2025 Tax Preparation Client Intake Form

Tax Preparation Client Intake Form

Please complete each field to the best of your ability before submitting to your tax professional.
PLEASE READ THE FOLLOWING IN ITS ENTIRETY BEFORE SUBMITTING YOUR INFORMATION.

Thank you for taking the time to complete your 2025 tax intake form for the tax year 2024. This information is critical to ensure your tax return is filed accurately. Please ensure your information is entered correctly so we can ensure our records are 100% correct.

This intake form may take 20-30 minutes to complete.

Please be sure to gather all of your documents prior to completing this form.

Note: If you are claiming any dependents, be sure to upload their SS CARDS, BIRTH CERIFICATES, and proof of address for dependents (school records, medical records, social services records, or lease).

Please be sure to hit submit to ensure the form is sent to us. If you close the browser before doing so, the information will be deleted and need to be re-entered.

If you choose not to proceed with the filing of your tax return after we have started the preparation process, a $100 fee will be charged to cover the time and resources spent on your return. This fee must be paid immediately. We appreciate your understanding and cooperation. If you have any questions regarding this policy, please let us know before we begin your tax preparation.

SOME OF THE QUESTIONS MAY NOT APPLY TO YOUR TAX SITUATION. IT IS OKAY TO SKIP QUESTIONS THAT DO NOT APPLY.
Select your tax professional.*
New or existing client?*
How did you hear about us?*
Name of person who referred you if any!
What tax year(s) are you filing?*

2024202320222021
Do you owe the IRS, Child Support, or are you in default with Student Loans?
IF YOU ARE NOT SURE IF YOU HAVE ANY PAST DUE TAX DEBTS PLEASE CONTACT THE IRS HOTLINE 1-800-304-3107.

PLEASE BE MINDFUL THAT TAX DEBTS ARE ADDED TO THE DATABASE DAILY.

Spouse Information
Name

First NameLast Name
Spouse SSN
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
Are they a full-time student?

YesNo
Are they totally and permanently disabled?

YesNo
Are they legally blind?

YesNo
Upload a photo ID, drivers license, or passport.

Cancelof

Dependents
Do you have any dependents?
If requested by the IRS, do you have documentation (receipts/records/etc.) to substantiate your eligibility for any applicable credits and/or head of household filing status?
Type yes or no
If the dependent you are claiming is not your child why is the parent not claiming them?

Does you, your spouse, and your dependents have health insurance within 12 months last year? If yes, who covers for it?

	Yes/No	Employer	Spouse Ins	Exchange/ Marketplace	Direct with Insurer	Medicare	Medicaid
Taxpayer
Spouse
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5

Did you pay any child or dependent care expenses this past year for a child under the age of 13 years old, or costs to care for a handicapped individual? If yes, please complete the following fields in the table below:

YesNo

Upload supporting dependent, and dependent care documents. (Example: Birth certificate, ss cards, school records, childcare statements)

Cancelof

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
Additional comments

Business Information
Please complete this section if you received a 1099-NEC, 1099-MISC., 1099-K, or own a small business. Examples include: Babysitter, Hair Stylist, Barber, Landscaper, Content Creator, Nail Tech, Uber/Lyft Driver, Truck Driver, Makeup Artist, Event Planner, Lash Tech, Entertainer
Date you started your business?

MonthDayYear
Date
Did you materially participate in this business this past year?

YesNo
Did you pay estimated taxes last year?

YesNo
Do you have records to support your business expenses?

YesNo
Did you use your vehicle for your business last year? If yes, please explain usage
Do you have written evidence to support your vehicle expenses?

YesNo
How many clients do you service on the average monthly?
What services do you provide?
Upload supporting business documents. (Example: Business cards, EIN letter, income statements, receipts, mileage logs).

Cancelof

Banking Information
Do you need credit repair? Our credit blast can get you results in less than 30 days, and for being our client you get the discounted price of $499. The fee will be deducted from your refund. Would you like to sign up?*

Yes, Sign me up!No, I have a 700 credit score
How would you like to receive your refund?

Direct DepositCheckPrepaid Card
Bank Name
Account Number
Routing Number
Would you like to apply for an advance loan up to $7000?*

YesNo

Acknowledgment & Signature
By signing this form, you agree to the following:

I acknowledge that to the best of my knowledge, the information provided to Premium Financial Advisors in this client intake form is true and accurate and includes all information necessary for the preparation of my income tax returns for which I have adequate records. I certify that I would like my taxes prepared using the information I have provided on this form to my tax preparer.

CLIENT NON-PAYMENT/OFFSET CLAUSE

Furthermore, I acknowledge by signing this form that if I and/or my spouse owes a federal debt such as child support, student loans, IRS, etc that I/we are still responsible for the tax preparation and filing fees due to Premium Financial Advisors I understand that if I decide to have my tax preparation fees taken from my refund and my taxes are intercepted for whatever reason, I am still responsible for my tax preparation fees. By signing, I am agreeing to pay the preparation fee regardless of if my refund is received or not. I understand that if the tax preparation fees are not paid to Premium Financial Advisors within 90 days of my scheduled refund date, the fee will be debited from my bank account or my account will be sent to collections and I will no longer be able to do business with Premium Financial Advisors until balance is paid in full.

PLEASE BE ADVISED THAT ONCE THIS FORM IS SUBMITTED YOU WILL RECEIVE A EMAIL NOTIFICATION TO CONFIRM THE EMAIL ON FILE FROM PREMIUM FINANCIAL ADVISORS. PLEASE CONFIRM THIS EMAIL TO ENSURE YOU RECEIVE FUTURE EMAIL CORRESPONDENCES AND REFUND UPDATES.

PLEASE CHECK SPAM TOO!!

FORMS WITH MISSING IDENTIFYING DOCUMENTS WILL BE DENIED.
As a part of the tax form completion process, we request that you upload a recent selfie. This additional measure is implemented to prevent fraud and enhance the overall security of your tax filing. Your cooperation is appreciated in ensuring the accuracy and authenticity of the provided information. Please upload your selfie.*

Please upload your selfie.
Cancelof
Please include any other information, questions, or comments for your tax professional.
Date Signed

MonthDayYear
Date
Taxpayer Signature

Clear
Date Signed

MonthDayYear
Date
Spouse Signature

Clear
Should be Empty:

	Dependent Name	Date of Birth	Relationship	SSN	Number of Months Lived with you?	Full-Time Student Yes or No?
1
2
3
4

	Name of Provider	Provider Address	Provide EIN or SSN	Amount Paid
1
2