File Taxes Client Intake Form Client Intake Form To be completed by clients requesting tax preparation services. Primary Taxpayer Name Primary Taxpayer Name First First Middle Middle Last Last Primary Taxpayer Social Security # * Spouse Name Spouse Name First First Middle Middle Last Last Spouse Social Security # Spouse’s social security # is required if your filing status is Married Filing Separately or Married Filing Jointly Mailing Address * Mailing Address Mailing Address Mailing Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal State of Residence * Primary Taxpayer Birthdate Spouse Birthdate Phone Email What was your marital status on December 31, 2024? * Single Married It’s Complicated Tax Filing Status * Single Married Filing Jointly (even if only one had income) Married Filing Separately (MFS) Head of Household Qualifying Surviving Spouse (QSS) Did you have children or dependents last year? * Yes No Did you pay for child and dependent care? * Yes No Provide Name, Social Security Number and Birthdate for each dependent. **By providing the following information for each dependent (Name, Social Security Number, and Date of Birth), you acknowledge that you are the legal claimant for the dependent(s) listed and that no one else, including other individuals or family members, has claimed or will claim the dependent(s) on their tax return for the current tax year. You affirm that all the information provided is accurate and truthful to the best of your knowledge.** How many form W-2s did you receive? 012345678910 Did you own your own business or do any gig work last year? (1099-NEC, 1099-MISC, 1099-K, or other records) Yes No Did you receive income from other states? Yes No Did you receive unemployment benefits? (Form 1099-G) Yes No Did you receive interest from a bank account? (Form 1099-INT) Yes No Did you sell any stocks or investments? (Form 1099-B) Yes No Did you sell or trade cryptocurrency? (CSV, 1099-B or supplemental statements) Yes No Did you withdraw funds or receive income from a retirement account? (Form 1099-R) Yes No Did you receive Social Security benefits? (SSA-1099 or RRB-1099) Yes No Did you receive any dividends? (Form 1099-DIV) Yes No Did you receive rental property income? (Form 1099-MISC, 1099-K or other records) Yes No Did you receive income from an S-corp, partnership , or trust? (Schedule K-1) Yes No Did you sell a home? (Form 1099-S or escrow statement) Yes No Did you have cancelled debt? (Form 1099-A, 1099-C) Yes No Did you, your spouse, or your dependents have health care insurance through the Marketplace (Form 1095A) * Yes No **If you answered Yes please attach the 1095A form. If you had Marketplace insurance but did not receive the form you can download it online from your account at healthcare.gov** You may provide additional explanation in the box below. A representative will contact you to go over your return and answer any questions you may have. Upload all your supporting tax documents and at least one photo ID * Drop a file here or click to upload Choose File Maximum file size: 516MB Submit If you are human, leave this field blank.
