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Client Engagement Form
Please fill out all required fields marked with
*
Choose your tax preparer
*
Please Select
Full Name
*
Email Address
*
Phone Number
*
Residential Address
*
Date of Birth
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Spouse/Partner Full Name
Tax Filing Status
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Single
Married Filing Jointly
Married Filing Separately
Head of Household
Qualifying Widow(er)
Dependents' Full Names (if any)
Number of Dependents
Did you receive any of the following income?
*
Wages, Salaries, Tips
Self-Employment Income
Rental Income
Interest and Dividends
Capital Gains
Retirement Distributions
Social Security Benefits
Unemployment Compensation
Other (please specify)
Please specify any other income not listed above.
Did you make any large financial transactions?
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Gifts over $15,000
Large Cash Transactions over $10,000
Sale of Property or Business
Other (please specify)
Please specify details of large transactions.
Are you claiming any of the following deductions?
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Mortgage Interest
Charitable Contributions
Medical Expenses
State and Local Taxes
Retirement Contributions
Education Expenses
Business Expenses
Other (please specify)
Please specify other deductions you are claiming.
Do you have any foreign financial accounts or assets?
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Yes
No
Are you involved in any IRS audits or investigations?
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Yes
No
Have you previously filed taxes with us?
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Yes
No
IRS Regulations Acknowledgment
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I confirm that I have reviewed and understand the IRS regulations applicable to my tax situation.
Signature
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