CLIENT INFORMATION FORM

Today's Date *

Client Type *

New Client

Returning Client

How Did You Hear About Us?

Did you have an address change since your last return?

Yes

TAXPAYER INFORMATION

First Name *

Middle Initial *

Last Name *

Date of birth *

Phone *

Email *

Taxpayer SSN *

IRS PIN# (if applicable)

SPOUSE INFORMATION

Spouse First Name

Spouse Middle Initial

Spouse Last Name

Spouse Date of Birth

Spouse Email

Spouse Phone Number

Spouse SSN

Spouse IRS PIN# (if applicable)

ADDRESS INFORMATION

Address

Street Address *

City *

State *

Country

Postal code *

Do you have any state returns to file? If so, which ones?

Additional charges per state will apply.

BANKING/DIRECT DEPOSIT INFORMATION

Routing Number *

Account Number *

Do you have Marketplace Insurance? If yes, we must have your 1095-A form to file *

Yes

Do you have Venmo? If yes, did you receive a 1099-K? *

Yes, but have not received a 1099-K

Yes, and I have received a 1099-K

BUSINESS INFORMATION

Business Name

Federal ID#

***Please include a copy of your federal ID letter

Copy of Federal Letter

(If applicable): For a small fee, would you like to do your:

Business License

F&E (LLC & S-Corp)

Annual Report (LLC & S-Corp)

DEPENDENT INFORMATION

DEPENDENT 1

Dependent 1: Name

Dependent 1: Relationship

Dependent 1: Date of Birth

Dependent 1: SSN

Dependent 1: Gender

Male

Female

DEPENDENT 2

Dependent 2: Name

Dependent 2: Relationship

Dependent 2: Date of Birth

Dependent 2: SSN

Dependent 2: Gender

Male

Female

DEPENDENT 3

Dependent 3: Name

Dependent 3: Relationship

Dependent 3: Date of Birth

Dependent 3: SSN

Dependent 3: Gender

Male

Female

DEPENDENT 4

Dependent 4: Name

Dependent 4: Relationship

Dependent 4: Date of Birth

Dependent 4: SSN

Dependent 4: Gender

Male

Female

ESTIMATED PAYMENTS

1st Quarter

2nd Quarter

3rd Quarter

4th Quarter

ADDITIONAL INFORMATION

Do you have any crypto currency accounts? *

Yes

Do you have any foreign bank accounts? *

Yes

Thank you for completing this information. Next, please review and sign the following documents.

2024 ENGAGEMENT LETTER

Personalized Bookkeeping & Tax Services, Inc. will prepare your 2024 federal and state income tax returns. We will depend on you to provide the information we need to prepare complete and accurate returns. We may ask you to clarify some items but will not audit or otherwise verify the data you submit. We will perform tax services only as needed to prepare your tax returns. Our standard fees do not include bookkeeping or keying in bank statements. Additional charges will apply for this service. Our work will not include procedures to find defalcations or other irregularities. Accordingly, our engagement should not be relied upon to disclose errors, fraud, or other illegal acts, though it may be necessary for you to clarify some of the information you submit. We will inform you of material errors, fraud, or other illegal acts we discover.

Should we encounter instances of unclear tax law, or of potential conflicts in the interpretation of the law, we will outline the reasonable courses of action and the risks and consequences of each. We will ultimately adopt, on your behalf, the alternative you select. Your returns may be selected for review by the taxing authorities. In the event of such government tax examination, we are available upon request to assist you in responding to tax authorities. In any event, you agree to contact us as soon as you receive notice of proposed changes or examination.

Our fee is based on the forms required to complete the tax return plus the complexity of and time spent on those forms. Invoices are due and payable upon presentation. As paid preparers, payment is required before we can e-file your tax return. Your tax return will not be e-filed until payment is received. Payment options include: check, a one-time debit from your bank account (authorization form provided upon request), debit or credit card (please note: a card fee of 3% will apply to all credit/debit card payments), or cash.

We will return any original records to you at the end of this engagement. Store these records, along with all supporting documents, in a secure location for 7 years. We retain copies of your records and our work papers from your engagement for up to three years, after which time these documents will be destroyed.

If you are ever in the position where you need to pick up a copy of a document, you have 30 days to pick those documents up from our office before they will be destroyed. After the 30-day period, you will have to call our office to schedule an appointment to pick up your documents. A small fee of up to $25 may be applied for any additional copies (physical & PDF) needed after your initial filing. A physical copy of your return will be provided at filing. Electronic (PDF) copies can be emailed at no additional charge at the time of filing only, after which the additional fee applies.

Review all returns carefully before signing them.

Taxpayer Signature (Engagement Letter) *

Clear

Date Signed (Engagement Letter) *

Spouse Signature (Engagement Letter)

Clear

Spouse Date Signed (Engagement Letter)

PERSONALIZED BOOKKEEPING & TAX DEBT RELIEF PRIVACY POLICY

Personalized Bookkeeping & Tax Debt Relief is required to inform our clients of our policies regarding privacy and client information in compliance with the requirements of the Gramm- Leach-Bliley Act of 1999. We have always been committed to protecting you personal and business information and your right to privacy.

Types of Non-Public Personal Information We Collect and How We Use It

We collect non-public information about you that is provided to us by you or obtained with your authorization. The client agrees to disclose all non-public information and income and expense information honestly and completely to us. We collect and use this information to prepare your tax return and respond to your requests.

Parties to Whom We Disclose Information

We do not disclose any information obtained in the course of our practice without your express written permission to do so, except as required by law. We restrict access to non-public information to those professionals necessary to complete the work you have hired our firm to complete. We maintain physical, electronic, and procedural safeguards to guard your non-public information and shield your privacy.

Our employees are required to sign a Procedure and Confidentiality statement that they will comply with our privacy policies as they relate to your information.

Your privacy, our professional ethics, and the ability to provide you with quality service are very important to us. If at any time you have concerns, you may call us at 615-773-2736

I/We have read, understand, and agree to this policy.

Taxpayer Signature (Privacy Policy) *

Clear

Date Signed (Privacy Policy) *

Spouse Signature (Privacy Policy)

Clear

Spouse Date Signed (Privacy Policy)

TAX OBLIGATIONS

Taxpayers who don't meet their tax obligations may owe a penalty.

The IRS charges a penalty for various reasons, including if you don't:

• File your tax return on time

• Pay any tax you owe on time and in the right way

• Prepare an accurate return

Provide accurate and timely filed information returns

If your amount due exceeds $500, the IRS may charge interest and penalties even if you pay in full by 4/15. This is based on your prior year tax liability.

There are various types of penalties that the IRS will send notices and letters about:

• Information Return applies to taxpayers who don't file or furnish their required information return or payee statement correctly by the due date Failure to File applies when you don't file your tax return by the due date Failure to File applies when you don't pay the tax you owe by the due date

• Underpayment of Estimated tax by individuals applies when you don't pay estimated tax accurately or on time as an individual

• Underpayment of Estimated tax by corporations applies when you don't pay estimated tax accurately or on time for a corporation.

This form is to ensure that our client understands that there are penalties and interest for various reasons. There are additional types of penalties not listed on this page, please go to irs.gov for more information and to familiarize yourself.

Please sign here to acknowledge that you have been made aware of these potential charges. You will be provided with a copy of this in your information packet and in addition we will scan to keep with your records.

Taxpayer Signature (Tax Obligations) *

Clear

Date (Tax Obligations) *

Thank you for trusting us with your taxes. We look forward to helping you this tax season.