2023
Client  Tax  Intake 

I am pleased that you are entrusting me to provide you with the professional services listed in my scope work (Tax Preparation). By using the fill-able upload form you are in agreement that I can begin the process of creating your Client Portal (U.S.G/MyTaxOffice). You also acknowledge that you will have access to the Portal to for the duration of my fiduciary obligations to your for tax year 2022.

Let Me Get To Know You

If you are starting the process by using this secure webform, please enter in as much detailed information as possible for me to begin filing your Income Tax Return.

Taxpayer #1 First Name: *  Taxpayer #1 Last Name:
    TaxPayer #1 Phone:     Which type :


    Birth Date:
    Street Address:     City:
    State:     Postal/Zip Code:
*  TaxPayer #1 Social Security Number:     If referred, by whom:
*  Your Email Address: *  Current Occupation:
*  Which banking account do you have:





    Bank Routing Number:     Bank Account Number:
*  Dec 31st Status:
    Taxpayer #2 First Name:     Taxpayer #2 Last Name:
    TaxPayer #2 Phone:     Taxpayer #2 Birth Date:
    TaxPayer #2 Social Security Number:     Taxpayer #2 Email Address:
*  Which Income type did you have in 2022:










    Current Health Insurance Provider:
    Higher Education Enrollement:




    Special Circumstances:










    Prior Year Street Address:     Prior Year City:
    Prior Year State:
    Dependent #1 Full Name:     Dependent #1 D.O.B:
    Dependent #2 Full Name:     Dependent #2 D.O.B:
    Dependent #3 Full Name:     Dependent #3 D.O.B :
*  Were you pregnant in 2022:
*  Are you Self-Employed:     Do you have an EIN:

Form Marketing by ZeSend Co.
Set Your Next Appointment

Guarantee that you have MY undivided attention to discuss your personal or business matters.