Blue Wave Tax & Services Intake Form
Financial Services
Filing Status
Single
Head of Household
Married Filing Separate
Married Filing Joint
Qualifying Widower
Taxpayer Information
Name*
First Name
Last Name
SSN*
Date of Birth*
-
Month
-
Day
Year
Date
Phone Number*
Please enter a valid phone number.
Format: (000) 000-0000.
Email*
example@example.com
Address*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation*
Are you a full-time student?*
Yes
No
Are you interested in a cash advance up to $7,000?
*
Yes
No
Do you or dependents have an identity pin?
*
Yes
No
Spouse Information
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
SSN
Please enter a valid social security number.
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
Are they a full-time student?
Yes
No
Dependents
Enter your dependents here ( A dependent is someone who relies on another person for financial support, such as housing, food, clothing, necessities, and more. Typically this includes your children or other relatives, but it can also include people who aren't directly related to you, such as a domestic partner.)
Rows
Name
Date of Birth
Relationship
Social Security Number
1
2
3
4
5
6
In the case of audit can you prove financial responsibility and residency for any of the dependents being claimed?*
Yes
No
Can any of your dependents be claimed by anyone else?*
Yes
No
Are any of the dependents being claimed disabled? Please list the nature of the disability. Does the dependent receive social security benefits? If so, what type?*
Are any of the dependents listed on this return not your biological son or daughter? If yes, why are parents not claiming the child?*(Please explain and list the child's name(s) if more than one is listed on the return).
Did you pay facility (daycare or after school program) or someone to keep your child or children? (13 & under)
Please Select
Tax Related Questions
Employment Status*
Employed
Unemployed
Self-employed
Did you receive any payments from a 3rd party companies? FORM 1099 NEC ( Cashapp, Zelle, PayPal,Square, Lyft, Uber, Door dash, or Uber-eats)*
Yes
No
Other
Was your income less than 20,000 this year?*
Yes
No
Were you or your dependent enrolled in college and received a 1098-T?*
Yes
No
Did you collect social security retirement income?*( If so please have documents ready).
Yes
No
Do you owe any federal agency's?* To find out call 1-800-304-3107 ( child support, federal or state taxes, student loans, etc.)
Yes
No
Schedule C- Business Income & Expenses
Complete this section if you are self-employed. Enter annual totals.
Did you have self-employment or 1099 income in 2025?*
Yes
No
Do you plan on purchasing a home in the next 2 years?*
Yes
No
How would you like to receive your refund?*
Please Select
Check
Debit Card
Direct Deposit
The IRS issues more than 9 out of 10 refunds in less than 21 days. However, it's possible your tax return may require additional review and take longer. Mailed in refunds usually take up to six weeks.
Are you the owner of this bank account?* ( NO CASHAPP ACCOUNTS)!
Yes
No
Are you applying for the advance?*
Yes
No
Did anyone refer you? If so by who?*
Acknowledgment & Signature
I confirmed that all information I entered here is accurate and true.
I allow Blue Wave Tax & Credit Services Financial to capture my sensitive data like personal id, government id, and other information.
I have read the terms and conditions and privacy policy of Blue Wave Tax & Credit Services Financial.
By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
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Taxpayer ( and spouse if applicable) : Unexpired Drivers License, State ID, Passport + Social Security Card or Birth Certificate. Filing Status Head of Household: Lease or Utility Bill. Dependents: Birth Certificate + Social Security Card. Income: W2, 1099, Quickbooks, 1098T, etc. Childcare: End of Year Statement. Market Place Insurance: 1095A. ETC.
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Taxpayer Signature
Date Signed
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Spouse Signature
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