verification (Please select which address verification document you have.)**

Utility BillLeaseRent StatementCable BillOther
Upload Address Verification*

Cancelof
Taxpayer's Email Address*
example@example.com
What is your marital status as of December 31st?*

SingleMarriedDivorcedSeparatedSurviving Spouse
Tax Payer Verification for Filing Status (Required)*

Sate Issue IDState Issued Driver's LicensePassportOther
FRONT AND BACK PHOTO OF YOUR Taxpayer's Driver's License/ State ID (Stand directly over the item on a flat surface and zoom in for a clear shot)*

Cancelof
Please upload a Selfie to Validate your Government Issued ID. (In order for your selfie to be considered validated, you MUST have your ID in hand when submitting your selfie.)* *

Cancelof

Use the drop-down menu below:

Rows	Taxpayer	Spouse
Blind
Disabled
Pres. Campaign Fund

Taxpayer's Social Security Card (Stand directly over the item on a flat surface and zoom in for a clear shot)

Cancelof
Were you previously issues an Identity Protection Pin (IP PIN) by the IRS?
IPPIN IDENTITY THEFT IF (APPLICABLE) (Stand directly over the item on a flat surface and zoom in for a clear shot.)

Cancelof
Can someone else claim you as a dependent?*
What is the Name of person that can claim you?
What is your relationship to that person? (I.e. Mother, Father, etc.)
How much support did they provide for you?
Do you owe the IRS, Child Support or in default with student loans?*
Have you ever been disallowed for EITC/AOTC/CTC/ACTC? *
Are you a business owner, self-employed or contractor *
Did you buy or trade Crypto Currency? (Bitcoin)
Which currency did you buy or trade?
How much currency did you buy or trade?
Do you have an investment account for trading?
Which currency did you buy or trade?
Did you work overtime in 2025?*
If you worked overtime, please provide a copy of your last check stub for 2025.*

Cancelof
Did you earn tips in 2025?*
If you earned tips in 2025, please upload your last pay stub from 2025 below.*

Cancelof
How much currency did you buy or trade?
Do you have gambling winnings for the year?*
Where are your winnings from?
How much did you win?
How much did you loss?
Upload W2-G Section

Cancelof
Did you make any charitable contributions during the year?
Who did you make charitable contributions to?
How much did you contribute?
Did you withdraw from your 401K during the year ?
How much did you withdraw?
How much Federal taxes were withheld?

ATTENTION: Please take the time to carefully answer the questions below about the type of insurance you had. If you do not answer these questions correctly or forget to upload your 1095 A,B, OR C FORM. Your tax return will be REJECTED by the IRS. If you do not remember what kind of insurance you received, contact your employer to see.

Was your insurance through the Affordable Care Act (The Marketplace)?*
Was your insurance through a current employer, or state?

EmployerStateOther
Are you looking to purchase a home anytime soon?
PLEASE UPLOAD YOUR 1095A IF APPLICABLE (Stand directly over the item on a flat surface and zoom in for a clear shot.)*

Cancelof

Spouse's Full Name
First Name
Spouse's Social Security
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 Driver's License/State ID (Stand directly over the item on a flat surface and zoom in for a clear shot)*

Cancelof
Spouse's Social Security Card (Stand directly over the item on a flat surface and zoom in for a clear shot)*

Cancelof
Did you and your spouse live apart for more than 6 months in 2022?
What months?

Do you have one of the following income documents:*

W2W2-G1099 NEC1099G unemploymentOther
Upload W2 statements (Stand directly over the item on a flat surface and zoom in for a clear shot.)

Cancelof
1099 NEC (Stand directly over the item on a flat surface and zoom in for a clear shot.)

Cancelof
Did you receive unemployment during the year?
1099 Unemployment Taxpayer/Spouse (Stand directly over the item on a flat surface and zoom in for a clear shot.)*

Cancelof
Upload other Misc. Income Documents such as 1099 INT, 1099 DIV, 1099 NEC. (Stand directly over the item on a flat surface and zoom in for a clear shot.)

Cancelof

Do you receive Subsidized Housing or Section 8?*
Do you receive any Government Assistance Programs such as Food stamps, FIP/SDA, Medicaid, or Medicare in during the year?*
How much do you receive monthly? *
Upload DHHS Annual Letter or any other document related to government assistance received.

Cancelof
For the selected year, Are you a DTE account holder?*

YesNo
Upload DTE bill for verifcation

Cancelof
Do you have a 1098 Mortgage Interest Statement?*
Upload, lease agreement, or utility bill. 1098 Mortgage Interest Statement. (Stand directly over the item on a flat surface and zoom in for a clear shot.)*

Cancelof
Did anyone in your household attend college for the selected tax year? *
What was the Name of the person who attended college?
What was the name of the college they attended?
How many years has this person claimed school credit?
Form 1098-T (School Credit) *Stand directly over the item on a flat surface and zoom in for a clear shot.

