2025 Client Intake Questionaire

NOTICE: ALL income statements, social security cards and/or state issued ID are required for this submission. Your file is subject to delays and/or cancellation if the required documents aren't attached. Attach ALL of your documents to this form DO NOT EMAIL documents. We will send a secure link for any additional documents. Thank you

What tax year is this submission for? (Please do not attach documents that are not for the tax year you selected. If you need more than 1 year filed it needs to be submitted as a separate submission for each year.

Is this an amendment?

Yes

Did you schedule a tax consultation this season?

Yes

Taxpayer's Date of Birth

Taxpayer's Social Security #

Is this a new address with the IRS?

Yes

Can another taxpayer claim you as a dependent on their tax return?

Yes

Will you be filing a tax return with your spouse?

Yes

Spouse's Date of Birth

Spouse's Social Security Number

How many Dependents are you claiming?

Dependent 1: First Name

Dependent 1: Last Name

Dependent 1: Date Of Birth

Dependent 1: Relationship *

Dependent 1: # of months this person lived in your home in 2020 *

Dependent 2: First Name

Dependent 2: Last Name

Dependent 2: Date Of Birth

Dependent 2: Relationship

Dependent 2: # of months this person lived in your home in 2020

Dependent 3: First Name

Dependent 3: Last Name

Dependent 3: Date Of Birth

Dependent 3: Relationship

Dependent 3: # of months this person lived in your home in 2020

Dependent 4: First Name

Dependent 4: Last Name

Dependent 4: Date Of Birth

Dependent 4: Relationship

Dependent 4: # of months this person lived in your home in 2020

Did you receive health insurance through the Market Place? *

Yes

Did you pay any child care expenses for any dependents listed above?

Yes

Did you, your spouse or any dependents attend college ?

Yes

Do you owe debt to any Government Agency; such as IRS, Student Loans, Child Support etc?

Yes

If you own your home, have you received form 1098 from your mortgage lender?

Yes

Did you or your spouse receive unemployment benefits ?

Yes

Did you or your spouse make payments on your student loans ?

Yes

Are you self employed or a business owner?

Yes

Upload your Profit & Loss (P&L) or Income & Expense Statement

Do you have an IRS IP PIN?

Yes

Are you interested in the SAME DAY Advance up to $6,000 with bank approval?

Yes

Do you have a copy of your tax return from last year?

Yes

Are you interested in Audit Protection for your tax return? ($79 Fee)

Yes

Verify Routing Number

Refund Dispersement Method

PLEASE PUT ACCOUNT AND ROUTING NUMBER IN TWICE TO MAKE SURE WE HAVE THE CORRECT NUMBERS

Verify Bank Account Number

1. Tax Document (W2, 1099, 1098-T, Etc)

2. Tax Document (W2, 1099, 1098-T, Etc)

3. Tax Document (W2, 1099, 1098-T, Etc)

4. Tax Document (W2, 1099, 1098-T, Etc)

Tax Payer Social Security Card

Dependent 1: Social Security Card

Dependent 2: Social Security Card

Dependent 3: Social Security Card

Dependent 4: Social Security Card

Driver License/ State ID *

Dependent 5: Social Security Card

Dependent 6: Social Security Card

Dependent 7: Social Security Card

Dependent 8: Social Security Card

Dependent 9: Social Security Card

Dependent 10: Social Security Card

Who Referred You to Me?

Anything you'd like us to know when preparing your return?

Spouse Signature

Clear

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