Client Intake Form

Client Intake Form

Tax Prep
Which tax year are you filing?
How did you hear about Wellington Group?
What is your preferred method of contact?
Taxpayer Information

Enter your legal name EXACTLY as it appears on your Social Security card.
Legal First Name
Middle Name/Initial
Legal Last Name
Social Security Number
Date of Birth

MonthDayYear
Date
Occupation/Job Title
Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Driver's License Number
Driver's License State
Driver's License Expiration Date

MonthDayYear
Date
Mailing Address
Street Address
Apt/Unit # (if applicable)
City
State
ZIP Code
Check all that apply to YOU:
Spouse Information

Complete this section ONLY if filing jointly with a spouse. Leave blank if filing single.
Are you filing jointly with a spouse?
Spouse's Legal First Name
Spouse's Middle Name/Initial
Spouse's Legal Last Name
Spouse's Social Security Number
Spouse's Date of Birth

MonthDayYear
Date
Spouse's Occupation
Spouse's Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Spouse's Driver's License Number
Spouse's Driver's License State
Check all that apply to SPOUSE:
Filing Status
Select your filing status:
Did any of the following occur in 2025?
Dependents (Maximum 2)

List ALL dependents you will claim. You MUST upload Social Security cards for ALL dependents in Section 7.
How many dependents will you claim? (Enter 0 if none)
Dependent #1
Dependent 1 - Full Legal Name
Dependent 1 - Social Security Number
Dependent 1 - Date of Birth

MonthDayYear
Date
Dependent 1 - Relationship
Dependent 1 - Months lived with you in 2025
Dependent #2
Dependent 2 - Full Legal Name
Dependent 2 - Social Security Number
Dependent 2 - Date of Birth

MonthDayYear
Date
Dependent 2 - Relationship
Dependent 2 - Months lived with you in 2025
Income Information

Check ALL that apply to your 2025 tax situation.
Employment & Wages
Self-Employment & Business
If self-employed, what is your business name?
If self-employed, what type of business/service?
Other Income
Deductions & Credits

Check ALL that apply to your 2025 tax situation.
Homeownership
Education
Childcare & Dependents
Charitable & Retirement
Prior Year & Estimated Payments
Document Uploads

⚠️ IMPORTANT: Upload clear photos or scans of ALL documents. Accepted formats: PDF, JPG, PNG
📎 Driver's License

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📎 Social Security Cards (Self, Spouse and All Dependents)

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Income Documents
📎 W-2 Forms (all employers)

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📎 1099 Forms (all types - NEC, MISC, INT, DIV, R, G, SSA, K)

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📎 Stock/Investment Forms (1099-B, K-1, brokerage statements)

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Deduction Documents
📎 Mortgage Forms (1098)

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📎 College/Education Forms (1098-T, 1098-E, 529 statements)

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📎 Childcare/Daycare Receipts

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📎 Other Tax Documents (1095-A, HSA, IRS letters, charity receipts, etc.)

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How Do You Want Your Refund?
Refund Distribution Method
Bank Account Information (for Direct Deposit)
Bank Name
Routing Number (9 digits)
Account Number
Re-enter Account Number (for verification)
Account Type
💰Fast Cash Advance (Optional)

Need money before your refund arrives? You may qualify for up to $7,000 with NO credit check. Available January 2 - March 13. Repaid from your refund.
Would you like to apply for a Fast Cash Advance?
Payment Options
How will you pay for tax preparation?
Bank Fee Disclosure

If you choose to pay your tax preparation fees from your refund (instead of paying upfront), the following bank fees apply: Refund Transfer Fee: $44.95 Technology Fee: $32.95 TOTAL BANK FEES: $77.90 These fees are IN ADDITION to your tax preparation fees.
I acknowledge and understand the bank fees
Audit Protection Plan - $99

★ RECOMMENDED ★ ✓ Up to 10 hours of IRS audit assistance ✓ We handle ALL IRS letters on your behalf ✓ Full documentation support ✓ Peace of mind protection ⚠️WITHOUT Audit Protection: • $150/hour for audit assistance • $1,500 minimum retainer required
Audit Protection Plan

NO- I decline Audit Protection. I understand that if I receive correspondence from the IRS or State Revenue Department, or if my tax return is selected for audit, review, or verification, Wellington Group will not provide document review or correspondence handling at no charge. Should I require assistance with any IRS or State notices, I acknowledge that audit support services will be available at Wellington Group's standard professional rates ($150 per hour, with a $1,500 minimum retainer required).
PAYMENT AGREEMENT

By selecting to pay from your refund, you authorize Wellington Group to deduct tax preparation fees and bank fees from your federal tax refund. ⚠️ If the IRS does NOT release your refund for ANY reason (including tax debts, child support, student loans, identity verification, audit holds, or errors), you agree to pay Wellington Group the FULL invoice amount for tax preparation services IMMEDIATELY upon invoice. Payment will be due within 7 days of invoice date. ⚠️Unpaid invoices will be sent to collections after 30 days. Collection costs and attorney fees will be your responsibility.
I AGREE to the payment terms above
Authorization & Electronic Signature
By checking ALL boxes below, I certify that:
Taxpayer Signature
Today's Date

MonthDayYear
Date
Spouse Signature (if filing jointly)
Should be Empty:

Client Intake Form

Taxpayer Information

Mailing Address

Spouse Information

Filing Status

Dependents (Maximum 2)

Dependent #1

Dependent #2

Income Information

Deductions & Credits

Document Uploads

How Do You Want Your Refund?

💰Fast Cash Advance (Optional)

Payment Options

Bank Fee Disclosure

Audit Protection Plan - $99

PAYMENT AGREEMENT

Authorization & Electronic Signature