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Remote Online Notary Signing Agent Appointment

(817) 726-2181

New / Current Client Intake Form

    You will need:
    • Tax Information such as Forms W-2, 1099, 1098, 1095.

    • Social security cards or ITIN letters for all persons on your tax return.

    • Picture ID (such as valid driver's license) for you and your spouse.

    • You are responsible for the information on your return. Please provide
      complete and accurate information

    Instructions:
    • Please choose Your Best Plan and submit payment

    • Complete the New Client Intake Form for US Taxpayers

    • Complete the Non-Residential Form for Foreign Taxpayers

    • Submit the form to the Tax Expert

    • A Tax Expert will contact you via phone or email with additional information

    Part I – Your Personal Information (If you are filing a joint return, enter your names in the same order as last year’s return)


    M.I.




    YesNo


    M.I.




    YesNo


    Apt #






    A. Full-time student   

    YesNo

    B. Totally and permanently disabled

    YesNo

    C. Legally blind

    YesNo



    A. Full-time student   

    YesNo

    B. Totally and permanently disabled

    YesNo

    C. Legally blind

    YesNo


    YesNoUnsure

    A. Been a victim of identity theft?

    YesNo

    B. Adopted a child?

    YesNo

    Part II – Marital Status and Household Information

    Never Married

    (This includes registered domestic partnerships, civil unions, or other formal relationships under state law)

    Married

    A. If Yes, Did you get married in 2020?         YesNo


    B. Did you live with your spouse during any part of the last six months of 2020?         YesNo

    Divorced

    Date of final decree

    Legally Separated

    Date of separate maintenance agreement

    Widowed

    Year of spouse’s death

    • Everyone who lived with you last year (other than your spouse)

    • Anyone you supported but did not live with you last year

    Name (first, last) Do not enter your name or spouse’s name below

    (a)

    Date of Birth (mm/dd/yy)

    (b)

    Relationship to you (for example: son, daughter, parent, none, etc)

    (c)

    Number of months lived in your home last year

    (d)

    US Citizen (yes/no)

    (e)

    Resident of US, Canada, or Mexico last year (yes/no)

    (f)

    Single or Married as of 2020 (S/M)

    (g)

    Full-time Student last year (yes/no) (h)

    Totally and Permanently Disabled (yes/no) (i)

    Check appropriate box for each question in each section

    Yes

    No

    Unsure

    Part III – Income – Last Year, Did You (or Your Spouse) Receive

    Yes

    No

    Unsure

    1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year?     

    Yes

    No

    Unsure

    2. (A) Tip Income?

    Yes

    No

    Unsure

    3. (B) Scholarships? (Forms W-2, 1098-T)

    Yes

    No

    Unsure

    4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV)

    Yes

    No

    Unsure

    5. (B) Refund of state/local income taxes? (Form 1099-G)

    Yes

    No

    Unsure

    6. (B) Alimony income or separate maintenance payments?

    Yes

    No

    Unsure

    7. (A) Self-Employment income? (Form 1099-MISC, cash)

    Yes

    No

    Unsure

    8. (A) Cash/check payments for any work performed not reported on Forms W-2 or 1099?

    Yes

    No

    Unsure

    9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S,1099-B)

    Yes

    No

    Unsure

    10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)

    Yes

    No

    Unsure

    11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R)

    Yes

    No

    Unsure

    12. (B) Unemployment Compensation? (Form 1099G)

    Yes

    No

    Unsure

    13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099, RRB-1099)

    Yes

    No

    Unsure

    14. (M) Income (or loss) from Rental Property?

    Yes

    No

    Unsure

    15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify     

    Yes

    No

    Unsure

    Part IV – Expenses – Last Year, Did You (or Your Spouse) Pay

    Yes

    No

    Unsure

    1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient’s SSN?    
    YesNo

    Yes

    No

    Unsure

    2. Contributions to a retirement account?
         IRA (A)    401K (B)  
      Roth IRA (B)     Other

    Yes

    No

    Unsure

    3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)

    Yes

    No

    Unsure

    4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)

    Yes

    No

    Unsure

    5. (B) Medical expenses? (including health insurance premiums)

    Yes

    No

    Unsure

    6. (B) Home mortgage interest? (Form 1098)

    Yes

    No

    Unsure

    7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)

    Yes

    No

    Unsure

    8. (B) Charitable contributions?

