CLIENT INTAKE FORM

Filing Status *

Single

Married Filing Seperate

Married Filing Joint

Qualifying Windower

Head of Household

TAXPAYER INFORMATION:

Full Name *

Date of birth

Phone *

Email *

Address *

City *

State *

Postal code *

Occupation *

Do you currently have life or health insurance?

Yes

No

If so who is your life or health insurance provider

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

Are they totally and permanently disabled?

Yes

No

Are they legally blind?

Yes

No

Are they your dependent?

Yes

No

DEPENDANTS:

Enter your dependents here

Name
Name
Name
Name
Name

TAX RELATED QUESTIONS:

Employment Status

Employment Status

Employed
Unemployed
Self-Employed
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ACKNOWLEDGMENT & SIGNATURE

I confirmed that all information I entered here is accurate and true.
I allow F2W Financial 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 F2W Financial.
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

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.