L & R Tax Preparation Client Intake Form
  • Tax Preparation Client Intake Form

    PLEASE READ CAREFULLY: Please complete all questions on this form. If a question does not apply to you, mark “No.” Read each question thoroughly and provide accurate and truthful responses. Once all questions have been answered, please review the terms and conditions and submit your completed form. After we receive your intake form, it will be reviewed, and we will contact you within 24 hours. Please be prepared to participate in a phone interview when contacted. If you do not hear from us within the stated timeframe, you may call our office for assistance. New Clients: Please attach a copy of your most recent tax return. ⚠️ Important Notice: This form is NOT for estimates. DO NOT complete this form to request an estimate. For estimates, please call our office directly. We appreciate your business and look forward to serving you.
  • Filing Status
  • Have you ever been married?
  • What year are you filing?
  • Wil this be an Amendment?
  • Are you applying for the Refund Advance Loan?
  • If you are applying for the REFUND ADVANCE LOAN, is the email you're sending this form from a good contact email?
  • Did you receive, sell, or exchange, give, or otherwise dispose of a digital asset?
  • What is the best way to contact you?
  • Who referred you to our location?
  • Are you a NEW or CURRENT CLIENT?
  • Do you have ALL your tax documents to avoid an amendment?
  • Do you have ANY outstanding balances with the Federal or State Agency?
  • Did you or your spouse receive Unemployment Benefits?
    • Taxpayer Information 
    • Date of Birth
       - -
    • Format: (000) 000-0000.
    • Are you a full-time student?
    • Are you totally and/or permanently disabled?
    • Are you legally blind?
    • Are you married?
    • Spouse Information 
    • Date of Birth
       - -
    • Format: (000) 000-0000.
    • Is your spouse a full-time student?
    • Is your spouse totally and/or permanently disabled?
    • Is your spouse legally blind?
    • How long have you and your spouse been married?
    • Dependents 
    • Rows
    • Rows
    • Did anyone receive a 1095-A form? (Marketplace)
    • Tax Related Questions 
    • Employment Status
    • Are you or your spouse reporting business income? (Self-employed, Contractor, or any other business)
    • Did you or your spouse received a W-2(s), 1099(s) or any reporting income?
    • Are you the custodial parent?
    • Did the child/children live with you for the full year?
    • Can your chid/children be claimed as someone else dependent?
    • Are you listed as the child/children legal guardian on school records, medical records, daycare records, etc. ?
    • Do/did you share custody of the child/children?
    • Do you provide more than half the cost of keeping up with the home?
    • Does anyone help you with the child/children?
    • Do your child/children have a disability?
    • Can you or your spouse provide any document to show your relationship status to the child? (Birth or marriage certificate, authorized adoption letter, or any social service agency)
    • Can you or your spouse provide the IRS with receipts and bills substantiating the cost of maintaining more than half of the cost of home? (Utility bills, grocery receipts, rent receipts etc.)
    • Did you or your spouse receive any nontaxable support/income? (Family support, food stamps, housing assistance, childcare assistance, etc.)
    • Do anyone else live in your home that you have NOT listed?
    • Did you, your spouse, or dependents have tuition expenses?
    • Did you, your spouse, or dependents received a 1098-T form?
    • Are you claiming a dependent under the age 13?
    • Do you have any expenses for childcare?
    • Are you currently renting?
    • Do you own your home?
    • Do you have documents that show you paid for property taxes?
    • Did you sell any stock?
    • If you sold stock, did you receive a 1099-B?
    • Did you borrow or withdrawn money from your 401K?
    • If you borrow or withdrawn money from your 401K, did you receive a 1099-R?
    • Are you contributing to 401K or other pre-tax account?
    • Did you pay your vehicle tax?
    • Do you have mortgage interest? (Form 1098)
    • Do you have real estate tax?
    • Did you receive a federal refund last year?
    • If you received a federal refund last year, did you get the full refund or partial?
    • Do you have any outstanding debt with the IRS, CHILD SUPPORT, STUDENT LOANS, or your STATE?
    • If you answered "YES" to the above question, please list which debt you have.
    • Have you ever been disallowed for any credits in the previous years? (Earn Income, Child Tax Credit, etc.)?
    • Do/did you receive ANY government assistance? (Unemployment, 1098E, etc.)
    • Are you a victim of identity theft?
    • Are you, your spouse, or dependents required to submit an IP PIN?
    • Do you want to add AUDIT PROTECTION for a fee of 99.00?
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    • Expenses 
    • Please FILL-IN the information with the current year expenses ONLY.

