INTAKE FORM

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What are you seeking-assistance with? *

Full Name *

Email *

Phone *

Address *

Street Address

City

State

Country

Postal Code

Primary Occupation

Are you claiming tax dependents this year?

YES

NO

Total dependents to be claimed on your tax return:

Please upload children's ssn and birth certificate

I acknowledge that only dependents meeting IRS eligibility requirements may be claimed on my tax return

YES

Owner Name *

Company Name *

Employer Identification Number

Business Start Year

Year Business Started

Company Type

Employee & Contractor Classification

Upload Business Tax Documents

Upload Business Documents (EIN letter, prior-year returns, formation docs, Bank's routing and account number or voided check, etc.)

HORIZON BUSINESS SOLUTION

Please review the pricing information below before proceeding. Final pricing is determined after document review.

PERSONAL TAX PREPARATION:

Base fee: $250 (includes up to 5 tax forms)
- $20 per additional form (investment income (1099-DIV, 1099-INT, 1099-B), cryptocurrency transactions, 1099-K income, retirement distributions (1099-R), unemployment income (1099-G), Marketplace insurance (1095-A), education credits (1098-T), mortgage interest (1098), HSA reporting, and childcare expenses)

BUSINESS TAX PREPARATION:

Base fee: $550 (includes up to 5 tax forms)
- $20 per additional form (Fees apply when business records are incomplete, unorganized, or require transaction categorization or cleanup prior to tax filing)

BOOKKEEPING & CATEGORIZATION:

Base fee $125 (monthly per reconciliation account)
- $20 per additional account (quarterly business review included)

ENTITY & BUSINESS STATUS SERVICES:

Additional fees apply for services such as:

• S-Corporation setup or election

• Entity conversions

• IRS or state entity compliance work

These services are quoted separately after review.

IMPORTANT TERMS:

• Fees are non-refundable once work has begun

• No refund amount or tax outcome is guaranteed

• Pricing may change based on complexity and documentation provided

• Late fee may be applied if required documents are not received by the requested deadline

• Final invoices are issued after document review

I have reviewed and understand the pricing structure with the outlined above. *

YES

CLIENT CONSENT & AUTHORIZATION

By signing below, I authorize Horizon Business Solution, through its owner and authorized representative, Valanna Lanauze, to prepare and/or assist with the preparation of federal, state, and local tax returns and/or provide bookkeeping and related financial services based on the information and documents I provide.

I acknowledge and agree that:

I am solely responsible for the accuracy, completeness, and truthfulness of all information and documentation submitted.
Horizon Business Solution relies entirely on information provided by me when preparing returns or performing services.
No refund amount, tax outcome, or IRS/state processing timeline is guaranteed.
Fees are non-refundable once work has begun

I consent to:

Electronic communication via email and text message.
Secure electronic storage and transmission of my documents and information.
The use of third-party software and service providers as necessary to perform services.

I understand that sensitive personal information, including Social Security numbers and identification documents, must be submitted through secure document upload and not entered directly into form fields.

Terms. *

By signing below, I have read, understand, and agree to the terms above.

Signature *

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