TAX PREP CLIENT INTAKE FORM

Filing Status *

TAXPAYER INFORMATION:

Full Name *

Date of birth

Social Security Number *

Phone *

Phone Carrier *

Email *

Address

Street Address *

City *

State *

Country

Postal code

Occupation *

Driver's Licenses / ID number *

Licenses Issue Date *

License Expiration Date *

Are you a full-time student?

Yes

No

Are you or anyone of your dependents Considered Blind or Disabled

Yes

No

Are you Considered Married ad of Dec 31st

Yes

No

Have you filed all of your Past Tax Returns/Documents

Yes

No

Did you have all documents need to file a full return

Yes

No

SPOUSAL INFORMATION

Spouse Full Name

Spouse Date Of Birth

Phone Number

Email Address

Spouse Occupation

Are they a full-time student?

Yes

No

Are they totally and permanently disabled?

Yes

No

Are they legally blind?

Yes

No

DEPENDANTS:

Enter your dependents here

Name
Social #1
Date of Birth
Name
Date of Birth
Social
Name
Date of Birth
Social

Explain your Tax Situation in detail here - Any past changes - Updates - Missing Returns - Divorces - Etc...

GENERAL EXPENSES:

Drivers License

Social Security Card

W2

Dependent Social Security Card

IPPIN

1099NEC or 1099Mis

1098t - 1098E - or 1098 Mortgage

1095- A Marketplace Insurance Form

Last Check Stub

Bank Deposit Form Name/ Account and Routing Numbers Showing *Can be screenshot with Bank name

ACKNOWLEDGMENT & SIGNATURE

I confirmed that all information I entered here is accurate and true.
I allow Honesty Tax Service 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 ABC Financial.
By signing below, you acknowledge that I have agreed to send my personal information to Honesty Tax Service for Tax Preparation and support of filing my taxes.

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.