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2023 Client Intake Form

Thank You For Choosing Income Tax Central

This is a Paid Preparer / Client (Taxpayer) Interview. As a Paid Preparer, it is a requirement by the IRS that I conduct a Due Diligence Interview when you, the taxpayer, are claiming Earned Income Tax Credits, Child Tax Credits, other Dependent Credits, are self-employed, operate a Schedule C Business, and are filing as Head of Household. Your responses may lead to additional questions to ensure clarity regarding your personal situation. Please be aware that not all questions may be relevant to your circumstances; in such cases, kindly indicate with a "NO" or type "N/A." However, your signature is mandatory in all designated areas.

This questionnaire may take you up to 20 minutes to complete. If a section or question does not apply to you please skip that question/section and answer the remainder of the questions

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[email protected]

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Dependent Info

If you are not claiming any dependents please skip this section

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Dependent #2

If you are only claiming one dependent please skip this section

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Dependent #3

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Small Business, Schedule C and Self Employed

**If you were not self employed or a small business owner, please skip this section

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Please only upload the documents that you have.

Trouble Uploading....Additional documents can be sent to:

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[email protected]

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Letter Of Engagement

We appreciate the chance to assist you in the preparation of your income tax returns. To ensure a comprehensive understanding of our collaboration, please take a moment to review the following details.

Our involvement in the preparation of your income tax returns does not extend to the detection of errors, irregularities, or unlawful activities, including but not limited to fraud that may exist within the information or figures you supply. We will exercise our professional judgment when addressing uncertainties in cases where the tax law is ambiguous or where there may be disparities between the tax authority's interpretations of the law and other justifiable positions. Unless explicitly directed otherwise by you, we will adopt a tax stance that is in your favor when it is reasonable to do so. However, we cannot guarantee that these tax positions will go unchallenged or predict their ultimate resolution. Additionally, any issues stemming from undisclosed income, expenses, or other information not provided to us during tax preparation or before filing your returns are beyond our responsibility.

Please be aware that our engagement and the services offered by our firm encompass general and annual income tax-related matters, but they do not extend to payroll tax, sales tax, excise tax, personal or real property tax unless expressly requested by you and agreed upon in writing. We cannot be relied upon to ascertain or report your compliance, or lack thereof, with Federal, State, or Local business-related laws, health care or human resources regulations, retirement plan compliance, or any requirements related to business, property, or professional permitting/licensing.

By endorsing this engagement letter, you acknowledge your commitment to remunerate Income Tax Central for the services you have specifically requested. In the event that you decide to terminate the engagement before the culmination of your tax accounting work, please be aware that Income Tax Central retains the prerogative to issue an invoice for any incurred out-of-pocket expenses, time expended at our hourly rate, or any other related expenses that may have arisen during the course of this engagement. If you have sought in-person consultation services, received advisory services via phone or email, sought representation, or received any tax accounting services, your signature on this engagement letter signifies your agreement to compensate Income Tax Central for these services, irrespective of whether the engagement was terminated before our firm completed the requested or requisite work.


Thank you for instructing us to act as your Income Tax Consultants, Preparers and/ or bookkeepers. To ensure that there are no misunderstandings regarding the nature and extent of the services that we will provide to you, this contract outlines the scope of work.

Terms of Contract

On the basis of information and instructions you provide, we will compile any required financial statements for you and/or your firm.

The services to be provided will include all matters ancillary to those services such as, for example, dealing with and responding to queries raised by the IRS or other taxation authority.

This letter of engagement will apply in respect of your financial year end and for future years unless otherwise agreed.

Extent of Services

We will not audit, review or carry out any other checks on the accuracy or completeness of the information you provide. It is up to you to give us accurate and complete information to enable us to provide the services described in this letter and we accept no liability for the accuracy or completeness of any information supplied by you in any form.

Accordingly, no assurance on any assertions contained in the financial information compiled will be provided.

Our engagement does not include the investigation or discovery of internal control weaknesses, errors, illegal acts or other irregularities, including without limitation, fraud, or non compliance with laws and regulations. However, we will inform you of any such matters which come to our attention during the course of our engagement.

The information you are to supply and any other information that we consider necessary to complete the engagement must be provided in a timely manner in order for the assignment to be completed on a timely basis.

Use and Distribution of the Financial Information

We understand that the intended use and distribution of the financial information we will compile is for the special

You may make copies of any reports for your own internal use or for providing to a third party. However, we accept no duty or responsibility to any party other than yourself who may seek to rely on our reports and furthermore you indemnify us against any claim by such other party in respect of the reports.