    Yes

    No

    Unsure

    9. (B) Child or dependent care expenses such as daycare?

    Yes

    No

    Unsure

    10. (B) For supplies used as an eligible educator such as a teacher, teacher’s aide, counselor, etc.?

    Yes

    No

    Unsure

    11. (A) Expenses related to self-employment income or any other income you received?

    Yes

    No

    Unsure

    12. (B) Student loan interest? (Form 1098-E)

    Yes

    No

    Unsure

    Part V – Life Events – Last Year, Did You (or Your Spouse)

    Yes

    No

    Unsure

    1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)

    Yes

    No

    Unsure

    2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)

    Yes

    No

    Unsure

    3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)

    Yes

    No

    Unsure

    4. (B) Have Earned Income Credit (EIC) or other credits disallowed in a prior year? If yes, for which tax year?

    Yes

    No

    Unsure

    5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)

    Yes

    No

    Unsure

    6. (B) Live in an area that was affected by a natural disaster? If yes, where?

    Yes

    No

    Unsure

    7. (A) Receive the First Time Homebuyers Credit in 2008?

    Yes

    No

    Unsure

    8. (B) Make estimated tax payments or apply last year’s refund to this year’s tax? If so how much?

    Yes

    No

    Unsure

    9. (A) File a federal return last year containing a “capital loss carryover” on Form 1040 Schedule D?

    Yes

    No

    Unsure

    Part VI - Health Care Coverage - Last year, did you, your spouse, or dependent(s)

    Yes

    No

    Unsure

    1. (B) Have health care coverage?

    Yes

    No

    Unsure

    2. (B) Receive one or more of these forms? (Check the box)     Form 1095-BForm 1095-C

    Yes

    No

    Unsure

    A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]

    • 3a. (A) If yes, were advance credit payments made to help you pay your health care premiums?

    • 3b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?

    Yes

    No

    Unsure

    4. (B) Have an exemption granted by the Marketplace?

    Visit http://www.healthcare.gov/ or call 1-800-318-2596 for more information on health insurance options and assistance.

    If advance payments of the premium tax credit were paid on your behalf to help pay your health insurance premiums, you should report life changes, such
    as, income, marital status or family size changes, to your Marketplace. Reporting changes will help to make sure you are getting the proper amount of
    advance payments.

    1. Provide an email address (this email address will not be used for contacts from the Internal Revenue Service)

    2. If you are due a refund, would you like:

    a. Direct deposit

    YesNo

    b. To purchase U.S. Savings Bonds

    YesNo

    c. To split your refund between different accounts

    YesNo

    3. If you have a balance due, would you like to make a payment directly from your bank account?     YesNo

    4. Have you or your spouse received any letters from the Internal Revenue Service?     YesNo

    Checking Account #

    Saving Account #

    Name of Bank:

    Routing #

    Signature of Taxpayer:     

    Signature of Spouse:     

    Additional Tax Preparer notes:

    Taxpayer:
    Presidential Election Campaign Fund (If you check a box, your tax or refund will not change) Check here if you, or your spouse if filing jointly, want $3 to go to this fund   

    Spouse:
    Presidential Election Campaign Fund (If you check a box, your tax or refund will not change) Check here if you, or your spouse if filing jointly, want $3 to go to this fund   

    This site uses cookies and other technologies, so we can remember you and understand how you and the other visitors use the site. By clicking “Accept All Cookies”, you consent to the storing on your device all the technologies. Continuing to browse, cookies will be setup. Please understand how we maintain the site, and how we may collect and use visitor data.   

    IRS Circular 230 Disclosure

    To ensure compliance with requirements imposed by the IRS, we inform you that any U.S. tax advice contained in this communication (including any attachments) is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any transaction or matter addressed herein.

    This message is intended only for the designated recipient(s). It may contain confidential or proprietary information and may be subject to the attorney-client privilege or other confidentiality protections. If you are not a designated recipient, you may not review, copy or distribute this message. If you receive this in error, please notify the sender by reply e-mail and delete this message. Thank you.

