Tax Preparation Onboarding Form

1
Who is your Tax Advisor?
Please Select
Please Select
Kimberly Talley
Harmony Coleman
Erika Petty
Erin Hamilton
Eniala Merritt
2
Are you a New or Returning Client
New
Returning
3
Do you want to see if you qualify for a cash advance?
Yes
No
4
Do you have an IP PIN?
Yes
No
5
If you have an IP PIN what is it?
6
Filing Status
Single
Head of Household
Married Filing Separate
Married Filing Joint
Qualifying Widower
7
Name
First Name
Last Name
8
SSN
9
Date of Birth
Date
Month
Day
Year
10
Phone Number
Please enter a valid phone number.
11
Email
example@example.com
12
Current Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
13
Occupation
14
Are you a full-time student?
Yes
No
15
Do you Receive SSI or SSA?
Yes
No
16
Are you legally blind?
Yes
No
17
Can someone else clam you as a dependent on their tax return?
Yes
No
18
Enter your dependents here
Name
SSN
Date of Birth
Relationship
1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
5
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
6
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Row 5, Column 3
1
2
3
4
5
6
Name
Row 0, Column 0
SSN
Row 0, Column 1
Date of Birth
Row 0, Column 2
Relationship
Row 0, Column 3
Name
Row 1, Column 0
SSN
Row 1, Column 1
Date of Birth
Row 1, Column 2
Relationship
Row 1, Column 3
Name
Row 2, Column 0
SSN
Row 2, Column 1
Date of Birth
Row 2, Column 2
Relationship
Row 2, Column 3
Name
Row 3, Column 0
SSN
Row 3, Column 1
Date of Birth
Row 3, Column 2
Relationship
Row 3, Column 3
Name
Row 4, Column 0
SSN
Row 4, Column 1
Date of Birth
Row 4, Column 2
Relationship
Row 4, Column 3
Name
Row 5, Column 0
SSN
Row 5, Column 1
Date of Birth
Row 5, Column 2
Relationship
Row 5, Column 3
1 of 6
19
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
Yes
No
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Row 0, Column 5
Row 0, Column 6
Spouse
Yes
No
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Row 1, Column 4
Row 1, Column 5
Row 1, Column 6
Dependent 1
Yes
No
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
Row 2, Column 4
Row 2, Column 5
Row 2, Column 6
Dependent 2
Yes
No
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
Row 3, Column 4
Row 3, Column 5
Row 3, Column 6
Dependent 3
Yes
No
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
Row 4, Column 4
Row 4, Column 5
Row 4, Column 6
Dependent 4
Yes
No
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Row 5, Column 3
Row 5, Column 4
Row 5, Column 5
Row 5, Column 6
Dependent 5
Yes
No
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Row 6, Column 3
Row 6, Column 4
Row 6, Column 5
Row 6, Column 6
Taxpayer
Spouse
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5
Yes/No
Yes
No
Row 0, Column 0
Employer
Row 0, Column 1
Spouse Ins
Row 0, Column 2
Exchange/ Marketplace
Row 0, Column 3
Direct with Insurer
Row 0, Column 4
Medicare
Row 0, Column 5
Medicaid
Row 0, Column 6
Yes/No
Yes
No
Row 1, Column 0
Employer
Row 1, Column 1
Spouse Ins
Row 1, Column 2
Exchange/ Marketplace
Row 1, Column 3
Direct with Insurer
Row 1, Column 4
Medicare
Row 1, Column 5
Medicaid
Row 1, Column 6
Yes/No
Yes
No
Row 2, Column 0
Employer
Row 2, Column 1
Spouse Ins
Row 2, Column 2
Exchange/ Marketplace
Row 2, Column 3
Direct with Insurer
Row 2, Column 4
Medicare
Row 2, Column 5
Medicaid
Row 2, Column 6
Yes/No
Yes
No
Row 3, Column 0
Employer
Row 3, Column 1
Spouse Ins
Row 3, Column 2
Exchange/ Marketplace
Row 3, Column 3
Direct with Insurer
Row 3, Column 4
Medicare
Row 3, Column 5
Medicaid
Row 3, Column 6
Yes/No
Yes
No
Row 4, Column 0
Employer
Row 4, Column 1
Spouse Ins
Row 4, Column 2
Exchange/ Marketplace
Row 4, Column 3
Direct with Insurer
Row 4, Column 4
Medicare
Row 4, Column 5
Medicaid
Row 4, Column 6
Yes/No
Yes
No
Row 5, Column 0
Employer
Row 5, Column 1
Spouse Ins
Row 5, Column 2
Exchange/ Marketplace
Row 5, Column 3
Direct with Insurer
Row 5, Column 4
Medicare
Row 5, Column 5
Medicaid
Row 5, Column 6
Yes/No
Yes
No
Row 6, Column 0
Employer
Row 6, Column 1
Spouse Ins
Row 6, Column 2
Exchange/ Marketplace
Row 6, Column 3
Direct with Insurer
Row 6, Column 4
Medicare
Row 6, Column 5
Medicaid
Row 6, Column 6
1 of 7
20
Employment Status/Check all that apply
W2
Unemployment Benefits
Self-employed
1099 MISC
1099 NEC
1099K
1099R
21
Are you contributing to 401k or other pre-tax accounts such as Mortgage Interest, 403B, IRA, HSA (health savings account), Insurance?
Yes
No
22
If yes to previous question do you have your 1099/1098 INT forms yet?
Yes
No
23
Please select what state return are you requesting?
State return
Property Tax Credit/Circuit Breaker
Lived in Another state
Worked in another state
Lived in 2 states in tax year
24
Do your dependents have tuition expenses?
Yes
No
25
Did the tuition expense dependent receive a 1098T form?
Yes
No
26
Do you have any child care expenses?
Yes
No
27
What is your monthly childcare expenses?
28
Are you currently renting and use your home as a home office?
Yes
No
29
What is the monthly rental amount?
30
Do you have mortgage interest?
Yes
No
31
Do you have documents that shows you paid for property taxes?
Yes
No
32
Did you sell any stock/cryptocurrency/Gains or Losses/Form 1099-B?
Yes
No
33
Did you pay for vehicle tax, or do you have a vehicle that you use to conduct business?
Yes
No
34
If you answer yes to the above question- What is the Year/Make/Model and total miles used for business purposes?
35
Do you have real estate tax?
Yes
No
36
Did you receive a federal tax refund last year?
Yes
No
37
Do you have to complete ID Verification for the release of your prior year's taxes?
Yes
No
38
Please fill out the information with the current year and if applicable only.
39
General Expenses
Amount
Medical Expenses
Row 0, Column 0
Dental Expenses
Row 1, Column 0
Supplies
Row 2, Column 0
Cell Phone
Row 3, Column 0
Home Office Square Footage
Row 4, Column 0
Cash Contributions
Row 5, Column 0
Non-Cash Contributions/ item donations<br>
Row 6, Column 0
Unreimbursed Business Expenses
Row 7, Column 0
Cost of NEW Car/Computer/ Equipment
Row 8, Column 0
Tax Preparation Fees
Row 9, Column 0
Investment Expenses
Row 10, Column 0
Medical Expenses
Dental Expenses
Supplies
Cell Phone
Home Office Square Footage
Cash Contributions
Non-Cash Contributions/ item donations<br>
Unreimbursed Business Expenses
Cost of NEW Car/Computer/ Equipment
Tax Preparation Fees
Investment Expenses
Amount
Row 0, Column 0
Amount
Row 1, Column 0
Amount
Row 2, Column 0
Amount
Row 3, Column 0
Amount
Row 4, Column 0
Amount
Row 5, Column 0
Amount
Row 6, Column 0
Amount
Row 7, Column 0
Amount
Row 8, Column 0
Amount
Row 9, Column 0
Amount
Row 10, Column 0
1 of 11
40
Total Expenses
41
Please Upload Current (unexpired) ID Driver's License or State ID/SSN cards OR Birth Certificates for all dependents/ Proof of Residences/ 1098T/ 1099s/ Banking Information* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
42
Additional comments
43
I confirmed that all information I entered here is accurate and true.

I allow TMC Life Restoration LLC to capture my sensitive data like personal id, government id, social security number (SSN), and other information to use to file my tax return/s.

I have read the terms and conditions and privacy policy of TMC Life Restoration LLC.

By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing your tax return/s.
44
Tax Preparation Fees
prevnext( X )
Description
USD
+ OR enter a custom value
Payment Methods
Credit Card
First Name
Last Name
Cash App
After submitting the form, you will be redirected to the Cash App Pay to complete the payment process.
Google Pay
After submitting the form, you will be redirected to the Google Pay to complete the payment process.
Apple Pay
After submitting the form, you will be redirected to the Apple Pay to complete the payment.
ACH Bank Transfer
Account Holder Name
Afterpay
After submitting the form, you will be redirected to the Afterpay to complete the payment process.
45
Date Signed
Date
Month
Day
Year
46
Taxpayer Signature
Powered by Jotform SignClear
47
Banking Information: Bank Name. 9-digit Routing Number and Full Account Number:
Should be Empty: