Client Intake Information

 

Name:    Tax Year:

Address:              Phone:  

                      Evening Phone:

       email:     SocSec#:

 

Filing Status (check one)  

This Area for Tax Preparer Use Only

Check Off Questionnaire on Left:

1-Return Prepared.................

2-Collect From Client............

3-Post Paid on Bill Screen.....

4-Print EIC1 & EIC3............

5-Print 8867, 8879 & Bill......

6-Client Signs ALL Forms.....

7-Archive.............................

8-email Archive............... -or-

9-Printout Return $5 fee........

10-Post to Daily....................

11-CSM Screen/Complete....

     Remember ...

     EIC Due Diligence EIC only

     EIC1 screen shot from their return

         they fill out and sign.

     EIC3 screen shot from their return

         they fill out and sign.

     Bank Products

Preparer # _______

 

     Married............................................
     Single...............................................
     Head Of Household..........................
Are You a Returning Client?...........
# of Children you Claim..................
Custodial Parent for ALL Claimed?
Can you Claim anyone else?...........
How Many W-2s?..........................
How Many 1099s?.........................
Stimulus Received in 2009?..
Answer with Yes or No please ...
Are You a Student?..........................
Did You Pay School Tuition?...........
Did You Receive Unemployment?....
Any Bank Interest Income?..............
Any Stock Dividend Income?...........
Any Social Security Income?............
Any Day Care Costs?......................
Do You Have a Retirement Plan?.....
Withdraw from a Retirement Plan?...
Are You Claimed by Someone Else?
Are You a First Time Home Buyer?.
Any Other Income?..........................
If yes, what kind of income (hobby, business, prizes)?

 

 

The undersigned guarantees that all information provided to Gregory's Tax and Bookkeeping Service for the purpose of preparing income tax returns is true and accurate.  This also constitutes a contract with Gregory's Tax and Bookkeeping Service for the purpose of preparing income tax returns and the undersigned agrees to be responsible for all charges incurred in that process.

 

Signature ___________________________________________            Date_____________

 

Please Print this Page, Sign and Bring with you to your appointment!!

 

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