Contact Us!
phone: 1-844-719-2808

Email: [email protected]

TAX PREP CLIENT INTAKE FORM

TAXPAYER INFORMATION:

Full Name *

Date of birth *

Phone *

Email *

Address

Street Address *

City *

State *

Country *

Postal code *

Occupation *

Are you a full-time student? *

Yes

No

College School Form (1098-T)

Have You Ever Received A Disallowance From The IRS?

Yes

No

Did You or Any Household Member Receive Health Insurance Through The Marketplace?

Yes

No

Health Care Form 1095-A

IDENTIFICATION DOCUMENTS

State Identification Card

Drivers License

Passport

SS Card *

SPOUSAL INFORMATION

Spouse Full Name

Spouse Date Of Birth

Phone Number

Email Address

Address

Street Address
City
State/Province
Postal/Zip Code

Spouse Occupation

Are they a full-time student?

Yes

No

College School Form (1098-T)

DEPENDENTS:

How Many Months Did The Dependent(s) Live With You?

Are they totally or permanently disabled?

Yes

No

Were Any Dependents A Full-Time or At Least A Half-Time College Student?

Yes

No

College School Form (1098-T)

Dependent 1

Name
Date Of Birth
Social Security Number

SS Card

Dependent 2

Name
Date Of Birth
Social Security Number

SS Card

Dependent 3

Name
Date of Birth
Social Security Number

SS Card

Dependent 4

Name
Date Of Birth
Social Security Number

SS Card

TAX RELATED QUESTIONS:

Employment Status

Are you contributing to 401k or other pre-tax account?

Yes

No

Is this your first time opening a pre-tax account?

Yes

No

Are you currently renting?

Yes

No

What is the monthly rental amount?

GENERAL EXPENSES:

Enter the following expenses total amount

Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses
Advertising
Utilities
Maintenance/Repairs
Contract Labor
Wages
Rent
Supplies
Office Expense

Total Expenses

INCOME DOCUMENTS

W-2s

1099 Forms

Social Security or Veteran Award Letter or 1099-SSA

Unemployment Document (1099-G)

Income Statement/Report

Expense Statement/Report

Business Documents

Would you Like to apply For The Fast Cash Advance Loan? Funds are Available Same Day once approved by our Bank. *

Yes

No

Terms and Conditions

By engaging the services of Keke One Stop Taxes, you agree to the following

Accuracy of Information: Clients are responsible for providing complete and accurate information. Keke One Stop Taxes is not liable for errors resulting from false or incomplete data.
Confidentiality: Client information will be kept confidential and used solely for tax preparation and filing purposes unless required by law.
Fees and Payments: All service fees are required upfront unless you opt in to our RT Refund Transfer option, which allows tax preparation fees to be deducted directly from your refund. Please note that tax preparation fees are non-refundable once the tax return process has commenced.
Liability: Keke One Stop Taxes is not responsible for penalties, interest, or taxes due to client-provided inaccuracies. Support during audits is limited to the original information submitted.
Service Termination: We reserve the right to terminate services if deadlines are missed, fees are unpaid, or accurate information is not provided.

ACKNOWLEDGMENT & SIGNATURE

I confirmed that all information I entered here is accurate and true.
I allow Keke One Stop Taxes to capture my sensitive data like personal id, government id, social security number (SSN), and other information.
I have read the terms and conditions and privacy policy of Keke One Stop Taxes.
By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.

Date Signed *

Taxpayer Signature *

Clear