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2023 Tax Intake Form (1)
Client Tax Data Sheet
Step
1
of
8
12%
Personal Information
How did you hear about us or who referred you to us?
Your name
First
Last
Social security number
(Required)
Occupation
(Required)
Date of birth
(Required)
MM slash DD slash YYYY
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Email
(Required)
Enter Email
Confirm Email
Phone number
(Required)
Driver’s license #
State driver’s license was issued
Date driver’s license was issued
MM slash DD slash YYYY
Driver’s license expiration date
MM slash DD slash YYYY
Image of social security
(Required)
Max. file size: 256 MB.
Image of driver’s license
Max. file size: 256 MB.
What is your filing status?
(Required)
Single
Head of Household (Single with dependents)
Married filing joint
Married filing separate
Spouse name
First
Last
Social security number
(Required)
Ocupation
Date of birth
(Required)
MM slash DD slash YYYY
Phone number
(Required)
Email
(Required)
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Driver’s license #
State driver’s license was issued
Date driver’s license was issued
MM slash DD slash YYYY
Driver’s license expiration date
MM slash DD slash YYYY
Image of driver’s license
Max. file size: 256 MB.
Payment/Refund
(Checks can be picked up in office or sent via email)
Select below the method you prefer to receive your refund
(Required)
Direct deposit
Check
Bank name (Skip if you prefer your refund via check)
Bank account number
Bank routing number
Account type
Checking
Savings
Is this your first year filing your taxes with CnetIncomeTax?
(Required)
Yes
No
Did your marital status change during this year?
(Required)
Yes
No
Did you have Marketplace Health Insurance (Obamacare-ACA) this year? (Should receive Form 1095-A)
Yes
No
Did you attend a college or university last year?
Yes
No
Do you currently have an offsets with the IRS (delinquent student loans, delinquent child support, tax liens etc)?
Yes
No
Do you have any children or dependents to file?
(Required)
Yes
No
Dependents
Should only be listed if you take care of the dependent over half of the year.
Image of the dependent’s social security card
Max. file size: 256 MB.
Name of the dependent
First
Last
Date of birth
MM slash DD slash YYYY
Social security number
Do you want to enter another dependent?
Yes
No, all dependents are entered
Image of dependent’s social security card
Max. file size: 256 MB.
Name of the Dependent
First
Last
Date of birth
MM slash DD slash YYYY
Social security number
Do you want to enter another dependent?
Yes
No, all dependents are entered
Image of dependent’s social security card
Max. file size: 256 MB.
Name of the dependent
First
Last
Date of birth
MM slash DD slash YYYY
Social security number
Did you pay any child care expenses throughout the year?
Yes
No
Child and Dependent Daycare Expenses
If the provider is a person, enter the care provider’s SSN
Child’s name
Amount paid
Provider’s Phone #
Provider’s name
First
Last
Tax ID #/SSN
Provider’s Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Do you want to enter another child care provider
Yes
No
Child’s name
Amount Paid
Provider’s name
Provider’s name
First
Last
Tax ID #/SSN
Provider’s Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Upload photos of your W-2,1099,and ALL documents
Attach an image of all documents that can be used to assist your tax preparer with the preparation of your tax return.
Upload here
Max. file size: 256 MB.
Upload here
Max. file size: 256 MB.
Enter any additional information or comments that you would like to include for your tax preparer
If you did not file your tax return with us last year, we recommend that you upload a copy of your previous year's tax return
Max. file size: 256 MB.
Do you owe from previous years?
Yes
No
I have not filed previous years
Do you have a business that you would like to be included on your return?
(Required)
Yes
No
Business Owner’s Data Sheet
Business name
Employer ID number
What is the legal structure of your business?
Sole Proprietor
Partnership
Corporation
LLC
Non-profit
Haven’t filed it
Business ADdress
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Amount of business taxes paid throughout the year? ($)
Business Income
All income received during the fiscal year
Total Income ($)
Business Expenses
Complete to the best of your ability. In each field enter the approximate amount you spent in each category.
Advertising
Contract Labor
Insurance
Interest
Legal & Professional Services
Office Expenses
Rent and Lease
Repair and maintenance
Supplies
Taxes and Licenses
Travel, Meals, and Entertainment
Utilities
Other Expenses
Is there any other information, questions, or concerns that you want to include to your tax preparer pertaining to your business?
Attach any photos or documents that you want us to have on file.
Max. file size: 256 MB.
Terms & Conditions
(Required)
By filling out this form, you are giving us permission to prepare your tax return and you are confirming that ALL information entered is accurate. If you have any questions do not hesitate to email us: info@cnetincometax.com
I agree to the Terms & Conditions.
Signature
(Required)
Type your name