Client Intake Form – Individual Tax Return

Personal Information

Your Legal Name *

First

Last

Filing Status *

Date of Birth *

Social Security Number / Taxpayer ID *

Email *

Phone Number *

ID, to Information:

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Cannot be a PO Box

Dependents

Dependent Info

Please click the "+" button below to add more dependents.

Name *

First

Last

Relationship to you *

Months Lived with You

Full Time Student?

Yes
No

Tax ID Number / SSN *

Additional Dependents

Drag & Drop Files, Choose Files to Upload

If you have more than 4 dependents, please upload a speadsheet / document with the relevant info.

Document Upload

PLEASE INCLUDE A COPY of your drivers license or government issued ID. That is required for me to transmit your tax return.

Upload ID, Last Year's Tax Return, Income documents, and expense documents (Required) *

Drag & Drop Files, Choose Files to Upload You can upload up to 20 files.

Any carryover amounts?

Yes
No

Examples: Capital Losses, Charitable Contributions, etc.

Have you been audited in the past? *

Yes
No

Direct Deposit Information (Optional)

This is required to recieve any refunds per Executive Order 14247. If you do not provide this information, you will receive a notice from the IRC (Form CP53E) demanding bank information or an explanation why you require a physical check, BEFORE a refund is issued.

For refund or payment purposes:

Bank Name

Routing Number

Account Number

Checking
Savings

Additional Information

Any significant life events this year? (e.g., marriage, divorce, home purchase, job change, lived in 2 different states / local tax jurisdictions?)

Any other relevant information or questions?

Additional Information:

Consent and Signature

I certify that the information provided on this form is accurate and complete to the best of my knowledge. I authorize Matthew Tae & Fellow Travelers to use this information to prepare my personal tax return.

Signature *

Clear Signature