EmailMe Form - GLOBAL TAX SERVICE LLC - Tax Client Intake Form

Taxpayer Name *

First Last

Social Security Number / ITIN Number *

Occupation *

Date of Birth *

MM / DD / YYYY

If the IRS provided you with an Identitiy Protection Pin (IPPIN)
please list it below: *

if you do not have an IPPIN type 0 in the box.

I need to file an extension.

Yes

No

Did you receive the first round stimulus payment? If so who did you receive it for? *

Myself

All eligible dependents

Did not receive for myself

Did not receive for dependents

Check the boxes that apply to you.

Did you receive the second round stimulus payment? If so who did you receive it for? *

Myself

My dependents

Did not receive for myself

Did not receive for dependents

Check the boxes that apply to you.

What tax year(s) are you needing to have processed? Choose all that apply. *

Do you need to file an amendment? If so for what year? Choose all that apply. *

If you have been working with a Tax Preparer please select their name below. *

Filing Status *

Can you be claimed as a dependent by anyone else? *

Yes

No

Unsure

Select one.

Were you disallowed any credits by the IRS? *

Yes

No

Unsure

If your earned income credit (EIC), child tax credit (CTC)/additional child tax credit (ACTC)/credit for other dependents (ODC), or American opportunity tax credit (AOTC) was disallowed by IRS, you must complete and file the Form 8862.

US Citizen *

Yes

No

Select one.

Resident Alien *

Yes

No

Select one.

Do you have W-2 Statements? *

Yes

No

Do you have 1099s? *

Yes

No

Are you self-employed? *

Yes

No

Mailing Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

This address is the address that you will receive correspondence from the IRS, payment, and updates to. PO Boxes are not allowed.

Email *

Phone *

### - ### - ####

Type of Identificaton *

Driver's License

State ID

Passport

Military ID

Choose One

Identification Number *

Issuing State *

Issue Date *

Expiration Date *

SPOUSE INFORMATION

If this section does not apply, please proceed to next section.

Spouse Demographics

First Last

If not applicable place NA in both boxes and continue to next section.

Social Security Number / ITIN Number

Date of Birth

MM / DD / YYYY

Occupation

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email

Phone

### - ### - ####

Can spouse be claimed as a dependent by anyone else?

Yes

No

Unsure

Select one.

US Citizen

Yes

No

Select one.

Resident Alien

Yes

No

Select one.

Type of Identificaton

Driver's License

State ID

Passport

Military ID

Choose One

Identification Number

Issuing State

Issue Date

Expiration Date

HEALTH INSURANCE INFORMATION

Do you have an HSA? *

Yes

No

Family

Self

Do you have 1099-SA? *

Yes

No

Did you have Health Insurance from the Marketplace in 2019? *

Yes

No

Would you like Global Tax Service to discuss your return with the IRS as a third party representative if needed? *

Yes

No

Select one.

Do you need additional state returns? *

Yes

No

Select one.

If yes, which states?

DEPENDENT AND EDUCATION EXPENSES

Are you or any of your dependents students in a secondary institution such as a university, community college, or trade school? *

Yes

No

Select one.

If yes list the student(s) name below *

Put n/a if there is no student

Did you or dependents have any tuition expenses? *

Yes

No

Select one.

If yes list the student(s) name below *

Put n/a if there is no student

Did you receive a 1095-T form in the mail? *

Yes

No

N/A

Select one.

Do you have child care expenses? *

Yes

No

Please provide statement from child care facility. The statement must have the facility/provider name, child's name, EIN or Social Security number for the provider, Address, phone number to the facility and the amount paid for the year.

HOMEOWNER (SKIP IF YOU RENT)

Did you purchase a new home in 2020? *

Yes

NA

Select NA if you did not purchase a new home and proceed to Renters questions.

Do you own your home? *

Yes

No

N/A

Did you make any energy efficient home improvements?

Yes

No

Do you have proof of property taxes paid in 2020? *

Yes

No

N/A

What is the amount of property tax you paid in 2020? *

Type 0 if this does not apply to you

RENTERS

Do you rent? *

Yes

No

Monthly rent amount you paid *

Type 0 if it does not apply.

Months you rented *

Type 0 if it does not apply.

Landlord Name *

Type N/A if it does not apply.

Landlord Address *

Type N/A if it does not apply.

SELF EMPLOYMENT

If you are unemployed answer the following questions. If you are not select N/A or fill out N/A.

Are you self employed? *

Yes

No

What is your EIN for your business? *

If yes, how does your business operate? *

Do you have proof of income? *

Yes

No

N/A

Income is any money earned while providing a service or selling goods to consumers. Proof would include invoices, log books, 1099 MISC, and receipts.

Do you have proof of expenses? *

Yes

No

N/A

Proof od expenses would include money spent to operate your business. These would include receipts, bank statements, invoices, 1099Ks

Do you have proof of mileage? *

Yes

No

Proof of mileage would include a mileage log, gas receipts, or other method you selected to keep track of mileage

Do you need assistance gathering all of your documents to show proof of INCOME, EXPENSES OR MILEAGE? *

Yes

No

Please note that bookkeeping services are an additional cost and is not included in your tax preparation fee.