Cancelof
Do you rent?*
How much is you rent?*
What’s your landlord name?*
Landlord's address?*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Did anyone else live in your home?*

YesNo

Are you interested in Audit Protection? (Mandatory For ALL Schedule C'S)*
Are you interested in Credit Repair?

STOP!

Did you finish uploading your documents?

IF YOU DID NOT UPLOAD ALL NECESSARY DOCUMENTS INTO THE INTAKE FORM, PLEASE GO BACK AND UPLOAD NOW.

CLIENT NON-PAYMENT/OFFSET CLAUSE

At Gol Connections, we strive to assist all of our clients in their tax needs, however, we understand that situations arise. If your refund is offset for any reason at all by the IRS, student loans, child support, others or your check is mailed, you are still obligated to pay our company the fees associated with filing your tax return.

By signing this agreement you acknowledge that if payment is not made in full within 30 days legal actions will be sought to resolve payment.

How would you like you refund disbursed if receiving on?*

Direct DepositBy mail
Name of Bank
Routing Number
Bank Account Number
I am permitting Gol Connections to prepare all forms related to my tax return and on my behalf, sign all necessary forms and file my taxes electronically. I take full responsibility for the accuracy of this form and understand that Gol Connections and/or associated affiliates hold no responsibility for any misrepresentation or false claims. By signing below, I certify that the information provided is true, correct, and complete to the best of my knowledge. I authorize my tax preparer to prepare and electronically file my federal and state tax returns. I consent to electronic records and electronic signatures.

I understand Gol Connections invoice for time spent, depending on schedules and forms completed and out-of-pocket expenses incurred. Our rates vary depending on the nature of work performed. We may invoice for partially completed work that is placed on extension or remains undone.

I acknowledge that there shall be a cancellation fee of $150 if I decide to cancel at any point following the signinig of this document. I understand that the reason for this cancellation fee is to cover any time spent and services rendered for tax preparation.
Taxpayer's Signature*

Clear
Date*

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

Clear
Date

MonthDayYear
Date
Form Status

Should be Empty:

Arabic	Hebrew	Polish
Bulgarian	Hindi	Portuguese
Catalan	Hmong Daw	Romanian
Chinese Simplified	Hungarian	Russian
Chinese Traditional	Indonesian	Slovak
Czech	Italian	Slovenian
Danish	Japanese	Spanish
Dutch	Klingon	Swedish
English	Korean	Thai
Estonian	Latvian	Turkish
Finnish	Lithuanian	Ukrainian
French	Malay	Urdu
German	Maltese	Vietnamese
Greek	Norwegian	Welsh
Haitian Creole	Persian

Arabic	Hebrew	Polish
Bulgarian	Hindi	Portuguese
Catalan	Hmong Daw	Romanian
Chinese Simplified	Hungarian	Russian
Chinese Traditional	Indonesian	Slovak
Czech	Italian	Slovenian
Danish	Japanese	Spanish
Dutch	Klingon	Swedish
English	Korean	Thai
Estonian	Latvian	Turkish
Finnish	Lithuanian	Ukrainian
French	Malay	Urdu
German	Maltese	Vietnamese
Greek	Norwegian	Welsh
Haitian Creole	Persian

Rows	Project Monthly Income $	Project Monthly Expenses $
Advertising
COGS
Mileage
Insurance
Legal Professional
Office Supplies
Rent
Business Supplies
Utilities
Income
Other:
Other:
Other
Other

Arabic	Hebrew	Polish
Bulgarian	Hindi	Portuguese
Catalan	Hmong Daw	Romanian
Chinese Simplified	Hungarian	Russian
Chinese Traditional	Indonesian	Slovak
Czech	Italian	Slovenian
Danish	Japanese	Spanish
Dutch	Klingon	Swedish
English	Korean	Thai
Estonian	Latvian	Turkish
Finnish	Lithuanian	Ukrainian
French	Malay	Urdu
German	Maltese	Vietnamese
Greek	Norwegian	Welsh
Haitian Creole	Persian

Arabic	Hebrew	Polish
Bulgarian	Hindi	Portuguese
Catalan	Hmong Daw	Romanian
Chinese Simplified	Hungarian	Russian
Chinese Traditional	Indonesian	Slovak
Czech	Italian	Slovenian
Danish	Japanese	Spanish
Dutch	Klingon	Swedish
English	Korean	Thai
Estonian	Latvian	Turkish
Finnish	Lithuanian	Ukrainian
French	Malay	Urdu
German	Maltese	Vietnamese
Greek	Norwegian	Welsh
Haitian Creole	Persian