    Please prove you are human by selecting the house.

      You will need:
      • Tax Information such as Forms W-2, 1099, 1098, 1095.

      • Social security cards or ITIN letters for all persons on your tax return.

      • Picture ID (such as valid driver's license) for you and your spouse.

      • You are responsible for the information on your return. Please provide
        complete and accurate information

      Instructions:
      • Please choose Your Best Plan and submit payment

      • Complete the New Client Intake Form for US Taxpayers

      • Complete the Non-Residential Form for Foreign Taxpayers

      • Submit the form to the Tax Expert

      • A Tax Expert will contact you via phone or email with additional information

      Part I – Your Personal Information (If you are filing a joint return, enter your names in the same order as last year’s return)


      M.I.




      YesNo


      M.I.




      YesNo


      Apt #






      A. Full-time student   

      YesNo

      B. Totally and permanently disabled

      YesNo

      C. Legally blind

      YesNo



      A. Full-time student   

      YesNo

      B. Totally and permanently disabled

      YesNo

      C. Legally blind

      YesNo


      YesNoUnsure

      A. Been a victim of identity theft?

      YesNo

      B. Adopted a child?

      YesNo

      Part II – Marital Status and Household Information

      Never Married

      (This includes registered domestic partnerships, civil unions, or other formal relationships under state law)

      Married

      A. If Yes, Did you get married in 2021?         YesNo


      B. Did you live with your spouse during any part of the last six months of 2021?         YesNo

      Divorced

      Date of final decree

      Legally Separated

      Date of separate maintenance agreement

      Widowed

      Year of spouse’s death

      • Everyone who lived with you last year (other than your spouse)

      • Anyone you supported but did not live with you last year

      Name (first, last) Do not enter your name or spouse’s name below

      (a)

      Date of Birth (mm/dd/yy)

      (b)

      Relationship to you (for example: son, daughter, parent, none, etc)

      (c)

      Number of months lived in your home last year

      (d)

      US Citizen (yes/no)

      (e)

      Resident of US, Canada, or Mexico last year (yes/no)

      (f)

      Single or Married as of 2021 (S/M)

      (g)

      Full-time Student last year (yes/no) (h)

      Totally and Permanently Disabled (yes/no) (i)

      Check appropriate box for each question in each section

      Yes

      No

      Unsure

      Part III – Income – Last Year, Did You (or Your Spouse) Receive

      Yes

      No

      Unsure

      1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year?     

      Yes

      No

      Unsure

      2. (A) Tip Income?

      Yes

      No

      Unsure

      3. (B) Scholarships? (Forms W-2, 1098-T)

      Yes

      No

      Unsure

      4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV)

      Yes

      No

      Unsure

      5. (B) Refund of state/local income taxes? (Form 1099-G)

      Yes

      No

      Unsure

      6. (B) Alimony income or separate maintenance payments?

      Yes

      No

      Unsure

      7. (A) Self-Employment income? (Form 1099-MISC, cash)

      Yes

      No

      Unsure

      8. (A) Cash/check payments for any work performed not reported on Forms W-2 or 1099?

      Yes

      No

      Unsure

      9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S,1099-B)

      Yes

      No

      Unsure

      10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)

      Yes

      No

      Unsure

      11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R)

      Yes

      No

      Unsure

      12. (B) Unemployment Compensation? (Form 1099G)

      Yes

      No

      Unsure

      13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099, RRB-1099)

      Yes

      No

      Unsure

      14. (M) Income (or loss) from Rental Property?

      Yes

      No

      Unsure

      15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify     

      Yes

      No

      Unsure

      Part IV – Expenses – Last Year, Did You (or Your Spouse) Pay

      Yes

      No

      Unsure

      1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient’s SSN?    
      YesNo

      Yes

      No

      Unsure

      2. Contributions to a retirement account?
           IRA (A)    401K (B)  
        Roth IRA (B)     Other

      Yes

      No

      Unsure

      3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)

      Yes

      No

      Unsure

      4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)

      Yes

      No

      Unsure

      5. (B) Medical expenses? (including health insurance premiums)

      Yes

      No

      Unsure

      6. (B) Home mortgage interest? (Form 1098)

      Yes

      No

      Unsure

      7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)

      Yes

      No

      Unsure

      8. (B) Charitable contributions?

