TAX INTAKE FORM

Please Complete & Submit the intake form below in order for our team to start your Tax Preparation Process!

PERSONAL INFORMATION

Full Name

Email *

Phone *

Address *

What Brings You Here?*

Did your marital status change during the year? *

Did your address change from last year? *

Can you be claimed as a dependent by another taxpayer? *

Did any of the taxpayers or dependents pass away or become legally blind during the year?

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

DEPENDENT INFORMATION

Were there any changes in dependents from the prior year?

Do you have any children under age 19 or a full-time student under age 24 with investment income in excess of $2,100 (dividends, interest, capital gains)?

Do you dependents who must file a tax return?

Did you provide over half the support for any other person(s) other than your dependent children during the year?Did you provide over half the support for any other person(s) other than your dependent children during the year?

Did you pay for child care while you worked or looked for work?

Did you pay any expenses related to the adoption of a child during the year?

If you are divorced or separated with child(ren), do you have a divorce decree or other form of separation agreement which establishes custodial responsibilities?

PURCHASES SALES DEBT INFORMATION

Did you start a new business or purchase rental property during the year?

Did you acquire a new or additional interest in a partnership, LLC or S Corporation?

Did you sell, exchange, or purchase any real estate during the year?

Did you purchase or sell a principle residence during the year?

Did you foreclose or abandon a principle residence or real property during the year?

Did you acquire or dispose of any stock during the year?

Did you take out a home equity loan this year?

Did you refinance a principal residence or second home this year?

Did you sell an existing business, rental, or other property this year?

Did you lend money with the understanding of repayment this year and it was totally uncollectable?

Did you have any debts cancelled or forgiven this year, such as home mortgage or student loans?

Did you purchase a qualified plug-in electric drive vehicle or qualified fuel cell vehicle this year?

INCOME INFORMATION

Did you have any foreign income or pay any foreign taxes during the year, directly or indirectly, such as from investment accounts, partnerships or a foreign employer?

Did you receive any income from property sold prior to this year?

Did you receive any Social Security benefits, unemployment benefits, disability income, or alimony during the year?

Did you receive tip income not reported to your employer this year?

Did any of your life insurance policies mature, or did you surrender any policies?

Did you receive any awards, prizes, hobby income, gambling or lottery winnings?

Do you expect a large fluctuation in income, deductions, or withholding next year?

RETIREMENT INFORMATION

Are you an active participant in a pension or retirement plan?

Did you receive any Social Security benefits during the year?

Did you make any withdrawals from an IRA, Roth, Keough, SIMPLE, SEP, 401(k), or other qualified retirement plan?

Did you receive any lump-sum payments from a pension, profit sharing or 401(k) plan?

Did you roll over any 401(k) or other retirement account balance to another qualified account?

Did you make any contributions to an IRA, Roth, Keogh, SIMPLE, SEP, 401(k), or other qualified retirement plan?

EDUCATION INFORMATION

Did you, your spouse, or your dependents attend a post-secondary school during the year, or plan to attend one in the coming year?

Did you have any educational expenses during the year on behalf of yourself, your spouse, or a dependent?

Did anyone in your family receive a scholarship of any kind during the year?

Did you make any withdrawals from an education savings or 529 Plan account?

Did you pay any student loan interest this year?

Did you cash any Series EE or I U.S. Savings bonds issued after 1989?

Did you make any contributions to an education savings or 529 Plan account?

HEALTH CARE INFORMATION

Did you have qualifying health care coverage, such as employer-sponsored coverage or government-sponsored coverage (i.e. Medicare/Medicaid) for every month of the year 2021 for your family? "Your family" for health care coverage refers to you, your spouse if filing jointly, and anyone you can claim as a dependent? (You will be asked to provide Form(s) 1095)

Did anyone in your family qualify for an exemption from the health care coverage mandate?

Did you enroll for lower cost Marketplace Coverage through healthcare.gov under the Affordable Care Act? You will be asked to provide any Form(s) 1095-A you received.

Did you make any contributions to a Health savings account (HSA) or Archer MSA?

Did you receive any distributions from a Health savings account (HSA), Archer MSA, Medicare Advantage MSA or ABLE account this year? (You will be asked to provide Form 1099SA.)