CLIENT INTAKE FORM

With the information you give us, we'll make a client file and start working on your tax returns. Please be aware that we might need to get in touch with you to ask for more details or supporting paperwork. If you have concerns or need to change your form,
elonmiree@gmail.com or call (334) 492-2486.

GENERAL INFORMATION

First Name

Last Name

Address

Phone Number

Social Security Number

Date of Birth

Occupation

Do any of the following apply?

Can be claimed as dependent

Blind

Deceased

Non of the above

Filing Status

spouse first name

spouse last name

spouse social security number

spouse date of birth

QUESTIONNAIRE
Please answer the following questions regarding your specific tax situation

Do you have dependents

dependent name/date of birth / ss number

If other income, please describe

If you are filing a business/self employed/side job/cash job? If yes, describe the nature.

Did you receive a tax refund last year?

YES

How much did you receive or owe?

Do you owe child support or student loans?

Did you purchase health insurance from the marketplace? OR have premium credits for your Health Insurance?

INCOME

DEDUCTIONS/ CREDITS

REFUND SELECTION

How would you like to receive your refund?

Direct Deposit Bank Name

Bank Account Type

Account Number

Routing Number

By filling out this form, you are giving us permission to prepare your tax return and you are confirming that ALL information entered is accurate.

Tax Preperation Check List

Personal identification (e.g., driver's license, passport)

Social Security cards for you, your spouse, your dependents

Wage and earning statements (e.g., Form W-2, Form 1099)

Interest and dividend statements (e.g., Form 1099-INT, Form 1099-DIV)

Bank routing and account numbers for direct deposit of any refund

Proof of any estimated tax payments made

Proof of any tax credits or deductions you are claiming (e.g., charitable donations, mortgage intere

A copy of your prior year's tax return

Any other documents that may be relevant to your tax situation (e.g., records of business expenses)

UPLOAD DOCUMENTS HERE

Your Signature

ALPHA & OMEGA TAX CENTERS

"we're with you from beginning to end".

CLICK ONE

CLIENT INTAKE FORM

With the information you give us, we'll make a client file and start working on your tax returns. Please be aware that we might need to get in touch with you to ask for more details or supporting paperwork. If you have concerns or need to change your form,
elonmiree@gmail.com or call (334) 492-2486.

GENERAL INFORMATION

QUESTIONNAIRE
Please answer the following questions regarding your specific tax situation

INCOME

DEDUCTIONS/ CREDITS

REFUND SELECTION

CLIENT INTAKE FORM

GENERAL INFORMATION

QUESTIONNAIRE Please answer the following questions regarding your specific tax situation

INCOME

DEDUCTIONS/ CREDITS

REFUND SELECTION

QUESTIONNAIRE
Please answer the following questions regarding your specific tax situation