      Yes

      No

      Unsure

      9. (B) Child or dependent care expenses such as daycare?

      Yes

      No

      Unsure

      10. (B) For supplies used as an eligible educator such as a teacher, teacher’s aide, counselor, etc.?

      Yes

      No

      Unsure

      11. (A) Expenses related to self-employment income or any other income you received?

      Yes

      No

      Unsure

      12. (B) Student loan interest? (Form 1098-E)

      Yes

      No

      Unsure

      Part V – Life Events – Last Year, Did You (or Your Spouse)

      Yes

      No

      Unsure

      1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)

      Yes

      No

      Unsure

      2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)

      Yes

      No

      Unsure

      3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)

      Yes

      No

      Unsure

      4. (B) Have Earned Income Credit (EIC) or other credits disallowed in a prior year? If yes, for which tax year?

      Yes

      No

      Unsure

      5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)

      Yes

      No

      Unsure

      6. (B) Live in an area that was affected by a natural disaster? If yes, where?

      Yes

      No

      Unsure

      7. (A) Receive the First Time Homebuyers Credit in 2008?

      Yes

      No

      Unsure

      8. (B) Make estimated tax payments or apply last year’s refund to this year’s tax? If so how much?

      Yes

      No

      Unsure

      9. (A) File a federal return last year containing a “capital loss carryover” on Form 1040 Schedule D?

      Yes

      No

      Unsure

      Part VI - Health Care Coverage - Last year, did you, your spouse, or dependent(s)

      Yes

      No

      Unsure

      1. (B) Have health care coverage?

      Yes

      No

      Unsure

      2. (B) Receive one or more of these forms? (Check the box)     Form 1095-BForm 1095-C

      Yes

      No

      Unsure

      A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]

      • 3a. (A) If yes, were advance credit payments made to help you pay your health care premiums?

      • 3b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?

      Yes

      No

      Unsure

      4. (B) Have an exemption granted by the Marketplace?

      Visit http://www.healthcare.gov/ or call 1-800-318-2596 for more information on health insurance options and assistance.

      If advance payments of the premium tax credit were paid on your behalf to help pay your health insurance premiums, you should report life changes, such
      as, income, marital status or family size changes, to your Marketplace. Reporting changes will help to make sure you are getting the proper amount of
      advance payments.

      1. Provide an email address (this email address will not be used for contacts from the Internal Revenue Service)

      2. If you are due a refund, would you like:

      a. Direct deposit

      YesNo

      b. To purchase U.S. Savings Bonds

      YesNo

      c. To split your refund between different accounts

      YesNo

      3. If you have a balance due, would you like to make a payment directly from your bank account?     YesNo

      4. Have you or your spouse received any letters from the Internal Revenue Service?     YesNo

      Checking Account #

      Saving Account #

      Name of Bank:

      Routing #

      Signature of Taxpayer:     

      Signature of Spouse:     

      Additional Tax Preparer notes:

      Taxpayer:
      Presidential Election Campaign Fund (If you check a box, your tax or refund will not change) Check here if you, or your spouse if filing jointly, want $3 to go to this fund   

      Spouse:
      Presidential Election Campaign Fund (If you check a box, your tax or refund will not change) Check here if you, or your spouse if filing jointly, want $3 to go to this fund   

      This site uses cookies and other technologies, so we can remember you and understand how you and the other visitors use the site. By clicking “Accept All Cookies”, you consent to the storing on your device all the technologies. Continuing to browse, cookies will be setup. Please understand how we maintain the site, and how we may collect and use visitor data.   

      IRS Circular 230 Disclosure

      To ensure compliance with requirements imposed by the IRS, we inform you that any U.S. tax advice contained in this communication (including any attachments) is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any transaction or matter addressed herein.

