• 8063 Madison Avenue #1263 Indianapolis, IN 46227

    8063 Madison Avenue #1263 Indianapolis, IN 46227

    (317) 560-4367 Info@mastersofthebookstaxservices.com

  • CLIENT INTAKE FORM

    Please take a moment to fill out the form with all applicable information. This form should ONLY be submitted AFTER speaking with your tax preparer, please DO NOT complete before.

  • Client Information:

  • Format: (000) 000-0000.
  • Date of Birth*
     - -

  • Spouse information

  • Date of Birth
     - -
  • Format: (000) 000-0000.
  • Filing Status:*

  • Dependent information:

  • Date of Birth
     - -
  • Date of Birth
     - -
  • Date of Birth
     - -

  • IF YOU ARE CLAIMING A DEPENDENT, PLEASE ANSWER THE QUESTIONS BELOW THAT PERTAINS TO YOUR DEPENDENT RELATIONSHIP. PER THE IRS REQUEST, WE MUST PROVE THAT NOBODY ELSE IS ELIGIBLE TO CLAIM YOUR DEPENDENT BUT YOURSELF.

  • If claiming Adopted child, can you submit documentation to support this?
  • Did you pay someone to watch your child/children?*
  • Did you collect social security or retirement income?*
  • Did you purchase health insurance through healthcare.gov marketplace (Obama Care)?*
  • If yes, did you receive a 1095-A Form from the marketplace?
  • Were you ever disallowed the E.I.T.C prior to this year?*

  • Income information:

  • Did you receive unemployment compensation (1099-G) last year?*
  • Did you make college tuition payments and received a 1098-T Form last year?*
  • Do you have any other income other than your w-2(s)?*
  • Do you owe any delinquent:*

  • Additional Services:

    *Services listed are done through a referral with a 3rd pary
  • Please select all additional services you are needing if any.*

  • Bank Information

    Please know bank information is needed in order to have your refund sent through direct deposit

  • By signing I, hereby, state that all the information above is true to the best of my knowledge and that I am allowing Masters of the Books Tax Services & Partners to prepare my taxes based on that fact.

    I understand that I am financially responsible for any outstanding balance due to any false information given.

    I agree that if requested from the IRS I am able to provide any documentation that supports the information provided above that was entered on my tax return.

    If there is a balance due, I agree to pay the tax preparation fee upfront. If for any reason i owe an entity and they take the entire refund, i agree that i am STILL responsible to pay the tax preparation fee for services rendered.

    I agree that if for any reason an amendment has to be filed with no fault of the tax preparer, i will pay the required fee of $150.00 which is required.

     

  • Date signed:*
     / /
  • Should be Empty: