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235 W. Roosevelt Ave, Suite 410-A Albany, Ga 31701
lakeshia@certifiedtaxsolutionz.com
(229) 338-3464
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Client intake form
Contact Us
Home
About
Services
What You Need
Client intake form
Contact Us
Call for consultation
Client Intake Form
Documents Needed for Deductions & Credits
Childcare: Provider EIN/SSN, receipts, year-end statements.
Education Credits: 1098-T, book receipts, transcripts.
Health Insurance: 1095-A, 1095-B, 1095-C.
Homeowner: 1098 mortgage interest, property tax statements.
Student Loan Interest: 1098-E.
Charitable Donations: Donation receipts.
Self-Employed: Receipts, mileage logs, expense list.
Retirement: 5498 forms, 1099-R.
IRS Letters: CP01A (IP PIN), CP12, CP75, etc.
Identity Protection PIN (IP PIN)
Have you been issued an IRS Identity Protection PIN (IP PIN)?
(Required)
Yes
No
If YES, enter your 6-digit IRS IP PIN
(Required)
Upload your CP01A IRS Letter (optional)
Max. file size: 5 MB.
Personal Information
Full Name
(Required)
Date of Birth
(Required)
MM slash DD slash YYYY
Social Security Number / ITIN
(Required)
Phone Number
(Required)
Email Address
(Required)
Address
Address
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
Tax Information
Filing Status
(Required)
Single
Married Filing Jointly
Married Filing Separately
Head of Household
Qualifying Widow(er)
Do you have dependents?
(Required)
Yes
No
Dependents (Name, DOB, SSN, Relationship)
(Required)
Income Documents
File
(Required)
Max. file size: 2 GB.
Deductions & Credits
File
(Required)
Max. file size: 2 GB.
Identity Verification
File
(Required)
Max. file size: 2 GB.
File
(Required)
Max. file size: 2 GB.
Previous Tax Year
File
(Required)
Max. file size: 2 GB.
Acknowledgement & Signature
Untitled
(Required)
I confirm the information provided is true.
I authorize preparation of my tax return.
Signature (Type Full Name)
(Required)
Date
(Required)
MM slash DD slash YYYY
