Tax Client Intake Form

Tax Client Intake Form

Client Identification

Client Name:

Taxpayer Identification

Social Security Number (SSN):

Employer Identification Number (EIN):

Contact Information

Engagement & Tax Year

Tax year for which services are requested:

Prior year tax preparer (if any):

Documents & Income Types

Please indicate which documents or income types you will provide:

Banking for Refunds / Payments (Optional)

Engagement Terms & Fee Authorization

By signing below, Client engages the preparer to prepare the federal and/or state tax returns identified above for the tax year specified. The preparer will prepare returns based on information provided by Client and will not audit or otherwise verify the data submitted. Client acknowledges responsibility for the accuracy and completeness of all information provided.

Client authorizes the preparer to contact third parties as necessary to obtain or verify information required to complete the engagement (including financial institutions and prior preparers). Client agrees to pay preparer fees in accordance with the preparer's standard billing practices and acknowledges that outstanding fees may be subject to collection.

Certification & Authorization (Please read carefully)

I, the undersigned Client, certify the following under penalty of perjury:

1. The information provided in this form and any attachments is true, correct, and complete to the best of my knowledge and belief. I will provide any additional documents or clarifications requested by the preparer to support entries on my tax returns.

2. I authorize the preparer to prepare and file my federal and state tax returns based on the information supplied, and to sign and submit such returns electronically where permitted, using my name as it appears on this form if I have provided explicit prior written authorization for electronic signature.

3. I authorize the preparer to disclose tax return information to third parties only as necessary to complete the engagement, collect fees, or as required by law. I further authorize the preparer to obtain tax information, transcripts, and records from financial institutions, employers, and prior preparers when necessary to complete this engagement.

4. I understand that I am ultimately responsible for the accuracy of the tax returns and for retaining supporting documents. I acknowledge that the preparer may rely on the information provided and that additional tax, penalties, or interest could be assessed by taxing authorities if information provided is incomplete or inaccurate.

5. I consent to the preparer retaining copies of my tax returns and supporting documents as required by the preparer's retention policies and relevant professional standards.

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