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)

1. Your first name

M.I.

Last name

Telephone number

Are you a U.S. citizen?
YesNo

2. Your spouse’s first name

M.I.

Last name

Telephone number

Is your spouse a U.S. citizen?
YesNo

3. Mailing address

Apt #

City

State

Zip Code

4. Your Date of Birth

5. Your job title

6. Last year, were you:

A. Full-time student

YesNo

B. Totally and permanently disabled

YesNo

C. Legally blind

YesNo

7. Your spouse’s Date of Birth

8. Your spouse’s job title

9. Last year, was your spouse:

A. Full-time student

YesNo

B. Totally and permanently disabled

YesNo

C. Legally blind

YesNo

10. Can anyone claim you or your spouse as a dependent?
YesNoUnsure

11. Have you or your spouse:

A. Been a victim of identity theft?

YesNo

B. Adopted a child?

YesNo

Part II – Marital Status and Household Information

1. As of December 31, 2020, were you:
	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

2. List the names below of: 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 star.

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)

1. Your first name

M.I.

Last name

Telephone number

Are you a U.S. citizen?
YesNo

2. Your spouse’s first name

M.I.

Last name

Telephone number

Is your spouse a U.S. citizen?
YesNo

3. Mailing address

Apt #

City

State

Zip Code

4. Your Date of Birth

5. Your job title

6. Last year, were you:

A. Full-time student

YesNo

B. Totally and permanently disabled

YesNo

C. Legally blind

YesNo

7. Your spouse’s Date of Birth

8. Your spouse’s job title

9. Last year, was your spouse:

A. Full-time student

YesNo

B. Totally and permanently disabled

YesNo

C. Legally blind

YesNo

10. Can anyone claim you or your spouse as a dependent?
YesNoUnsure

11. Have you or your spouse:

A. Been a victim of identity theft?

YesNo

B. Adopted a child?

YesNo

Part II – Marital Status and Household Information

1. As of December 31, 2021, were you:
	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

2. List the names below of: 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.

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 heart.

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)

1. Your first name

M.I.

Last name

Telephone number

Are you a U.S. citizen?
YesNo

2. Your spouse’s first name

M.I.

Last name

Telephone number

Is your spouse a U.S. citizen?
YesNo

3. Mailing address

Apt #

City

State

Zip Code

4. Your Date of Birth

5. Your job title

6. Last year, were you:

A. Full-time student

YesNo

B. Totally and permanently disabled

YesNo

C. Legally blind

YesNo

7. Your spouse’s Date of Birth

8. Your spouse’s job title

9. Last year, was your spouse:

A. Full-time student

YesNo

B. Totally and permanently disabled

YesNo

C. Legally blind

YesNo

10. Can anyone claim you or your spouse as a dependent?
YesNoUnsure

11. Have you or your spouse:

A. Been a victim of identity theft?

YesNo

B. Adopted a child?

YesNo

Part II – Marital Status and Household Information

1. As of December 31, 2022, were you:
	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

2. List the names below of: 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.

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.

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)

1. Your first name

M.I.

Last name

Telephone number

Are you a U.S. citizen?
YesNo

2. Your spouse’s first name

M.I.

Last name

Telephone number

Is your spouse a U.S. citizen?
YesNo

3. Mailing address

Apt #

City

State

Zip Code

4. Your Date of Birth

5. Your job title

6. Last year, were you:

A. Full-time student

YesNo

B. Totally and permanently disabled

YesNo

C. Legally blind

YesNo

7. Your spouse’s Date of Birth

8. Your spouse’s job title

9. Last year, was your spouse:

A. Full-time student

YesNo

B. Totally and permanently disabled

YesNo

C. Legally blind

YesNo

10. Can anyone claim you or your spouse as a dependent?
YesNoUnsure

11. Have you or your spouse:

A. Been a victim of identity theft?

YesNo

B. Adopted a child?

YesNo

Part II – Marital Status and Household Information

1. As of December 31, 2023, were you:
	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

2. List the names below of: 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.

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 star.

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)

1. Your first name

M.I.

Last name

Telephone number

Are you a U.S. citizen?
YesNo

2. Your spouse’s first name

M.I.

Last name

Telephone number

Is your spouse a U.S. citizen?
YesNo

3. Mailing address

Apt #

City

State

Zip Code

4. Your Date of Birth

5. Your job title

6. Last year, were you:

A. Full-time student

YesNo

B. Totally and permanently disabled

YesNo

C. Legally blind

YesNo

7. Your spouse’s Date of Birth

8. Your spouse’s job title

9. Last year, was your spouse:

A. Full-time student

YesNo

B. Totally and permanently disabled

YesNo

C. Legally blind

YesNo

10. Can anyone claim you or your spouse as a dependent?
YesNoUnsure

11. Have you or your spouse:

A. Been a victim of identity theft?

YesNo

B. Adopted a child?

YesNo

Part II – Marital Status and Household Information

1. As of December 31, 2024, were you:
	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 2024? YesNo B. Did you live with your spouse during any part of the last six months of 2024? YesNo
	Divorced	Date of final decree
	Legally Separated	Date of separate maintenance agreement
	Widowed	Year of spouse’s death

2. List the names below of: 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 2024 (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.

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 key.

You will need:

Instructions:

IRS Circular 230 Disclosure

You will need:

Instructions:

IRS Circular 230 Disclosure

You will need:

Instructions:

IRS Circular 230 Disclosure

You will need:

IRS Circular 230 Disclosure

You will need:

IRS Circular 230 Disclosure