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First & Last Name

Spouse First & Last Name

Phone

Address

City

State

Zip Code

Occupation

Spouse Occupation

Primary Social Security Number

Spouse Social Security Number

Primary Date of Birth

Primary Date of Death

Spouse Date of Birth

Spouse Date of Death

First Time Filing With Us?

Filing Status

Are You A Student?

Do You Have Dependents? (Proof Required)

Dependent #1 First & Last Name

Dependent #1 Social Security

Add 2nd Dependent?

Yes No

Dependent #2 First & Last Name

Dependent #2 Social Security

Add 3rd Dependent?

Yes No

Dependent #3 First & Last Name

Dependent #3 Social Security

Add 4th Dependent?

Yes No

Dependent #4 First & Last Name

Dependent #4 Social Security

Add 5th Dependent?

Yes No

Dependent #5 First & Last Name

Dependent #5 Social Security

Please upload all dependent proof (birth certificates, SS cards, proof of dependency)

Upload FRONT of Drivers License, SS Card or Passport (If filing married joint include both)

Upload BACK of Drivers License, SS Card or Passport (If filing married joint include both)

Do You Have Income? Describe what kind of income you have.

W2 1099 Sole Proprietor Other

Would you like to apply for a refund advance? $500-$6000 against your refund

Do you owe student loans, taxes or child support that might offset your refund?

Did you or your family have health insurance at any time in 2024?

Please upload ALL income/deduction documentation (W2, 1099, 1098, etc)

New York Residents Only:

If you earned under $18,000 and paid less than $450 per month in rent, you may be eligible for the Renter's credit. How much was your rent per month?

Did the rent include any utilities?

If so which utilities?

Are you required by New York State to pay Child Support?

How would you like your refund?

Name of Bank

Account Type

Account Number (Please verify)

Routing Number (Please verify)

Please provide any additional information or questions you may have that pertains to your specific tax situation.

I understand when signing and submitting this client taxes intake form, I agree and acknowledge that I am giving Biz Pro HQ authorization to prepare and E-File my taxes! I understand and agree to all Fees and swear all information I have provided is accurate and true! If any information I have failed to provide warrants an audit by the IRS, Biz Pro HQ is not held liable but will assist with the audit to the best of their ability.

When filing with Biz Pro HQ I understand that audit protection is mandatory for a fee of $124 that will be applied to my tax file fees. This insurance covers up to $2,500 if I have to pay back any funds due to an inaccurate filing or audit. If I still need to submit tax forms or my file needs an amendment, there is an upfront $100 amendment processing fee.

I agree that in the event of an offset, my refund is subject to garnishment by either the state or federal government. I have 10 business days to make payment or set up payment arrangements with Biz Pro HQ for all prep and processing fees associated with my tax filing. After the 10-day grace period, if service fees remain unpaid and no payment arrangements are made, Biz Pro HQ and or it's banking partners have the right to initiate an ACH withdrawal for all preparation fees linked to this intake form from the account on record.

I have read the privacy policy.

Yes

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