      This message is intended only for the designated recipient(s). It may contain confidential or proprietary information and may be subject to the attorney-client privilege or other confidentiality protections. If you are not a designated recipient, you may not review, copy or distribute this message. If you receive this in error, please notify the sender by reply e-mail and delete this message. Thank you.

      Please prove you are human by selecting the tree.

        You will need:
        • Tax Information such as Forms W-2, 1099, 1098, 1095.

        • Social security cards or ITIN letters for all persons on your tax return.

        • Picture ID (such as valid driver's license) for you and your spouse.

        • You are responsible for the information on your return. Please provide
          complete and accurate information

        Instructions:
        • Please choose Your Best Plan and submit payment

        • Complete the New Client Intake Form for US Taxpayers

        • Complete the Non-Residential Form for Foreign Taxpayers

        • Submit the form to the Tax Expert

        • A Tax Expert will contact you via phone or email with additional information

        Part I – Your Personal Information (If you are filing a joint return, enter your names in the same order as last year’s return)


        M.I.




        YesNo


        M.I.




        YesNo


        Apt #






        A. Full-time student   

        YesNo

        B. Totally and permanently disabled

        YesNo

        C. Legally blind

        YesNo



        A. Full-time student   

        YesNo

        B. Totally and permanently disabled

        YesNo

        C. Legally blind

        YesNo


        YesNoUnsure

        A. Been a victim of identity theft?

        YesNo

        B. Adopted a child?

        YesNo

        Part II – Marital Status and Household Information

        Never Married

        (This includes registered domestic partnerships, civil unions, or other formal relationships under state law)

        Married

        A. If Yes, Did you get married in 2022?         YesNo


        B. Did you live with your spouse during any part of the last six months of 2022?         YesNo

        Divorced

        Date of final decree

        Legally Separated

        Date of separate maintenance agreement

        Widowed

        Year of spouse’s death

        • Everyone who lived with you last year (other than your spouse)

        • Anyone you supported but did not live with you last year

        Name (first, last) Do not enter your name or spouse’s name below

        (a)

        Date of Birth (mm/dd/yy)

        (b)

        Relationship to you (for example: son, daughter, parent, none, etc)

        (c)

        Number of months lived in your home last year

        (d)

        US Citizen (yes/no)

        (e)

        Resident of US, Canada, or Mexico last year (yes/no)

        (f)

        Single or Married as of 2022 (S/M)

        (g)

        Full-time Student last year (yes/no) (h)

        Totally and Permanently Disabled (yes/no) (i)

        Check appropriate box for each question in each section

        Yes

        No

        Unsure

        Part III – Income – Last Year, Did You (or Your Spouse) Receive

        Yes

        No

        Unsure

        1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year?     

        Yes

        No

        Unsure

        2. (A) Tip Income?

        Yes

        No

        Unsure

        3. (B) Scholarships? (Forms W-2, 1098-T)

        Yes

        No

        Unsure

        4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV)

        Yes

        No

        Unsure

        5. (B) Refund of state/local income taxes? (Form 1099-G)

        Yes

        No

        Unsure

        6. (B) Alimony income or separate maintenance payments?

        Yes

        No

        Unsure

        7. (A) Self-Employment income? (Form 1099-MISC, cash)

        Yes

        No

        Unsure

        8. (A) Cash/check payments for any work performed not reported on Forms W-2 or 1099?

        Yes

        No

        Unsure

        9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S,1099-B)

        Yes

        No

        Unsure

        10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)

        Yes

        No

        Unsure

        11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R)

        Yes

        No

        Unsure

        12. (B) Unemployment Compensation? (Form 1099G)

        Yes

        No

        Unsure

        13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099, RRB-1099)

        Yes

        No

        Unsure

        14. (M) Income (or loss) from Rental Property?

        Yes

        No

        Unsure

        15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify     

        Yes

        No

        Unsure

        Part IV – Expenses – Last Year, Did You (or Your Spouse) Pay

        Yes

        No

        Unsure

        1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient’s SSN?    
        YesNo

        Yes

        No

        Unsure

        2. Contributions to a retirement account?
             IRA (A)    401K (B)  
          Roth IRA (B)     Other

        Yes

        No

        Unsure

        3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)

        Yes

        No

        Unsure

        4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)

        Yes

        No

        Unsure

        5. (B) Medical expenses? (including health insurance premiums)

        Yes

        No

        Unsure

        6. (B) Home mortgage interest? (Form 1098)

        Yes

        No

        Unsure

        7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)

        Yes

        No

        Unsure

        8. (B) Charitable contributions?

