Tax Preparation Client Intake Form

Which Year Are You Filing? *

2025

2024

2023

2022

Amended Return

Filing Status *

Single

Married Filing Seperate

Married Filing Joint

Qualifying Windower

Head of Household

Are you legally blind? *

Yes

Are you totally and permanently disabled? *

Yes

Select Your Tax Specialist *

Social Security Number *

TAXPAYER INFORMATION:

Full Name *

Date of birth *

Phone *

Email *

Address *

Street Address

City

State

Country

Postal code

Occupation *

IP PIN

If Applicable

DEPENDANTS:

Enter your dependents here

Name
Name
Name
Name
Name

Relationship to Dependent.

Date of Birth

1
2
3
4
5

Relationship

1
2
3
4
5

Social Security Number of Dependants

1
2
3
4
5

DEPENDENT ELIGIBILITY VERIFICATION

Did your qualifying dependents live with you more than half the year?

Phone Call

Text Message

Did you pay more than half the cost of maintaining your home?

Yes

If carrying dependents, can you provide proof of residency?

Yes

N/A

If yes, please list the documents provided:

Examples: School records, Medical records, Daycare records or Lease agreement

DOCUMENT UPLOADS

Upload Government ID or Driver's License *

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Upload Social Security Card *

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Upload Utility Bill

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

EMPLOYMENT & INCOME INFORMATION

Employment Status *

Employed

Unemployed

Self-Employed

Household Employee

What did you make in total, and what did you spend to run your business?

Upload W-2 or 1099

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

EDUCATION INFORMATION

Are you a full-time student? *

Yes

Upload Form 1098-T

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

HEALTH INSURANCE INFORMATION

Do you, your spouse, and your dependents have health insurance? *

Yes

Coverage Types:

Employer

Spouse Insurance

Exchange / Marketplace

Direct with Insurer

Medicare

Medicaid

Covered Individual:

Taxpayer

Spouse

Dependent(s)

Upload Form 1095-A Marketplace Health Insurance Form

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

PRIOR TAX RETURN

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF Upload Last Year Tax Return (Form 1040)

ADDITIONAL INFORMATION:

Do you want a Refund Advance? *

Yes

Do you want Preparation Fees Deducted From Your Refund? *

Yes

Do you acknowledge and agree to the preparation fees and bank product terms? *

Yes

How would you like to receive your refund? *

Direct Deposit

Paper Check

GreenDot Card

DIRECT DEPOSIT INFORMATION *

Bank Name
Routing Number
Account Number

I confirm this account belongs to me.

Yes

TAXPAYER DUE DILIGENCE QUESTIONS

I have provided complete and accurate information to the best of my knowledge. *

Yes

I understand that knowingly providing false information is illegal. *

Yes

I understand the preparer may ask for additional documentation. *

Yes

I understand the preparer cannot claim credits I do not qualify for. *

Yes

I reviewed my return before signing. *

Yes

I understand the preparer is not responsible for IRS penalties caused by my false statements. *

Yes

ACKNOWLEDGMENT & SIGNATURE

I confirmed that all information I entered here is accurate and true.
I allow 777 Figure Solutions Headquarters LLC to collect and securely process my personal information, identification documents, and tax-related information for tax preparation and compliance purposes.
I have read the Terms & Conditions and Privacy Policy of 777 Figure Solutions Headquarters LLC.
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

By checking this box, I consent to receive non-marketing text messages from 777 Figure Solutions Headquarters LLC regarding tax preparation services, appointment updates, and filing notifications.

By checking this box, I consent to receive marketing and promotional messages from 777 Figure Solutions Headquarters LLC.