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Self Employed Returns

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Start your journey to financial success today. Fill out the intake form and make sure to complete all required sections marked with an asterisk (*).

TAX PREP CLIENT INTAKE FORM

Previous Tax Preparation Information

Who was your previous Tax Preparer? *

How much was your refund last year? (guesstimate) *

Did you receive an Advance Refund last year? *

Facebook Page Link (If you do not have one please put “Need to create”) *

Would you like to apply for an Advance Refund this year? *

How much did your previous preparer charge you to prepare your return? *

Taxpayer Information:

Full Name *

Date of birth *

What is your SSN? *

Occupation *

Email *

Phone *

Address *

City *

State *

Postal code *

What County do you live in? *

What school distict do you live in? *

Are you a full-time student?

Yes

No

Are you totally and permanently disabled?

Yes

No

Are you legally blind?

Yes

No

Self Employment Info (IF APPLICABLE)

Business Name

What is your business EIN?

Business Income

Full Business Address

Country

Spousal Information (Optional)

Spouse Full Name

Spouse Date Of Birth

What is your spouse's SSN?

Spouse Occupation

Email Address

Phone Number

Address

Street Address
City
State/Province
Postal/Zip Code

Are they a full-time student?

Yes

No

Are they totally and permanently disabled?

Yes

No

Are they legally blind?

Yes

No

Are they your dependent?

Yes

No

Spouse Self-Employment Info (Optional)

What is your spouse's business name?

What is your spouse's business EIN?

What is your spouse's business income?

What is your spouse's business address?

Dependent Info (IF APPLICABLE)

Dependent 1

What is Dependent 1's birthdate?

What is Dependent 1's SSN?

Relationship of Dependent 1

Dependent 2

What is Dependent 2's birthdate?

What is Dependent 2's SSN?

Relationship of Dependent 2

Dependent 3

What is Dependent 3's birthdate?

What is Dependent 3's SSN?

Relationship of Dependent 3

Dependent 4

What is Dependent 4's birthdate?

What is Dependent 4's SSN?

Relationship of Dependent 4

Tax Related Questions:

Employment Status

Did you pay someone to watch your child/children

YES

NO

Are you contributing to 401k or other pre-tax account?

Yes

No

Is this your first time opening a pre-tax account?

Yes

No

Did you collect social security or retirement income?

YES

NO

Did you purchase health insurance through healthcare.gov marketplace (Obama Care)?

YES

NO

If yes, did you receive a 1095-A Form from the marketplace?

YES

NO

Were you ever disallowed the E.I.T.C prior to this year?

YES

NO

Did you receive unemployment compensation (1099-G) regular or PUA last year?

YES

NO

If yes, did you receive regular unemployment or PUA?

REGULAR

PUA

Do you have any other income than your w-2(s)?

YES

NO

Do you owe any delinquent:

ACKNOWLEDGMENT & SIGNATURE

I confirmed that all information I entered here is accurate and true.
I allow Taxilly Ever After to capture my sensitive data like personal id, government id, social security number (SSN), and other information.
I have read the terms and conditions and privacy policy of Taxilly Ever After.
By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.

Date Signed

Taxpayer Signature

Clear

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