        Yes

        No

        Unsure

        9. (B) Child or dependent care expenses such as daycare?

        Yes

        No

        Unsure

        10. (B) For supplies used as an eligible educator such as a teacher, teacher’s aide, counselor, etc.?

        Yes

        No

        Unsure

        11. (A) Expenses related to self-employment income or any other income you received?

        Yes

        No

        Unsure

        12. (B) Student loan interest? (Form 1098-E)

        Yes

        No

        Unsure

        Part V – Life Events – Last Year, Did You (or Your Spouse)

        Yes

        No

        Unsure

        1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)

        Yes

        No

        Unsure

        2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)

        Yes

        No

        Unsure

        3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)

        Yes

        No

        Unsure

        4. (B) Have Earned Income Credit (EIC) or other credits disallowed in a prior year? If yes, for which tax year?

        Yes

        No

        Unsure

        5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)

        Yes

        No

        Unsure

        6. (B) Live in an area that was affected by a natural disaster? If yes, where?

        Yes

        No

        Unsure

        7. (A) Receive the First Time Homebuyers Credit in 2008?

        Yes

        No

        Unsure

        8. (B) Make estimated tax payments or apply last year’s refund to this year’s tax? If so how much?

        Yes

        No

        Unsure

        9. (A) File a federal return last year containing a “capital loss carryover” on Form 1040 Schedule D?

        Yes

        No

        Unsure

        Part VI - Health Care Coverage - Last year, did you, your spouse, or dependent(s)

        Yes

        No

        Unsure

        1. (B) Have health care coverage?

        Yes

        No

        Unsure

        2. (B) Receive one or more of these forms? (Check the box)     Form 1095-BForm 1095-C

        Yes

        No

        Unsure

        A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]

        • 3a. (A) If yes, were advance credit payments made to help you pay your health care premiums?

        • 3b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?

        Yes

        No

        Unsure

        4. (B) Have an exemption granted by the Marketplace?

        Visit http://www.healthcare.gov/ or call 1-800-318-2596 for more information on health insurance options and assistance.

        If advance payments of the premium tax credit were paid on your behalf to help pay your health insurance premiums, you should report life changes, such
        as, income, marital status or family size changes, to your Marketplace. Reporting changes will help to make sure you are getting the proper amount of
        advance payments.

        1. Provide an email address (this email address will not be used for contacts from the Internal Revenue Service)

        2. If you are due a refund, would you like:

        a. Direct deposit

        YesNo

        b. To purchase U.S. Savings Bonds

        YesNo

        c. To split your refund between different accounts

        YesNo

        3. If you have a balance due, would you like to make a payment directly from your bank account?     YesNo

        4. Have you or your spouse received any letters from the Internal Revenue Service?     YesNo

        Checking Account #

        Saving Account #

        Name of Bank:

        Routing #

        Signature of Taxpayer:     

        Signature of Spouse:     

        Additional Tax Preparer notes:

        Taxpayer:
        Presidential Election Campaign Fund (If you check a box, your tax or refund will not change) Check here if you, or your spouse if filing jointly, want $3 to go to this fund   

        Spouse:
        Presidential Election Campaign Fund (If you check a box, your tax or refund will not change) Check here if you, or your spouse if filing jointly, want $3 to go to this fund   

        This site uses cookies and other technologies, so we can remember you and understand how you and the other visitors use the site. By clicking “Accept All Cookies”, you consent to the storing on your device all the technologies. Continuing to browse, cookies will be setup. Please understand how we maintain the site, and how we may collect and use visitor data.   

        IRS Circular 230 Disclosure

        To ensure compliance with requirements imposed by the IRS, we inform you that any U.S. tax advice contained in this communication (including any attachments) is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any transaction or matter addressed herein.

