TAX PREP CLIENT INTAKE FORM

TAXPAYER INFORMATION:

Head of Household filers must present one of the following to file this status. Pick one of the 3 options that will submit to be approved to file Head of Household

Lease

Utility Bill

Mortgage Statement

Full Name *

Date of Birth

Phone *

Email *

Street Address

City

State

Country

Postal code

Social Security # *

Occupation *

Are you a full-time student?

Yes

Are you totally and permanently disabled?

Yes

Are you legally blind?

Yes

Did you collect Social Security or retirement income?

Yes

Please your upload your DL/ ID?

SPOUSE INFORMATION

Spouse Full Name

Spouse Date Of Birth

Phone Number

Email Address

Address

Street Address
City
State/Province
Postal/Zip Code

Did your spouse collect social security or retirement income?

Yes

Employment Status

Spouse Occupation

Please Upload your Spouse Driver's License

Are they a full-time student?

Yes

Are they totally and permanently disabled?

Yes

Are they legally blind?

Yes

Are they your dependent?

Yes

Dependents Information

Dependents First Name

Dependents Last Name

Dependents Date of Birth

Dependent Social Security Number

Dependent 2 First Name

Dependent 2 Last Name

Dependent 2 Date of Birth

Dependent 2 Social Security #

If claiming son/daughter who is the other parent of the dependent/dependents? Is the other parent providing any financial support?

If claiming niece/nephew, aunt, uncle, how are you related to the dependent? Where are the parents to the dependent/dependents?

If low income status, How are you able to provide for the dependent/dependents?

Are you contributing to 401k or other pre-tax account?

Yes

Do you own a business?

Yes

Are you currently renting?

Yes

Please Upload W-2's

Utility Bill/ Lease Agreement/ Mortgage Statement

Please Upload all Social Security Cards

Please Upload business documents.

Last Year's Tax Return

Please Upload Business Expenses, P&L Statements

Bank Information *

Bank Name
Routing Number
Account Number
Account Type

Did you receive advance CTC or Stimulus? *

Yes

Are you or your spouse subject to a tax refund offset through the Treasury Offset Program (e.g., student loans, child support, back taxes)?” *

Yes

Please select your Tax Preparer *

Foreign Bank Accounts *

Yes

Do you have an IP Pin? *

Yes

ACKNOWLEDGMENT & SIGNATURE

At Elevation Financial Services, we are committed to preparing tax returns with accuracy, integrity, and full compliance with Internal Revenue Service (IRS) regulations. This agreement outlines the responsibilities of both the client and the tax preparer.

By signing this agreement, you acknowledge and agree to the following terms:

1. Client Responsibility for Information Provided

You certify that all information, documents, and statements you provide to Elevation Financial Services are:

True, accurate, and complete to the best of your knowledge
Provided without omission, misrepresentation, or fabrication
Supported by documentation when requested

This includes, but is not limited to: income, expenses, dependents, residency, marital status, filing status, and eligibility for any tax credits or deductions.

2. Documentation & Verification

You understand that Elevation Financial Services may require documentation to verify information reported on your tax return, including:

Government-issued photo identification
Social Security cards or ITIN documentation
Income documents (W-2s, 1099s, bank statements, profit & loss statements)
Expense records and receipts
Proof of residency, support, or relationship for dependents

Failure to provide requested documentation may result in delays or refusal to prepare or file the return.

3. Accuracy Over Refund Amount

You acknowledge that:

Refund amounts are determined by IRS rules, not estimates or expectations
Elevation Financial Services does not manipulate income, expenses, or credits to increase refunds
No guarantee is made regarding refund amount or timing

Tax preparation decisions are based on accuracy and eligibility, not desired outcomes.

4. IRS Due Diligence & Compliance

Elevation Financial Services is legally required to comply with IRS due-diligence regulations and may ask detailed or follow-up questions to determine eligibility for certain filing statuses, deductions, or credits.

You understand that:

Refusal to answer required questions may prevent preparation of your return
The preparer may decline services if information appears inconsistent, unverifiable, or non-compliant
Required IRS forms (including Form 8867, when applicable) will be completed as part of the preparation process

5. Review & Client Certification

You agree to:

Review your completed tax return thoroughly before signing
Confirm all personal, financial, and dependent information is correct
Understand that signing the return certifies its accuracy under penalty of perjury

Elevation Financial Services is not responsible for errors resulting from incorrect or incomplete information provided by the client.

6. Audits, Notices & IRS Correspondence

You acknowledge that:

The IRS may review, delay, adjust, or audit any tax return
Elevation Financial Services does not control IRS processing times, refund approvals, or determinations
You are solely responsible for any additional taxes, penalties, or interest assessed due to inaccurate or unsupported information

Audit assistance or representation services, if offered, require a separate agreement and fee.

7. Third-Party Products & Refund Advances

You understand that:

Refund advances, audit protection, or other financial products are offered by third-party providers
Approval or denial of such products is determined solely by the issuing institution
Elevation Financial Services does not influence these decisions.

8. Right to Decline or Terminate Services

Elevation Financial Services reserves the right to:

Decline preparation or filing of a tax return
Pause or terminate services
Withdraw from representation

if IRS compliance standards cannot be met or required documentation is not provided.

9. Limitation of Responsibility

Elevation Financial Services prepares tax returns based solely on information provided by the client. We are not responsible for:

Information withheld or misrepresented
Future IRS changes to tax law interpretation
Outcomes resulting from client-provided inaccuracies

10. Client Acknowledgment & Agreement

By signing below, you confirm that:

You have read and understand this agreement
You agree to provide truthful, complete, and accurate information
You accept responsibility for the contents of your tax return.

Date Signed *

Taxpayer Signature *

Clear

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.