    • Rows
    • Rows
    • Do you have an EIN?
    • Do you have your business register with your Secretary of State?
    • How long have you been in business?
    • Do you have a business bank account?
    • If you answered "NO" to the above question, how do you keep records of your business income?
    • Who maintains your business records?
    • Did you pay anyone to work for or with you?
    • Will you be issuing a 1099-NEC to anyone?
    • Did you receive a 1099-NEC?
    • Have you file this business before?
    • Do you travel for business?
    • Do you have receipts to show proof of your expenses?
    • Do you have a PROFIT and LOSS STATEMENT?
    • Would you like assistance with setting up your business for an additional fee? (Tax Professional will discuss during phone interview.)
    • Would you like to add Bookkeeping to your service for an additional fee? (Tax Professional will discuss during phone interview.)
    • Once your application is received, one of our team members will contact you by phone or video to complete the tax preparation process. Do you give us permission to contact you?
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    • Acknowledgment & Signature 
      • I confirmed that all information I entered on this form is accurate and true.
      • I understand this is NOT an Estimate and information above is enter to have my services prepared and E-file by L & R Tax Services LLC.
      • I allow L & R TAX SERVICES LLC 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 L & R TAX SERVICES LLC.

      • By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.

      Client Acknowledgment and Terms & Conditions

      I understand that if the information I provide is incorrect, incomplete, or inconsistent, my tax return may be subject to an audit by the IRS or another government agency. In the event of an audit, I understand that I am responsible for providing any requested documentation to support my tax return.

      I understand that it is imperative that I retain all tax records for at least five (5) years after my return is filed or after the due date, whichever is later.

      I understand that I will receive a copy of my tax return by email or in printed form. If additional copies are requested, a $25.00 fee will apply.

      I understand that my tax preparer is not responsible for any delayed refund or refund offset. If I am claiming certain credits, including the Earned Income Credit (EIC) or Child Tax Credit (CTC), I acknowledge that my refund may not be released before February 15th or later, as required by law.

      I understand that I may check the status of my refund at www.irs.gov/wheresmyrefund. I further acknowledge that my tax preparer is not responsible for the amount, timing, approval, or issuance of my refund.

      If I applied for a refund advance loan, I understand that the lending bank will deduct the loan amount and any applicable interest or fees from my refund. I understand that my tax professional is not responsible for the approval or denial of any refund advance.

       

      Fees, Payments, and Financial Responsibility


      I agree to all charges processed and submitted through this form.

      I understand that if my refund is offset for any reason by a federal, state, or other government agency, I remain fully responsible for paying my tax preparer’s fees in full, along with any additional fees that may be incurred due to delayed payment.

      I acknowledge that L & R Tax Services LLC is a paid service, and all fees are due at the time of service. I understand that I may pay my fees directly to L & R Tax Services LLC using cash, card, or check, or through L & R Tax Services LLC’s selected bank option.

      If payment is made by check and the check is returned, I understand that a $75.00 returned check fee will apply. If I choose to pay through the bank option, I acknowledge that additional bank fees will be added to the service fee.

      I understand that all charges are assessed on a per-form basis. I further understand that L & R Tax Services LLC will not transmit or release any tax documents until payment has been made in full.

      If my return is transmitted using the bank payment option and my refund is offset or I owe a balance to any agency, I understand that I am fully responsible for paying the remaining balance, including interest.

      If my account remains unpaid or incomplete, I understand that legal action may be taken. In such cases, I agree to be responsible for all court costs, legal fees, and any additional fees incurred by L & R Tax Services LLC due to inconvenience.

       

      Due Diligence & Client Interview Acknowledgment


      I understand that this is a paid tax preparer/client interview. I acknowledge that my preparer is required by the IRS to complete a Due Diligence Interview, and that all information provided must be true, complete, and accurate.

      I understand that my responses may require follow-up documentation or clarification before my tax return can be filed and submitted.

      I understand that this service is not an estimate. If I decide not to proceed with L & R Tax Services LLC for any reason after services have begun, I agree to pay a $180.00 inconvenience fee for time spent reviewing and preparing my file.

      If the inconvenience fee is not paid, I understand that a daily penalty of up to $20.00 may apply for up to 30 days. After 30 days, I acknowledge that a maximum inconvenience fee of $1,000.00 may be assessed.

      I understand that all documents submitted on my behalf will be retained by L & R Tax Services LLC for recordkeeping purposes and to document the completion or inquiry of my tax return.

       

      Consent


      By signing below, I acknowledge that I have read, understood, and agreed to all terms and conditions outlined above. I further consent to L & R Tax Services LLC preparing and submitting my tax return on my behalf.

       

    • Date Signed
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    • Date Signed
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