        This message is intended only for the designated recipient(s). It may contain confidential or proprietary information and may be subject to the attorney-client privilege or other confidentiality protections. If you are not a designated recipient, you may not review, copy or distribute this message. If you receive this in error, please notify the sender by reply e-mail and delete this message. Thank you.

        Please prove you are human by selecting the tree.

          You will need:
          • Tax Information such as Forms W-2, 1099, 1098, 1095.

          • Social security cards or ITIN letters for all persons on your tax return.

          • Picture ID (such as valid driver's license) for you and your spouse.

          • You are responsible for the information on your return. Please provide
            complete and accurate information

          Part I – Your Personal Information (If you are filing a joint return, enter your names in the same order as last year’s return)


          M.I.




          YesNo


          M.I.




          YesNo


          Apt #






          A. Full-time student   

          YesNo

          B. Totally and permanently disabled

          YesNo

          C. Legally blind

          YesNo



          A. Full-time student   

          YesNo

          B. Totally and permanently disabled

          YesNo

          C. Legally blind

          YesNo


          YesNoUnsure

          A. Been a victim of identity theft?

          YesNo

          B. Adopted a child?

          YesNo

          Part II – Marital Status and Household Information

          Never Married

          (This includes registered domestic partnerships, civil unions, or other formal relationships under state law)

          Married

          A. If Yes, Did you get married in 2023?         YesNo


          B. Did you live with your spouse during any part of the last six months of 2023?         YesNo

          Divorced

          Date of final decree

          Legally Separated

          Date of separate maintenance agreement

          Widowed

          Year of spouse’s death

          • Everyone who lived with you last year (other than your spouse)

          • Anyone you supported but did not live with you last year

          Name (first, last) Do not enter your name or spouse’s name below

          (a)

          Date of Birth (mm/dd/yy)

          (b)

          Relationship to you (for example: son, daughter, parent, none, etc)

          (c)

          Number of months lived in your home last year

          (d)

          US Citizen (yes/no)

          (e)

          Resident of US, Canada, or Mexico last year (yes/no)

          (f)

          Single or Married as of 2023 (S/M)

          (g)

          Full-time Student last year (yes/no) (h)

          Totally and Permanently Disabled (yes/no) (i)

          Check appropriate box for each question in each section

          Yes

          No

          Unsure

          Part III – Income – Last Year, Did You (or Your Spouse) Receive

          Yes

          No

          Unsure

          1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year?     

          Yes

          No

          Unsure

          2. (A) Tip Income?

          Yes

          No

          Unsure

          3. (B) Scholarships? (Forms W-2, 1098-T)

          Yes

          No

          Unsure

          4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV)

          Yes

          No

          Unsure

          5. (B) Refund of state/local income taxes? (Form 1099-G)

          Yes

          No

          Unsure

          6. (B) Alimony income or separate maintenance payments?

          Yes

          No

          Unsure

          7. (A) Self-Employment income? (Form 1099-MISC, cash)

          Yes

          No

          Unsure

          8. (A) Cash/check payments for any work performed not reported on Forms W-2 or 1099?

          Yes

          No

          Unsure

          9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S,1099-B)

          Yes

          No

          Unsure

          10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)

          Yes

          No

          Unsure

          11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R)

          Yes

          No

          Unsure

          12. (B) Unemployment Compensation? (Form 1099G)

          Yes

          No

          Unsure

          13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099, RRB-1099)

          Yes

          No

          Unsure

          14. (M) Income (or loss) from Rental Property?

          Yes

          No

          Unsure

          15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify     

          Yes

          No

          Unsure

          Part IV – Expenses – Last Year, Did You (or Your Spouse) Pay

          Yes

          No

          Unsure

          1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient’s SSN?    
          YesNo

          Yes

          No

          Unsure

          2. Contributions to a retirement account?
               IRA (A)    401K (B)  
            Roth IRA (B)     Other

          Yes

          No

          Unsure

          3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)

          Yes

          No

          Unsure

          4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)

          Yes

          No

          Unsure

          5. (B) Medical expenses? (including health insurance premiums)

          Yes

          No

          Unsure

          6. (B) Home mortgage interest? (Form 1098)

          Yes

          No

          Unsure

          7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)

          Yes

          No

          Unsure

          8. (B) Charitable contributions?