Information and Disclosure

All assignments will be conducted in accordance with the professional standards, rules and ethical requirements of Circular 230. Information we obtain in the course of this engagement is subject to confidentiality requirements. We will not disclose that information to other parties without your express consent, except as required by law or professional obligations. 

Limitation of Liability

At all times we will use reasonable skill and care in providing our services to you. However, in spite of this our liability to you whether in contract, tort, equity or otherwise, for any loss or damage or expenses (including legal costs) suffered or incurred directly by you as a direct result of any act or omission by us in providing our services, shall be limited to a maximum amount equal to the fee (excluding tax, disbursements and expenses) paid to us by you in respect of the services in question. If the Services were provided in respect of more than one financial year the fee on which the liability amount is based shall be the fee paid in respect of the financial year in respect of which the act or omission occurred. Any claim against us must be brought within twelve months of the date on which we complete the services.

Fees and Payment

Our service fees are determined on a "per form" basis, accounting for the time invested by our professional staff to perform the necessary work and the expenses incurred for associated supplies, including copy charges, long-distance phone fees, and computer processing costs. The fee for preparing your tax returns is payable upon presentation of your completed income tax filing. It is our company policy not to release tax returns, tax-related reports, schedules, information, advice, or notes without full payment. In the event that services have been provided but payment is not received, and our firm is compelled to seek legal assistance to collect outstanding fees, please be aware that you may be required to reimburse our firm for the legal expenses associated with recovering any outstanding balances.

Unless otherwise agreed with you in writing our fees are calculated on the basis of the time spent on the assignment by our team and on the levels of skill and responsibility involved.

We will not submit your tax return to the IRS until you have approved and signed the return.

Payment for Income Tax Preparation and any document prep fees must be paid up front or some type of payment arrangement must be made in advance.

If you are due a refund and elect to have a bank product, you have the option to pay the tax prep fees, bank fees and all additions fees associated with your tax return.

If your refund amount is less than the amount of the fee, you will be required to pay the difference out of pocket.

Tax Returns will not be submitted to the IRS without Income Tax Central receiving payment or some type of payment arrangement has been made.

If you are receiving your refund using one of our bank products and are in agreeance with the tax prep, document and any other fees associated with the preparation of your tax return, this agreement suffices as an official payment arrangement

If for some reason, you do not receive your tax refund due to some type of offset or audit or mis-calculation due to documents you provided, you are agreeance that you are still responsible for all fees associated with the tax return. In the event that a Refund Transfer remains unfunded for a period of at least 11 weeks from the IRS Acknowledgment date, your payment will become immediately due. If payment is not received, we will proceed to withdraw the full payment amount from the bank account we have on record for you. If you initiate a chargeback on the amount, we will be compelled to refer your case to local authorities and press charges for theft of services. It is important to note that we diligently prepared your taxes, and it is not within our control if your payment was offset due to a previous debt. We are unable to recover the time and effort invested in providing our services, and we believe that we rightfully deserve compensation for the services rendered to you.

Once collection processes are started you are responsible for all fees associated with the process.

You should be aware that, like all other providers of services, we are entitled to retain possession of your records that have been used in relation to this engagement until outstanding fees are settled.

We understand that cost considerations are important for our clients, and we make every effort to provide you with a fee estimate before finalizing your returns. However, please be aware that circumstances may arise that could potentially adjust the estimated fee, either higher or lower. If such a situation arises after you have received an estimate, we will promptly communicate with you to discuss any changes.

Ownership of Work Papers

Material that you provide to us remains yours and will be returned to you when the engagement is completed. Work papers that we create remain our property.

Where we provide taxation services for you we will store tax records that we hold on your behalf for a period of seven years after the applicable balance date. At the end of that period, unless you ask us to send that information to you, the records will be destroyed using a secure document destruction service.

Non-accounting advice and financial advice

This firm does not provide legal or financial advice. Any opinion expressed should be confirmed by the appropriate professional. Any comment made on the subject of legal or investment matters should be interpreted as only a personal view and not professional advice.

Future Years

This letter applies for future years unless you or we wish to end or change the arrangement.

Audits and Received Correspondence

We want to inform you that should you receive any correspondence from a taxing authority pertaining to a tax return prepared by our firm, we are more than willing to address the issue on your behalf. As part of your tax preparation package, we include 120 minutes of correspondence assistance per tax year at no additional cost. Within this allocated time, we will evaluate your situation and provide you with our recommended course of action. If deemed necessary, we will also draft and submit a response to the relevant taxing authority.

However, if the matter or issue requires more than 180 minutes of work, each additional hour (or fraction thereof) will be billed at our standard hourly rate of one hundred and fifty dollars ($150) per 60-minute hour. While we will make every effort to inform you in advance if we believe your situation may exceed the 180-minute timeframe, there may be circumstances where prior notification is not possible. In such cases, the standard hourly rate mentioned above will apply and will be invoiced upon the completion of our work.

