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Client Intake Form

Gather all necessary documents FIRST before proceeding with this form! If not completed fully & rejected, it will delay processing time.

Taxpayer Information

Country

Spousal Information

Ex: 1 month in April or 3 months (Jan-March)

Eligible Dependents & Relative Information

List the names below of everyone who lived with you last year (other than your spouse), or anyone you supported but did not live with. Please Note you will only be able to add 3 dependents on this form, If more there will be a Box to input extra dependents (Name, Dob, SSN).

DEPENDENT #1

DEPENDENT #2

Dependent 3

If you have more than 3 dependents, Please list those dependents Name, DOB, & SSN. Please remember to upload docs on the Upload pg.
If you do not have your Childcare provider's SSN, you will not be able to claim the ChildCare Credit! SSN are required by the IRS now.
More than 3 dependent? List the pay amount in the (Dependents Extended) Section above please.

Tax Related Questions & Upload center

Time to get your Documents ready for upload.

Ex. o years, 6 months
If yes, What Type Of offset?
If married filing Jointly, Include Spouse
If married filing Jointly, Include Spouse
1099-A, Medicare acceptance letter, Medicaid acceptance letter, etc. If married filing Jointly, Include Spouse

For Self-Employed Clients! I provide Small business start-up assistance. If you do not have a Profit & Loss statement. We provide tax reconstruction Services $39.99

Direct Deposit information

Additional Services?

If you would like any additional services listed, A team member will reach out to you via email for a follow up.

Signature Pg.

I am giving Jackson Inspire Accounting Solutions permission to prepare all forms related to my tax return; to apply for and secure RAC's and RAL's on my behalf; and sign all necessary forms and file my taxes electronically. I take full responsibility for the accuracy of this form and understand that Jackson Inspire Accounting Solutions and/or associated affiliate responsible hold no liability for any misrepresentation or false claims. By signing this agreement, I consent to use & Disclosure for purposes related to my tax return.

Clear

I am giving Jackson Inspire Accounting Solutions permission to prepare all forms related to my tax return; to apply for and secure RAC's and RAL's on my behalf; and sign all necessary forms and file my taxes electronically. I take full responsibility for the accuracy of this form and understand that Jackson Inspire Accounting Solutions and/or associated affiliate responsible hold no liability for any misrepresentation or false claims. By signing this agreement, I consent to use & Disclosure for purposes related to my tax return.

Clear
if married filing jointly, Spouse signature is required

CLIENT NON PAYMENT/OFFSET CLAUSE

At Jackson Inspire Accounting Solutions, we strive to assist all of our clients in their tax needs, however we understand that situations arise. If your refund is offset by the IRS, student loans, child support or your check is mailed, you are still obligated to pay our company the fees associated with filing your tax return. I

 By signing this agreement, you acknowledge that if payment is not made in full with in 30 days legal actions will be sought to resolve payment.

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