          Yes

          No

          Unsure

          9. (B) Child or dependent care expenses such as daycare?

          Yes

          No

          Unsure

          10. (B) For supplies used as an eligible educator such as a teacher, teacher’s aide, counselor, etc.?

          Yes

          No

          Unsure

          11. (A) Expenses related to self-employment income or any other income you received?

          Yes

          No

          Unsure

          12. (B) Student loan interest? (Form 1098-E)

          Yes

          No

          Unsure

          Part V – Life Events – Last Year, Did You (or Your Spouse)

          Yes

          No

          Unsure

          1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)

          Yes

          No

          Unsure

          2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)

          Yes

          No

          Unsure

          3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)

          Yes

          No

          Unsure

          4. (B) Have Earned Income Credit (EIC) or other credits disallowed in a prior year? If yes, for which tax year?

          Yes

          No

          Unsure

          5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)

          Yes

          No

          Unsure

          6. (B) Live in an area that was affected by a natural disaster? If yes, where?

          Yes

          No

          Unsure

          7. (A) Receive the First Time Homebuyers Credit in 2008?

          Yes

          No

          Unsure

          8. (B) Make estimated tax payments or apply last year’s refund to this year’s tax? If so how much?

          Yes

          No

          Unsure

          9. (A) File a federal return last year containing a “capital loss carryover” on Form 1040 Schedule D?

          Yes

          No

          Unsure

          Part VI - Health Care Coverage - Last year, did you, your spouse, or dependent(s)

          Yes

          No

          Unsure

          1. (B) Have health care coverage?

          Yes

          No

          Unsure

          2. (B) Receive one or more of these forms? (Check the box)     Form 1095-BForm 1095-C

          Yes

          No

          Unsure

          A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]

          • 3a. (A) If yes, were advance credit payments made to help you pay your health care premiums?

          • 3b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?

          Yes

          No

          Unsure

          4. (B) Have an exemption granted by the Marketplace?

          Visit http://www.healthcare.gov/ or call 1-800-318-2596 for more information on health insurance options and assistance.

          If advance payments of the premium tax credit were paid on your behalf to help pay your health insurance premiums, you should report life changes, such
          as, income, marital status or family size changes, to your Marketplace. Reporting changes will help to make sure you are getting the proper amount of
          advance payments.

          1. Provide an email address (this email address will not be used for contacts from the Internal Revenue Service)

          2. If you are due a refund, would you like:

          a. Direct deposit

          YesNo

          b. To purchase U.S. Savings Bonds

          YesNo

          c. To split your refund between different accounts

          YesNo

          3. If you have a balance due, would you like to make a payment directly from your bank account?     YesNo

          4. Have you or your spouse received any letters from the Internal Revenue Service?     YesNo

          Checking Account #

          Saving Account #

          Name of Bank:

          Routing #

          Signature of Taxpayer:     

          Signature of Spouse:     

          Additional Tax Preparer notes:

          Taxpayer:
          Presidential Election Campaign Fund (If you check a box, your tax or refund will not change) Check here if you, or your spouse if filing jointly, want $3 to go to this fund   

          Spouse:
          Presidential Election Campaign Fund (If you check a box, your tax or refund will not change) Check here if you, or your spouse if filing jointly, want $3 to go to this fund   

          This site uses cookies and other technologies, so we can remember you and understand how you and the other visitors use the site. By clicking “Accept All Cookies”, you consent to the storing on your device all the technologies. Continuing to browse, cookies will be setup. Please understand how we maintain the site, and how we may collect and use visitor data.   

          IRS Circular 230 Disclosure

          To ensure compliance with requirements imposed by the IRS, we inform you that any U.S. tax advice contained in this communication (including any attachments) is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any transaction or matter addressed herein.

          This message is intended only for the designated recipient(s). It may contain confidential or proprietary information and may be subject to the attorney-client privilege or other confidentiality protections. If you are not a designated recipient, you may not review, copy or distribute this message. If you receive this in error, please notify the sender by reply e-mail and delete this message. Thank you.

          Please prove you are human by selecting the plane.