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2026 Lux Business Firm Intake Form
!!ONLY COMPLETE THIS FORM IF YOU HAVE ALL YOUR TAX DOCUMENTS!!
Demographics
Which Tax Expert Are You Looking For?
*
Shae Jordan
Tiffany Wallace
Ashley Heard
Any Agent
Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
Cell Phone Carrier
*
Email Address
*
Date Of Birth
*
-
Month
-
Day
Year
Occupation
*
Social Security Number
*
Physical Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Filing Status
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Single
Head of household
Married/Filing joint
Married/Filing single
Widow
Spouse Information
Spouse Name
First Name
Last Name
Spouses date of birth
-
Month
-
Day
Year
Spouses Phone Number
Format: (000) 000-0000.
Spouses Cell Phone Carrier
Spouses Email Address
Spouses Occupation
Additional Questions:
Do you or any dependents have an identity PIN?
*
Yes
No
What is it? and who do it belong to?
Spouse Information end
Income
Select the type of income you received in 2024
*
W2 / Wages Income
1099NEC / Contractor Income
1099k Self-Employment Income
1098T Filer (College Credit)
Cryptocurrency
1099G- Unemployment Income
Household Income (ex: Nanny/Home Health)
Interest Income (1099INT, 1099DIV)
Self-Employment Income
What was your total income this year?
*
Did you receive payments from third-party companies? (Cash app, Zelle, PayPal etc.)
*
Yes
No
Was your income less than $20,000?
*
Yes
No
How were you able to financially manage?
Did you receive assistance from the state, received assistance from children's other parent, friends and family assisted, etc.
Choose one
*
Rows
Yes
No
Did you purchase marketplace (Obama Care) health insurance?
Were you or your dependent enrolled in college and received a 1098-T?
Did you collect social security retirement income?
Are you ONLY self-employed?
Do you plan on purchasing a home in the next 2 years?
Do you owe any federal agencies (e.g., child support, federal/state taxes, student loans)?
*
Yes
No
For More Informachtion, Call
1-800-304-3107
How many people live with you?
*
Did anyone help support you through the year?
*
Yes
No
List the amount and source
*
Dependents
Do you have any dependents?
*
Yes
No
Dependent Details
Additional Questions:
Rows
Yes
No
In the case of audit can you prove financial responsibility and residency for any of the Dependents being claimed?
Can your dependent be claimed by anyone else?
Were you ever disallowed to the EITC prior to this year?
Are any of the dependents disabled?
Yes
No
Nature of the disability and whether they receive Social Security benefits. Specify the type of benefits.
*
Are any of the dependents not your biological child?
Yes
No
Why are the parents not claiming the child?
*
Childcare
Did you pay facility (daycare or after school program) or someone to keep your child or children?
Yes
No
If you paid an individual, let us know a little more information
Provider/Facility Name
Phone Number
Format: (000) 000-0000.
Social Security Number or EIN
Amount Paid
Refund Questions
How would you like to receive your refund?
*
Check
Debit Card
Direct Deposit
Provide your bank details for Direct Deposit:
Retype Bank Details (for confirmation):
Are you the owner of this bank account?
Yes
No
Are you applying for the advance?
*
Yes
No
Were you referred to our services?
*
Yes
No
By Who?
*
Upload ALL Tax Documents
*
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