TAX CLIENT INTAKE FORM

DEPENDENT INFORMATION *

New Client

Existing Client (Filed with us last year)

Returning Client (Filed with us prior to last year)

Tax Filing Year *

2024

2023

2022

Any Year Prior

If you are filing for any year prior to 2021, please enter the year here

First Name *

Last Name *

Date Of Birth *

Driver's License *

Social Security *

Social Security Card *

Phone *

Email *

Address

Street Address

City

State

Country

Postal Code

Proof of Billing *

Taxpayer's Occupation *

Is your current address your last filing address? *

Yes

No

If no, please complete the next question

Previous Address

Does this address differ from the address on your wage statements (W2/1099)? *

Yes

No

What address is listed on your wage statements (W2/1099)?

Are you a U.S. citizen? *

Yes

No

Can you be claimed as a dependent on someone else's tax return? *

Yes

No

Unsure

Have you ever been denied the Earned Tax Credit (EITC)? *

Yes

No

Do you plan on purchasing a home within the next (2) two years? *

Yes

No

Best time to reach you *

Morning

Afternoon

Evening

Supporting Documents

SPOUSAL INFORMATION

Do you have a spouse? *

Yes

No

Spouse Full Name

Spouse Date Of Birth

Copy of Spouse's Driver's License

Spouse's Social Security

Copy of Spouse's Social Security

Is your spouse's address different than yours?

Yes

No

If yes what is your Spouse's Address

Phone Number

Email Address

Upload Supporting Documents W2, SS Card, License etc

DEPENDENT INFORMATION

Do you have dependent(s) to report? *

Yes

No

How many dependents will you be claiming for this filing year?

Dependent 1

First Name
Middle Name
Date of Birth
Social Security Number
Relationship
How many months did dependent live with you in filling year? (If all year, enter 12)
Childcare Expenses Paid
Education Expenses
Tuition

Dependent 2

First Name
Middle Name
Date of Birth
Social Security Number
Relationship
How many months did dependent live with you in filling year? (If all year, enter 12)
Childcare Expenses Paid
Education Expenses
Tuition

Dependent 3

First Name
Middle Name
Date of Birth
Social Security Number
Relationship
How many months did dependent live with you in filling year? (If all year, enter 12)
Childcare Expenses Paid
Education Expenses
Tuition

Dependent 4

First Name
Middle Name
Date of Birth
Social Security Number
Relationship
How many months did dependent live with you in filling year? (If all year, enter 12)
Childcare Expenses Paid
Education Expenses
Tuition

Dependent 5

First Name
Middle Name
Date of Birth
Social Security Number
Relationship
How many months did dependent live with you in filling year? (If all year, enter 12)
Childcare Expenses Paid
Education Expenses
Tuition

Dependent Documents Birth Cert, SS Card, passport

If any of your dependents are in daycare please upload the form you received from your daycare provider.

Yes

No

Daycare Documents

INCOME

Total number of W2's?

Number of 1099's?

Spouse's number of W2's?

Did you trade any virtual currency? *

Yes

No

Do you have any self-employment or 1099 income to report? *

Yes

No

Unsure

Please list any other income you have

Rental Income
Investment Earnings
Unemployment
Other

Supporting Documentations:

Profit or Loss From Business

Self-Employment/1099 Income/LLC (Schedule C)

Business Name

Is your business address the same as your residential address?

Yes

No

Business Address

Check here if you started or acquired this business during the current tax filing year

Did you make any payments in the current filing year that would require you to file form(s) 1099

Yes

No

Unsure

Business/Self Employment Information

Started a new business or purchased any rental property during the past year

Purchased any business assets or converted any assets to business use?

