New Client Intake Form

M.F.G Intake Form

How did you hear about us?

Tax Preparer Name

If someone referred you, please type his or her name here.

What is the best day & time to contact you?

Did you file a 2025 tax return?

Are you trying to buy a new home within the next 2 years?

Are you interested in Credit Repair?

Would you like to apply for the Advance Loan, up to $7,000?

example@example.com

First name

Last name

Phone

Example: xxx-xxx-xxxx

Job Title

Date of Birth

Month

Day

Year

SSN

Example: xxx-xx-xxxx

Spouse's Full Name

Spouse's SSN

Example: xxx-xx-xxxx

Spouse's Date of Birth

Example: 01/01/2001

Spouse's Phone Number

Example: xxx-xxx-xxxx

Spouse's Email Address

example@example.com

Spouse's Job Title

Home Address

Are you self employed?

Did you and your spouse live apart during the year?

What is your marital status as of December?

Did you pay over half the expenses of maintaining your residence for the entire year?

Did you support a child or family member for more than 6 months out of the year?

If yes, did you live together at any time after June 30, 2025?

Are you on any Government Assistance?

How many dependents are you claiming?

Dependent #1 Full Name

Dependent #1 Date of Birth

Dependent #1 SSN

What is Dependent #1's Relationship to you (son, daughter, etc.)?

How many months did Dependent #1 live with you in 2025? (If all year, enter 12)

Dependent #2 Full Name

Dependent #2 Date of Birth

Dependent #2 SSN

What is Dependent #2's Relationship to you (son, daughter, etc.)?

How many months did Dependent #2 live with you in 2025? (If all year, enter 12)

Dependent #3 Full Name

Dependent #3 Date of Birth

Dependent #3 SSN

What is Dependent #3's Relationship to you (son, daughter, etc.)?

How many months did Dependent #3 live with you in 2025? (If all year, enter 12)

Dependent #4 Full Name

Dependent #4 Date of Birth

Dependent #4 SSN

What is Dependent #4's Relationship to you (son, daughter, etc.)?

How many months did Dependent #4 live with you in 2025? (If all year, enter 12)

Dependent #5 Full Name

Dependent #5 Date of Birth

Dependent #5 SSN

What is Dependent #5's Relationship to you (son, daughter, etc.)?

How many months did Dependent #5 live with you in 2025? (If all year, enter 12)

Are there any dependents in daycare? If yes, please upload the form you received from your daycare provider.

Upload a copy of your daycare form here.

How would you like to receive your tax refund?

Name of Bank

Which type of account would you like your refund deposited into?

Checking Account

Saving Account

Other

Routing Number

Bank Account Number

Can someone else claim you as a dependent?

Did you have health insurance in 2025?

Did you have health insurance for the entire year?

Who was your insurance coverage through in 2025?

Was your insurance through your employer?

Did your dependents have health insurance for the entire year?

Was YOUR DEPENDENTS' insurance through your employer?

Who was your Dependents insured with in 2025?

Upload Taxpayer & Dependent(s)Insurance Documents

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

Please list the kind of vehicle you drove last year.

Were you or any of your dependents in college in 2025?

Did you trade any Virtual Currency?

Do you have a 1098-T Form for either you or your dependents?

If you have a 1098-T form, upload it here.

Please upload your driver's license.

If you have a Spouse, please upload driver's license.

SSN Card

If you have a Spouse, please SSN Card.

Please upload your birth certificate for your dependents.

Please upload all proof of income; ex. W-2, 1099, and Profit Loss Sheet.

Primary Taxpayer's Signature

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