Complete the Client Intake Form Below!

Complete the Form Below to File Your Taxes Today!

First Name

Middle Name

Last Name

Phone *

Email *

Address

Street Address

City

State

Country

Postal code

County

Date of Birth

Social Security Number

Occupation

Spouse First Name

Spouse Middle Name

Spouse Last Name

Spouse Email

Spouse Phone

Spouse Date of Birth

Spouse Social Security Number

Spouse Occupation

Dependent 1 Name, Dependent 1 Social Security #, Dependent 1 Date of Birth, Dependent 1 Relationship:

Dependent 2 Name, Dependent 2 Social Security #, Dependent 2 Date of Birth, Dependent 2 Relationship:

Dependent 3 Name, Dependent 3 Social Security #, Dependent 3 Date of Birth, Dependent 3 Relationship:

Dependent 4 Name, Dependent 4 Social Security #, Dependent 4 Date of Birth, Dependent 4 Relationship:

If any of your dependents are disabled list them here:

Are you disabled?

Select your filing status:

Were you audited by the IRS last year?

Did you receive marketplace health insurance??

Do you have an IP PIN?

Do you have any credits that were disallowed or reduced?

If you have any credits that were disallowed or reduced, please enter here.

2024 Identity Protection Pin & who it was issued to.

Please upload proof of residency for each dependency.

If you are filing head of Houshold, what documents will you provide for proof of head of household?

Please upload proof of head of household, if applicable.

Please upload your drivers license/ID for you & your spouse (if applicable)*

Social Security Cards for Each Individual on Return*

Please answer only if it applies to you.

If your address is different than the one thats on your government ID or drivers license, please indicate the reason why

If applicable, please indicate why you are claiming a dependent that is not related to you. What are the circumstances that you have supported this dependent for at least 6 months of 2024. Please outline the support you have provided to this dependent.

Are all of the dependents being claimed related to the taxpayer by birth or bloodline? If not, please identify which child is not related to you?

Please answer if applicable, if your last name is different than your dependent's last names, that you are filing, what is the reason why? Please indicate the reason why there is a difference in the last names between you and your dependents.

Please answer, only if applicable: If your income is at or below $13,000.00 & you have 2 or more children, how are you able to maintain the household. For example, did you receive government assistance, as such as: section 8, public housing, SNAP benefits, or other.

If you are the father of the child and claiming the child. Please indicate the reason why the child is living with you and not the mother. Please outline the support you have provided to the child.

Federal Financial Documents

Financial Tax Documents (W2,1099's,1099G for Unemployment,ect))

If you received a 1098T form for school, please upload here.

Do you need assistance with organizing your/side hustle, side business, entrepreneurial income & expenses?

Did you have a business in 2024? Includes 1099s, Entrepreneurial Ventures or side business. Ex. event planning, hair braiding, hair stylist, baby sitting, uber, lyft, door dashing, & etc. If so, what is the name & nature of your business or entrepreneurial venture or side business. If you don't have a name, you can bypass the name.

Do you have a vehicle that you use for your business?

If yes, please list the year make and model of the vehicle.

Other Documents

Do you want to apply for cash advance up to $7k. No credit check. You will be notified if you are approved within 24 hours.

How do you want to receive your refund?

If you selected direct deposit, please enter your information below

Bank Name

Account Number

Confirm Account Number

Routing Number

Confirm Routing Number

Integrity First Tax and Financial Services LLC

will prepare your 2024 individual tax return from the information you furnished to us. You, the taxpayer, are ultimately responsible for the preparation and filing of your tax return. I, the Taxpayer named above, have provided to Integrity First Tax and Financial Services LLC the attached tax information and to the best of my knowledge this information is true, correct, and complete.

Tax Form Abandonment/Ach Agreement

Here at Integrity First Tax and Financial Services LLC Unfulfilled Tax Quotes will result in a $150 Service Fee - If the client decides to file their tax return elsewhere. This fee will be processed through our payment merchant until fulfilled. If the client files their taxes with us, they will be charged the regular tax filing fees processed from the tax return per usual. No upfront fees - all fees will be cured from the tax return unless otherwise agreed due to intricate tax situations. Thank you - Integrity First Tax and Financial Services.

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Text HELP to (XXX) XXX-XXXX for assistance. You can reply STOP to unsubscribe at any time.

Tax Payer Signature ( Must be legible)

Clear

Spouse Signature

Clear

Notes (anything you think we need to know :)