HIM Tax Pro Client Intake Form

1
Who is your preparer?* This field is required.
2
What is your filing status?* This field is required.
Single
Married filing jointly
Married filing seperately
Widow
Head of Household
Dependent on another return
3
Taxpayer Name* This field is required.
Prefix
First Name
Middle Name
Last Name
Suffix
4
Taxpayer Social Security Number* This field is required.
5
Taxpayer Birthday* This field is required.
Date
Year
Month
Day
6
Taxpayer Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
7
Taxpayer Email* This field is required.
example@example.com
8
Taxpayer Cell Phone Number* This field is required.
Please enter a valid phone number.
9
Do you have an IP PIN* This field is required.
YESNO
10
Please Provide IP Number If You Require One
11
Can you be claimed as a dependent?* This field is required.
YESNO
12
Spouse Name
Prefix
First Name
Middle Name
Last Name
Suffix
13
Spouse Social Security Number
14
Spouse Birthday
Date
Year
Month
Day
15
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
16
Email
example@example.com
17
Cell phone number
Please enter a valid phone number.
18
Do you have an IP PINIf you answered yes then please answer the questions
YESNO
19
Can you be claimed as a dependent?
YESNO
20
Do you have dependent(s)?* This field is required.
YESNO
21
Additional Dependent Questionnaire
22
ARE YOU SELF EMPLOYEDIF YES PLEASE EXPECT TO RECIEVE A LINK FOLLOWING SUBMISSION FOR SELF EMPLOYED INDIVIDUALS.
YESNO
23
What Method of refund would you prefer?* This field is required.
Paper check
Direct Deposit
24
Direct deposit form
Bank Name
Routing number
Account number
25
Acknowledgements* This field is required.I (We, if filing jointly) acknowledge that the above information provided by me is true and accurate to the best of my knowledge. I hereby relieve HIM Tax Pros and its agents and affiliates from any liability whatsoever, regarding the preparation of this/these tax returns, and agree to hold harmless from any damages I may suffer and understand that my sole relief is limited to the return of any fee paid for the preparation of these tax documents. I (we) guarantee payment of the preparation fee and any related charges.
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26
Please Upload Front of Taxpayer Id* This field is required.
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Max. file size: 10.6MB
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27
Please Upload Back of Taxpayer Id
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Max. file size: 10.6MB
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28
Please Upload A Photo Of You Holding Your ID:* This field is required.
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Max. file size: 10.6MB
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29
Please Upload Taxpayer Social
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Max. file size: 10.6MB
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30
Please Upload Your IRS Compliance Report:* This field is required.
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Max. file size: 10.6MB
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31
Please Upload Your Healthcare Form:
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Max. file size: 10.6MB
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32
Please Upload W-2's
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Max. file size: 10.6MB
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33
Please Upload 1099
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Max. file size: 10.6MB
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34
Please Upload Dependent(s) Social, Birth Certificate and/ or Any Supporting Dependent(s) Documentation
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Select files to upload
Max. file size: 10.6MB
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35
Please Upload Other Required Documents
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Max. file size: 10.6MB
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36
1. I/ We certify that the child(ren) for whom the tax credit(s) will be requested can be claimed as my/ our dependent(s), as per the information provided at the end of this questionnaire.:* This field is required.
Please Select
Please Select
YES
NO
N/A
37
2. The child(ren) for whom the tax credit(s) will be requested lived with me/us for the year, except for temporary absences:* This field is required.
Please Select
Please Select
YES
NO
N/A
38
3. I am the custodial parent of the child(ren) for whom the tax credit(s) will be requested, and I released the dependency deduction to my former spouse for 2026 by signing Form 8332 (Release/Revocation of Claim to Exemption for Child by Custodial Parent).* This field is required.
Please Select
Please Select
YES
NO
N/A
39
4. I am not the custodial parent of the child(ren) but I have been given a signed Form 8332 by my former spouse, the custodial parent, allowing me to claim the child(ren) as the dependent(s) on my 2025 tax returns (you must give me the Form 8332.* This field is required.
Please Select
Please Select
YES
NO
N/A
40
5. I/we, or my child(ren), have documentation to substantiate the credit(s) being claimed, such as Form 1098-T, bills, statements, and receipts for college tuition, fees, and book and material costs (you are responsible for keeping this documentation and providing it to the IRS if you are audited or questioned):* This field is required.
Please Select
Please Select
YES
NO
N/A
41
6. Was a Child Tax Credit, Additional Child Tax Credit, or American Opportunity Credit claimed by you disallowed or reduced by the IRS on a past tax return?* This field is required.
Please Select
Please Select
YES
NO
N/A
42
7. I claim I am unmarried or separated, support a qualifying person as your dependent, and pay more than half the cost of maintaining your household.:* This field is required.
Please Select
Please Select
YES
NO
N/A
Should be Empty: