This form is used to collect all necessary information and documentation from clients to begin tax preparation and advisory services.

To ensure accurate and timely preparation of your tax return, all relevant documents must be uploaded through this form.

For Individual Filers: Photo ID, Social Security cards for yourself and any dependents, W-2s, 1099s, prior year tax return (if not previously filed with us), 1095-A form (if applicable), income statements, and any documentation supporting dependents or tax credits claimed.

For Self-Employed or Business Filers: All of the above, plus your business EIN, business income documents (1099-NEC, invoices, etc.), expense reports or categorized spreadsheet, balance sheet (if available), and any other documentation related to business operations.

Full Name

Date of birth *

Email Address *

Phone Number *

Address

Street Address

City *

State *

Country *

Postal code *

New Client?

Yes

No

Filing Status

If married

Spouse's Full Name
Spouse’s Date of Birth
Spouse’s Social Security Number

Dependent Information Please complete for up to 3 dependents. If you have more, notify us to send a separate dependent entry form.

Full Name

Date of Birth

Social Security Number

Relationship to You

Did the dependent live with you for more than 6 months?

Yes

No

U.S. Citizen/Resident?1

Yes

No

Student/Disabled Status

If the dependent is NOT your biological child:

Why are you claiming the dependent instead of the parent?

Where is the biological parent?

Do you have legal custody/guardianship?

Yes

No

Can you provide documentation?

Yes

No

What documentation are you providing? (Select all that apply)

School Records

Medical Records

Court Documents

Daycare Provider Statements

Earned Income Tax Credit

Is anyone else also claiming this child?

Yes

No

If yes, who?

Did you earn income from work?

Do you or your spouse have investment income over $11,000?

Child Tax Credit (CTC)/Additional Child Tax Credit

Is the child under the age of 17?

Are you claiming the child as a dependent?

American Opportunity Tax Credit (AOTC)

Is the student enrolled at least half-time in a degree program?

Was the student enrolled in at least one academic period this year?

Has the student completed the first 4 years of postsecondary education?

Has the student been convicted of a felony drug offense?

Can you provide Form 1098-T?

Were qualified education expenses paid (tuition, books, etc.)?

Did you or any household member receive health insurance through the Marketplace (Obamacare)?

Yes

No

If yes, upload Form 1095-A

Business Information (if applicable)

Business Name

EIN (Employer Identification Number)

Upload Business Expenses/Balance Sheet

Are you interested in starting or restructuring a business?

Business Advisory

Are you interested in credit building or credit services?

Credit Advisory

How did you hear about us?

Do you have questions about filing back taxes?2

Yes

No

Acknowledgment & Signature Please read carefully:

I certify that all the information provided on this form is accurate and true to the best of my knowledge.

I understand that Jackson Tax Preparation Services is not responsible for any incorrect or false information submitted.

Signature

Clear

Date

Upload your files here

Valid IDs, Birth Certificates, Proof of Income, W2, and etc.

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