BANKING INFORMATION FOR REFUND OR BALANCE DUE (OPTIONAL)

If you receive a tax refund how would you like to receive your refund? *

Direct Deposit (Account must be in Tax Payer's Name)

Check (check will be mailed to the address on file)

Walmart to Walmart (funds can be picked up at Walmart)

Debit Card Supplied by Global Tax Service LLC (Debit card provided in office)

Use Account For: (choose all that apply) *

Select Account Type *

Checking

Savings

Routing #

Account#

Bank Name

Taxpayer's name must be on the bank account in order for it to be deposited.

DEPENDENT ELIGIBILITY

Will your dependents be claimed by someone other than yourself? *

Yes

No

Is your dependent totally/permanently disabled? *

Yes

No

N/A

If you answered yes list the dependent's name

Months did your child/children/dependents live with you?

Did your children acquire health insurance through the Market Place? *

Yes

No

Dependent Information

Below you will provide information for dependents you are filing on your tax return.

Dependent 1 Name

First Last

Dependent Relationship to you *

Date of Birth

MM / DD / YYYY

Social Security Number

Dependent 2 Name

First Last

Dependent Relationship to you

Date of Birth

MM / DD / YYYY

Social Security Number

Dependent 3 Name

First Last

Dependent Relationship to you

Date of Birth

MM / DD / YYYY

Social Security Number

Dependent 4 Name

First Last

Dependent Relationship to you

Date of Birth

MM / DD / YYYY

Social Security Number

General Engagement Letter For Tax Return Preparation

This is to inform you, the tax payer, of the services we will provide you, and the responsibilities you have for preparation of your tax return.

Tax Return Preparation

We will prepare your federal and state tax returns based on information you provide. Services for preparation of your return do not include auditing or verification of information provided by you and may result in additional fees.

Additional fees for bookkeeping or additional tax consults will be charged if applicable.

This engagement does not include any audit or examination of your books or records. In the event your return is audited, you will be responsible for verifying the items reported.

You must review the return carefully before signing to make sure the information is correct.

The tax preparation fee does not include bookkeeping or receipts management.

The tax preparation fee does not include additional services you may elect.

Fees must be paid via refund transfer or if you are paying out of pocket for your tax return before it is delivered to you or filed for you. If you terminate this engagement before completion, you agree to pay a fee for work completed.

Failure to pay for services will result in further collection action plus any collection and legal fees.

Fees charged for tax return preparation do not include bank fees, audit representation or preparing materials to respond to correspondence from taxing authorities.

Preparation fees do cover limited assistance and consultation during the year. This limitation is 1 hour of consultation as it relates to tax returns prepared in our office. Any additional consultation will be charged based on the consultation fee for that particular service.

No additional consultations or service will be provided without payment.

Once we begin working on your account fees for tax preparation, consultancy or other services are non-refundable. No Exceptions. Our services are guaranteed and mistakes will be corrected.

Amended tax returns processed after your tax return has been filed require a minimum fee of $150.00 and will need to be paid up front prior to services rendered.

The engagement to prepare your tax returns terminates upon the delivery of your completed returns and original documents to you. Please store your supporting documents and copies of your tax returns in a secure place for at least seven years.

Taxpayer Responsibilities

 You agree to provide us all income and deductible expense information. If you receive additional information after we begin working on your return, you will contact us immediately to ensure your completed tax returns contain all relevant information.

 You affirm that all expenses or other deduction amounts are accurate and that you have all required supporting written records. In some cases, we will ask to review your documents.

 You must be able to provide written records of all items included on your return if audited by either the IRS or state taxing authority. We can provide guidance concerning what evidence is acceptable.

Signatures.

By signing below, you acknowledge that you have read, understand, and accept your obligations and responsibilities and that you understand our responsibilities in preparing you tax returns as explained above. For a joint return, both tax payers must sign.

Taxpayer Signature

Clear

Date Time

MM / DD / YYYY

Submit your document

You may upload your documents to this form or you may email your documents to info@globaltaxservice4u.com.

If you are emailing please put your NAME and TAX DOCUMENTS in the subject line.

Identification card(s) - Upload here *

Example: Driver's License, State ID, Passport, Military ID

Social Security card(s) - Upload here *

Upload a copy of all persons being filed on the tax return social security card here

W2 (s)- Uplpoad here

1099s - Uplpoad here

Miscellaneous Forms

Privacy Policy.

The nature of our work requires us to collect certain nonpublic personal information about you from various sources. We collect financial and personal information from applications, worksheets, reporting statements, and other forms, as well as interviews and conversations with our clients and affiliates. We may also review banking and credit card information about our clients in the performance of receipt of payment. Under our policy, all information we obtain about you will be provided by you or obtained with your permission. Our firm has procedures and policies in place to protect your confidential information. We restrict access to your confidential information to those within our firm who need to know in order to provide you with services. We will not disclose your personal information to any third party without your express permission, except where required by law. We maintain physical, electronic, and procedural safeguards in compliance with federal regulations that protect your personal information from unauthorized access. Please contact us with any questions regarding our privacy policy. I declare under penalty of perjury under the laws of the State Indiana that the foregoing is true and correct.

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