You have the option to request that we discontinue our involvement in handling your correspondence at any point during the process, but such a request must be submitted in writing with your name and signature. If, during our work, it becomes evident that the correspondence received was a result of an error or omission on our part, there will be no charge for addressing the matter, regardless of the time invested.

It's important to understand that audit or examination representation services are not covered by the tax preparation fee and are considered a distinct engagement with a separate fee structure. If you have any inquiries about the details of audit/examination representation, please don't hesitate to ask at any point—before, during, or after your appointment. It's worth noting that if your tax returns undergo auditing or examination by a taxing authority, regardless of the reason, the fee you paid for tax preparation does not include the expenses associated with representing you during such an audit or examination. However, you have the option to opt in for the Audit Maintenance Protection for an additional $49.99, which will be included in your overall tax preparation fees.

Conclusion

If you have any questions regarding this letter of engagement please do not hesitate to call us.

In order to signify your acceptance of the terms of engagement, please sign below in your client portal.

We appreciate your business and thank you for engaging us.


Income Tax Central

1420 Roosevelt Road

Broadview, Il 60155

Phone: 773-570-7330

Email: [email protected]

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Consent For Payment

At Income Tax Central, we highly value our relationship with all our clients and are committed to delivering the highest quality service. It's important to clarify that our service is not tied to a refund; rather, it is a service provided to you as a taxpayer. You have several payment options available for your tax preparation fees, including cash, check, money order, credit card, or deducting the fees directly from your refund*.

*Should you choose to have the tax preparation fees deducted from your refund and, for any reason, your taxes are intercepted, it's crucial to understand that YOU ARE STILL LIABLE FOR THE TAX PREPARATION FEES. In such a situation, please promptly get in touch with our office to arrange for payment or discuss payment options. By signing your return, you are committing to paying the preparation fees regardless of whether your refund is received or not.

If, for any reason, no payment or payment arrangement has been made within 90 days from the scheduled refund date, we may be compelled to initiate collection procedures and/or debit your bank account. Our intention is to avoid taking this course of action, so we strongly encourage open communication with us to facilitate collaboration and resolution. Your cooperation is greatly appreciated.

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CONSENT TO USE OF TAX RETURN INFORMATION:

For the purposes of this consent form, “we,” “us,” and “our” mean Income Tax Central Federal law requires this consent form be provided to you. Unless authorized by law, we cannot use your tax return information for purposes other than the preparation and filing of your tax return without your consent. You are not required to complete this form to engage in our tax return preparation services. If we obtain your signature on this form by conditioning our tax preparation services on your consent, your consent will not be valid. Your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature. If you do not consent, you may still have your tax return prepared and electronically filed by us for a fee. For your convenience, we have entered into an arrangement with third parties to provide qualifying taxpayers with the opportunity to apply for an Electronic Refund Disbursement Service and/or Loan product. To determine whether these products may be available to you, we will need to use your tax return information in order to calculate the amount of your anticipated refund. If you would like us to use your tax return information to determine whether these products may be available to you while we are preparing your return, please sign and date this consent to the use of your tax return information. By signing below, you authorize us to use the information you provide to us during the preparation of your 2023 tax return to determine whether to present you with the opportunity to apply for these products and services.

If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by e-mail at [email protected]

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CONSENT TO USE OF TAX RETURN INFORMATION

For the purposes of this consent form, “we,” “us,” and “our” mean Income Tax Central Federal law requires this consent form be provided to you.

Unless authorized by law, we cannot use your tax return information for purposes other than the preparation and filing of your tax return without your consent. You are not required to complete this form to engage in our tax return preparation services. If we obtain your signature on this form by conditioning our tax preparation services on your consent, your consent will not be valid. Your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature. If you do not consent, you may still have your tax return prepared and electronically filed by us for a fee. For your convenience, we have entered into an arrangement with third parties to provide qualifying taxpayers with the opportunity to apply for an Electronic Refund Disbursement Service and/or Loan product. To determine whether these products may be available to you, we will need to use your tax return information in order to calculate the amount of your anticipated refund. If you would like us to use your tax return information to determine whether these products may be available to you while we are preparing your return, please sign and date this consent to the use of your tax return information. By signing below, you authorize us to use the information you provide to us during the preparation of your 2023 tax return to determine whether to present you with the opportunity to apply for these products and services.

If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by e-mail at [email protected]

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Thank you for taking time to complete your 2023 Client Questionnaire. For new clients, this information is critical to ensure we accurately file your tax return. For existing clients, we kindly request you provide this information again to ensure our records are 100% accurate and up to date.

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