Disposed of any business assets

Ceased operating any business or rental property

Gross receipts or sales

Returns & allowances

Please list any business expense amounts

Advertising
Car & truck expenses
Car & truck mileage
Commissions & fees
Contract labor
Depreciation & section - 179 expense deduction epletion
Employee benefit programs
Insurance
Interest
Mortgage (paid to banks, etc.)
Other
Legal and professional services
Office expense
Pension and profit-sharing plans
Rent or lease
Vehicles, machinery, & equipment
Other business property
Repairs & maintenance
Supplies
Taxes & licenses
Travel & meals
Travel
Deductible meals
Utilities
Wages
Other expenses

Quarterly Taxes Paid

Federal Amount Paid 1st Quarter
State Amount Paid 1st Quarter
State Amount Paid 2nd Quarter
Federal Amount Paid 2nd Quarter
Federal Amount Paid 3rd Quarter
State Amount Paid 3rd Quarter
Federal Amount Paid 4th Quarter
State Amount Paid 4th Quarter

Business Supporting Documents:

Business Supporting Documents

ITEMIZED DEDUCTIONS

Please indicate if any of the following items apply to you, your spouse or your dependents during the filing year

Were you or any of your dependents in college this filing year?

Yes

No

If you have any 1098-T forms for yourself or your dependents please upload it here

Do you have a vehicle?

Yes

No

If yes, what is the year, make, and model of your vehicle?

DEBTS

Have any of your refunds ever been offset? (by student loans or a state entity)

Yes

No

Unsure

Do you currently have any debt or owe the IRS?

Yes

No

Unsure

Approximate amount owed

Have you made any tax payment toward your tax liability or debt?

Yes

No

Unsure

Tax Liability/Debt Amount Paid

REFUND OPTIONS

Would you like to receive a text message when bank funding occurs? *

Yes

No

How would you like to receive your refund? *

Direct Deposit

Check

E1 Card

Returning clients, please note: Your banking details will not roll over from the previous filing year. The IRS requires that these details are submitted annually.

Direct Deposit Bank Name

Direct Deposit Routing Number

Direct Deposit Account Number

Are you interested in receiving a Refund Advance? *

Yes

No

Please select one of the following advance options:

Up to $1,000 (NO finance charge)

Up to $7,000 (WITH bank finance charge)

Are you interested in receiving Audit Protection? *

Yes

No

Select a security question: *

What is your Mother's Maiden Name?

What high school did you attend?

Option What is the name of your oldest child?3

Answer *

Were you or your dependent previously issued an Identity Protection PIN (IP PIN) by the IRS? *

Yes

No

Enter IRS ID Pin

Taxpayer
Spouse
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5

Please select any of the following goals you would like to accomplish in the coming year

Restore my personal credit

Start a business

Business

Other

Other intended accomplishments

By checking this box, I acknowledge and agree to the following:

I consent to allow Bawse Enterprises to disclose my tax return information to Refund Advantage for evaluating and processing their electronic disbursement service or loan.
I understand this consent is not required for Bawse Enterprises’ tax preparation services.
I understand that without this consent, I cannot apply for Refund Advantage products.
If no duration is specified, this consent is valid for one year from the date of submission.
By checking this box, I agree to Privacy Policy and Terms & Conditions provided. By providing my phone number, I agree to receive text messages from Bawse Enterprises. You can SMS opt out at any time by responding "Stop."

By checking this box, I acknowledge and agree to the following:

Bawse Enterprises provides this form and its materials for personal, temporary use only. I may not copy, modify, distribute, or reverse-engineer any content.
All materials are provided “as is,” with no warranties. Bawse Enterprises is not liable for any damages resulting from use of this form or its materials.
Bawse Enterprises may update or change the form, terms, or materials at any time without notice.
Any disputes will be governed by Georgia law.
My tax preparation fees are deferred until my IRS refund is released. If my refund is delayed, reduced, intercepted, or not received, I am still responsible for all fees and must pay by October 15 unless a payment arrangement is made.
I am responsible for any legal, filing, or attorney fees if collection action is required.
Bawse Enterprises may collect, use, and protect my personal information as described in its Privacy Policy, and will only retain data as needed or as required by law.
By submitting this form, I consent to Bawse Enterprises verifying any federal or state non-tax debts on my behalf.
I want to receive news, feature updates, discounts, and offers from Bawse Enterprises.

Taxpayer's Signature *

Clear

SPOUSAL INFORMATION

DEPENDENT INFORMATION

INCOME

Profit or Loss From Business

REFUND OPTIONS

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