Tax Preparation Client Intake Form
How did you hear about us?
Client Referral
Catrina's Returning Client
Sabina's Returning Client
Facebook
Radio Ad
Instagram
Tik Tok
Google Search
Other____________________________________________
Filing Status
*
Single
Head of Household
Married Filing Separate
Married Filing Joint
Qualifying Widower
Taxpayer Information
Name
*
First Name
Last Name
Age
*
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
*
SSN
*
Are you a full-time student?
Yes
No
Are you totally and permanently disabled?
Yes
No
Are you legally blind?
Yes
No
Can you or your spouse be claimed as a dependent by another taxpayer?
Yes
No
Spouse Information
Name
First Name
Last Name
Age
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
SSN
Are you a full-time student?
*
Yes
No
Do you want to apply for a refund advance loan?
Yes
No
Are you totally and permanently disabled?
*
Yes
No
Are you legally blind?
*
Yes
No
Dependents
Do you have any Dependents
*
Yes
No
Enter your dependents here
Name
SSN
Date of Birth
Relationship
1
2
3
4
5
6
Tax Related Questions
Employment Status
*
Employed
Unemployed
Self-employed
Self Employment Worksheet
*
Company Information
1 Company Name
2 Type of Business
3 Business Phone
4 Business Address
5 Are you own 100% of this company
6 EIN
7 Total Revenue (Sales)
8. Total Expenses
9. Entity Type (LLC, Sloe Proprietor, S Corp, C corp etc
Does your dependents have tuition expenses?
*
Yes
No
Do you have any expenses for child care?
*
Yes
No
Do you have your own home?
Yes
No
Do you have documents that shows you paid for property taxes?
Yes
No
Did you sold any stock?
Yes
No
Did you take money from your 401?
Yes
No
Did you pay for vehicle tax?
Yes
No
Do you have mortgage interest?
Yes
No
Do you have real estate tax?
Yes
No
Did you receive a federal tax last year?
Yes
No
Are you a victim of identity theft?
*
Yes
No
Expenses
Please fill-up the information within the current year only.
General Expenses
Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses
Total Expenses
How would you like to pay for your tax preparation?
*
Deduct from Refund
Zelle
Debit Card/ Card Card
How would you like to receive your refund?( If Applicable)
*
Direct Deposit
GreenDot Debit Card
Cashiers Check
Routing Number
Account Number
Additional comments
Acknowledgment & Signature
I confirmed that all information I entered here is accurate and true.
I allow Tax Advantages to capture my sensitive data like personal id, government id, social security number (SSN), and other information.
I have read the terms and conditions and privacy policy of Legacy Tax Solutions.
By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Date Signed
-
Month
-
Day
Year
Date
Taxpayer Signature
Date Signed
-
Month
-
Day
Year
Date
Spouse Signature
Upload Tax Documents , Identification and Social Security Cards
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Print
Continue
Continue
Should be Empty: