UpScore Tax

Thank you for choosing to file with Upscore Financial.

We are eager to serve you! Please complete the intake form to the best of your ability. If you have any questions or need any assistance, please don't hesitate to reach out via email to UpscoreFinancial@gmail.com

CHOOSE YOUR TAX PREPARER

FILING STATUS

Name

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Please provide Social

Please provide Date of Birth

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Do you have an IP PIN? If So Please Provide

Select All That Apply

Upload TaxPayer ID

Upload TaxPayer Social Security Card

Name

First NameLast Name

Date Of Birth

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Select All That Apply

Upload Spouse ID

Upload Spouse Social Security Card

Please Type Dependent (1)

First NameLast Name

Date Of Birth .

Please Provide Social Security Number

Dependent (1) Relationship To Tax Payer

Select All That Apply

Upload Birth Certificate Dependent (1)

Upload Social Security Card Dependent (1)

Please Type Dependent (2)

First NameLast Name

Dependent (2) Date Of Birth

Dependent (2) Social Security Number

Dependent (2) Relationship To Tax Payer

Upload Birth Certificate Dependent (2)

Upload Social Security Card Dependent (2)

Please Type Dependent (3)

First NameLast Name

Dependent (3) Date Of Birth

Dependent (3) Social Security Number

Dependent (3) Relationship To Tax Payer

Select All That Apply

Upload Birth Certificate Dependent (3)

Upload Social Security Card Dependent (3)

Does You, Your Spouse, and Your Dependents Have Health Insurance Within 12 Months Last Year? If Yes, Who Covers For It?

If Anyone, Attended College Please Upload 1098 T Documents

Do You Have Any Expenses For Child Care?

Please Upload Day Care Invoice

Do You Own You Home?

Please Upload Property Tax Documents

Select All That Apply

Are You Interested In Credit Repair?

Did You Receive Any W2's?

Please Upload 1099 -R, 1099 - INT Or Any Other Supporting Documents

Please Provide Bank Name

Please Provide Bank Information (Account Number)

Please Provide Bank Information (Routing Number)

Business Name

Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

EIN

Upload Any 1099's And Other Business Income Documents

Upload Profit & Loss Statement

Would You like to Add 4 Months Of credit repair for $299? It can be paid from your refund

By Signing this form. I achnowlege and confirm the following:

Accuracy of Information: I have provided accurate, complete, and truthful information to the best of my knowledge. I understand that it is my responsibility to ensure the accuracy of the details I have provided in this form and any supporting documents.

Tax Liability: I understand that it is my responsibility to pay any taxes owed to the IRS or state taxing authorities. I acknowledge that the tax preparer cannot guarantee any specific tax outcomes or refunds.

Electronic Filing: I consent to the electronic filing of my tax return, if applicable, and understand that I will receive an electronic copy of my tax return and supporting documents.

Fees And Payments: I acknowledge that I am responsible for paying any agreed - upon fees for tax preparation services, which may include preparation fees, filing fees, and other charges associated with the preparation of my tax return.

IRS Communication: I authorize UpScore Financial to communicate with the IRS or state tax authorities on my behalf regarding the preparation and submission of my tax return, if necessary.

Retention Of Documents: I understand that my tax documents may be retained for the duration required by law and that I can request copies of my tax return or any related documents at any time.

Date Signed

Date

Tax Payer Signature

2025 - 2026 TAX CLIENT INTAKE FORM

TAX PAYER INFORMATION

SPOUSE INFORMATION

DEPENDENTS

TAX RELATED QUESTIONS

INCOME

SELF EMPLOYMENT

ACKNOWLEDGMENT & SIGNATURE

THANK YOU FOR CHOOSING UpScore FINANCIAL