2026 CLIENT INTAKE FORM

Please set aside at least 30 minutes to complete the intake form. Completing this form is REQUIRED to ensure your personal and/or business income and expenses are filed accurately and to ensure full compliance with IRS regulations. If you need assistance, please call [BUSINESS PHONE NUMBER HERE] or email [BUSINESS EMAIL HERE]. Thank you!

BASIC INFORMATION

Referral Source
Client Status
Prior-Year Tax Return
Document Readiness.

Keep in mind we will NOT begin working on your file until all documents have been received by our office.

Prior-Year Tax Outcome
Refund Advance Interest
Refund Advance Option
Tax Return Documents
Prior Year Preparation
Prior-Year Tax Year
Expected Filing Status
Head of Household Documentation
HOH proof Upload
FILING STATUS WILL ULTIMATELY BE DETERMINED BY THE INFORMATION PROVIDED AND THE TAX PREPARER’S PROFESSIONAL DETERMINATION.

Primary Taxpayer Full Name

Taxpayer DOB
Taxpayer SSN
ID/Passport Front
PHOTO ID/PASSPORT CANNOT BE EXPIRED
ID/Passport Back
PHOTO ID/PASSPORT CANNOT BE EXPIRED
Social Security Verification

SPOUSE INFORMATION

Spouse Full Name

Your spouse will need to complete a separate tax intake for their individual return.

Spouse Identification

PHOTO ID/PASSPORT CANNOT BE EXPIRED

Current Address

County
U.S. Residency
Primary Phone
Primary Email
Occupation
IRS IP PIN Requirement
IP PIN Issued For
IRS IP PIN Notice
This number is issued by the IRS and is required to process your return. If you are required to use an IP PIN, please provide the current-year notice.
Legal Marital Status
Prior-Year IRS Audit
Dependent Eligibility

DEPENDENT INFORMATION

Dependent Claim
Other Claimant Eligibility
Dependent Disability
Dependent Support and Residency
Child Support Payments
Dependent Medicaid
Dependent Public Assistance
Number of Dependents

DEPENDENT 1

Dependent 1 DOB
Relationship

Dependent 2

Dependent 2 DOB
Relationship

Dependent 3

Dependent 3 DOB
Relationship

Dependent 4

Dependent 4 DOB
Relationship

Dependent 5

Dependent 5 DOB
Relationship

Dependent 6

Dependent 6 DOB
Relationship

DEPENDENT DOCUMENTATON

Dependent Social Security Cards

Acceptable documents include an immunization record, school document, physician statement, or Food Stamp/Medicaid letter showing the parent’s name, child’s name, and taxpayer’s address.

PLEASE KEEP IN MIND: WITHOUT PROOF OF DEPENDENCY, WE CANNOT PROCESS YOUR RETURN.

Non-Biological Dependent Permission
Biological Parent Explanation

INCOME & DEDUCTIONS

HEALTH INSURANCE

Marketplace Health Insurance

If yes: You MUST report Form 1095-A, as the IRS requires it to accept your return.

Form 1095-A

INCOME

W-2 Income
W-2 Documents
1099-K Income
Examples: Etsy, Square, PayPal, Shopify, Cash App, Venmo, etc.
1099-K Documents
Other 1099 Income
If you received a 1099-NEC, do not upload it here. You’ll be asked for that in the Self-Employment section.
Other 1099 Documents
Form 1099-G
Unemployment Income
Retirement Income
Retirement Documents
Early Retirement Withdrawal
Early Withdrawal Documents
Early Withdrawal Type
Gambling and Prize Income
Gambling and Prize Documents
Canceled Debt or Foreclosure

Forms 1099-C and 1099-A

Canceled Debt Documents

SELF-EMPLOYMENT

If you conducted any kind of side business and received cash or electronic payments, you are self-employed. Payment examples include Apple Pay, PayPal, Zelle, Cash App, Venmo, and Google Pay.
1099-NEC Income
Form 1099-NEC
Business or Self-Employment
Business Income Records
Cash Business Income
Business Type
1099-NEC Company
If you received Form 1099-NEC or earned self-employment income, you are required to file Schedule C. This allows you to deduct business expenses such as gas, tolls, mileage, meals, supplies and other business-related costs. Please provide your total annual expenses below.
Business Name
Business EIN Status
Business EIN
Federal Tax Classification
Business Address

BUSINESS EXPENSES WORKSHEET (LEAVE SLOT BLANK IF IT DOES NOT APPLY)

PLEASE LIST ALL OF YOUR BUSINESS EXPENSES FOR 2026

$
Business Telephone Expense
$
Advertising Expense
$
Contract Labor Expense
$
Business Repairs
$
Office Expense
$
Business Supplies
$
Business Utilities
$
Business Meals
$
Business Travel
$
Business Health Insurance
$
Other Business Insurance
$
Depletion Expense
$
Business Mortgage Interest
$
Other Business Interest
$
Equipment Rental Expense
$
Business Property Rent
$
Business Taxes and Licenses
$
Business Training
$
Professional Services
$
Other Business Expenses

VEHICLE USED FOR BUSINESS AND PERSONAL PURPOSES

Business Vehicle Use
Vehicle Make and Model
Business Mileage
Total Vehicle Mileage
$
Vehicle Insurance
$
Vehicle Maintenance
Home Office Use

HOME OFFICE — LEAVE THIS SECTION BLANK IF IT DOES NOT APPLY

You may be able to deduct certain expenses for the part of your home used exclusively and regularly for business. This may include an office, inventory-storage area, or space used to meet clients or customers.
Entire Home Square Footage
Home Office Square Footage
$
Home Office Mortgage Interest
$
Home Electricity
$
Home Real Estate Taxes
$
Home Water Expense
$
Home Rent Expense
$
Homeowners Insurance
$
Home Security Expense
$
Home Office Repairs
$
Home Internet Expense
$
Home Office Furniture
$
Home HOA Expense
$
Home Gas Expense

CREDITS

College Attendance
Previously Disallowed Tax Credit
Form 1098-T
First Four College Years Completed
Student Felony Drug Conviction

ADJUSTMENTS TO INCOME

IRA Activity
IRA Documents
Student Loan Payments
Form 1098-E

ITEMIZED DEDUCTIONS

Medical Expenses
Medical Expenses
Home Purchase or Sale
Home Purchase or Sale
Mortgage Payments
Mortgage Payments
Charitable Contributions
Charitable Contributions
Tithe and Offering
Tithe and Offering

E-SIGN

REFUND, CONSENT & E-SIGNATURE

Please review the following information carefully before completing the consent and signature sections.
Refund Delivery Method
Bank Account Ownership
Bank Name
Routing Number
Confirm Routing Number
Account Number
Confirm Account Number
Bank Information Confirmation
Client Questions
IRS Balance Owed

BANK VERIFICATION SECURITY QUESTIONS

Bank Verification Answer

The following information may be required by the bank to verify your identity.

Additional Documents
Tax Preparation Authorization
IRS Processing Acknowledgment

TAX PREPARATION ENGAGEMENT AGREEMENT

Thank you for choosing Fortune Financial Multi Services LLC to assist with the preparation of your requested tax returns. This agreement confirms the terms of our engagement and describes the services we will provide.

Tax Preparation Services
Fortune Financial Multi Services LLC will prepare your requested federal and state income tax returns based on the information and documentation you provide. You are responsible for providing complete and accurate information necessary to prepare your returns. We may ask you to clarify information or provide additional documentation; however, our engagement does not include auditing or independently verifying the information you submit.

Any accounting services performed as part of this engagement will be limited to those reasonably necessary to prepare your tax returns. Our tax preparation services are not designed to detect fraud, errors, or illegal acts. If we become aware of a material issue while preparing your return, we will bring it to your attention.

Taxpayer Responsibility
By accepting this agreement, you certify that the information and documentation you provide to Fortune Financial Multi Services LLC is true, complete, and accurate to the best of your knowledge. You understand that you are responsible for maintaining documentation supporting the income, deductions, credits, dependents, filing status, and other information reported on your tax return.

You understand that knowingly providing false or fraudulent information for inclusion on a tax return may result in penalties, repayment of improperly received refunds or credits, interest, and potential civil or criminal consequences. Fortune Financial Multi Services LLC is not responsible for inaccuracies resulting from false, incomplete, omitted, or incorrect information supplied by you.

Fees & Payment
Tax preparation fees are due according to the invoice and payment arrangement provided to you. If you or your spouse owe federal or government debts—including IRS debts, child support, student loan obligations, or other offsets—you remain responsible for all tax preparation fees regardless of whether your expected refund is reduced, offset, delayed, or otherwise unavailable.

If your refund is issued by mail or your tax preparation fees cannot be deducted from your refund as anticipated, you remain responsible for payment of the applicable preparation fees.

If you decide not to file your return through Fortune Financial Multi Services LLC after preparation of the return has been completed, a $99 non-filing fee will be due. Unpaid balances may be pursued through lawful collection methods as permitted by applicable law.

You agree not to initiate a payment dispute solely because of IRS processing delays, refund offsets, garnishments, or other circumstances outside the control of Fortune Financial Multi Services LLC when tax preparation services have been properly performed.

Records & Documents
Original records provided by you will be returned at the conclusion of the engagement. You are responsible for securely maintaining your tax records and supporting documentation in case they are needed in the future.

Fortune Financial Multi Services LLC may retain copies of records and workpapers related to this engagement in accordance with its document-retention policies and applicable legal requirements. Additional paper copies of tax returns or other documents may be subject to a fee.

Completion of Services & Filing
Our engagement concludes when your completed tax return is delivered to you for paper filing or, for an electronically filed return, after you have reviewed the completed return, provided all required authorizations and signatures, and the return has been submitted electronically.

If you choose not to electronically file through our office, you are responsible for timely filing your return with the appropriate taxing authorities.

You are responsible for carefully reviewing your completed tax return before authorizing its filing and notifying us of any information you believe is incorrect or incomplete.

By accepting this agreement, you acknowledge that you have read and understand these terms and agree to the tax preparation services described above.

Agreement Acknowledgment

Please sign below to acknowledge your acceptance of the Letter of Engagement & Taxpayer Agreement.

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If filing a joint return, your spouse must also review and acknowledge the Letter of Engagement & Taxpayer Agreement.

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