Upload-Securely File Your Taxes Online

WELCOME

This intake form serves as a follow-up to the survey and is designed to collect any additional information needed to complete your tax preparation. It will gather all necessary details to ensure accuracy and efficiency. You can expect a response within 24-48 hours after submission. Please read each question carefully and provide complete answers. Missing or incomplete information may lead to processing delays. Thank you for your prompt attention to this step!

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You are allowed to apply for either or both of the loans but keep in mind all tax information must be submitted. (Including W-2s if waiting, CAN NOT use pay stubs)

Do you want to apply for the NO fee advance up to $1000? (Available Jan 2nd-Mar 1st) *

Yes

Do you want to apply for a preseason loan for up to $9500? (loans available Jan 2nd-Mar 1st) *

Yes

Are you a new or returning client? *

New

Returning

Estimate

Social Security Number *

Social Security Card *

First Name *

Last Name *

Date of birth *

Unexpired Identification *

Occupation *

Phone *

Email *

Address

Street Address *

City

State

Country

Postal code

Spouse Full Name

Spouse Social Security Number

Spouse Date Of Birth

Spouse Number

Spouse Email

Spouse Occupation

Spouse Identification

Spouse Social Security Card

Dependent 1

Full Name
Social Security Number
Birthday
Relationship
Income (put 0 if n/a)
Yes/No for disabled
Yes/No Student

Dependent 1 Social Security Card

Dependent 1 Birth Certificate

Dependent 1- Insurance Form

Dependent 2

Full Name
Social Security Number
Birthday
Relationship
Income (put 0 if n/a)
Yes/No for disabled
Yes/No for Student

Dependent 2 Social Security Card

Dependent 2 Birth Certificate

Dependent 2- Insurance Form

Dependent 3

Full Name
Social Security Number
Birthday
Relationship
Income (put 0 of n/a)
Yes/No for Disabled
Yes/No for Student

Dependent 3 Social Security Card

Dependent 3 Birth Certificate

Dependent 3- Insurance Form

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Is any of the following true about the taxpayer?

Taxpayer can be claimed as a dependent on someone else's return. *

Yes

Taxpayer is blind. *

Yes

Taxpayer is deceased. *

Yes

Taxpayer was affected by a natural disaster during the current tax year. *

Yes

Taxpayer received, sold, or disposed of a digital asset (or financial interest in a digital asset) in the current tax year. *

Yes

Did you have insurance through the year? *

Yes

Insurance Form (1095-A/B/C)

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INCOME

W-2 (1)

W-2 (2)

W-2 (3)

W-2 (4)

W-2 (5)

W-2 (6)

1099-NEC (1)

1099-NEC (2)

1099-NEC (3)

1099-MISC (1)

1099-MISC (2)

1099-R

1099-SSA (1)

1099-SSA (2)

1099-G (Unemployment or Govt Payments)

W-2G (1)

W-2G (2)

W-2G (3)

Additional Income (Not Business)

___________

SELF-EMPLOYMENT

Business Name

Business Type

Year Business Established

Business Address

Address Line 1
Address Line 2
City
State
Zip

Gross Business Income

Expenses

Advertising
Car & Truck
Commission & Fees
Contract Labor
Home Office Expense
Depreciation
Insurance (Other than Health)
Interest
Legal & Professional Services
Office Expense
Rent or Lease of Property
Repairs & Maintenance
Supplies
Taxes & Licenses
Travel
Meals
Utilities
Entertainment
Wages
Business Miles (Log Needed)
Other Expenses
Other Expenses
Other Expenses
Other Expenses

___________

DEDUCTION QUALIFICATIONS

Did you and/or your dependent have qualifying college expenses and 1098-T? If so, upload below.

1098-T (1)

1098-T (2)

Did you pay qualify daycare or childcare expenses for a dependent 13 y/o or younger during 2023? Upload form below or if paying a person, list the amount paid, full name, address, and SSN of provider.

Dependent Care Form

Child Care Provider

Did you pay rent for your home/apartment?

Lease

Personal Landlord Information (Address where you mail payments)

Full Name or Company
Address Line 1
Address Line 2
City
State
Zip Code
Rent Amount
Months Rented

Did you pay property taxes?

Yes

ADDITIONAL INFORMATION

Referral

Any Additional Comments, Questions Or Special Requests?

I consent to Quick Stop Tax using my personal information for the SOLE purpose of preparing my (our) taxes. I understand I will be contacted within 24 hours or less if there is something missing. I still have to confirm my refund amount by email or phone to have it processed. *

Yes

Call 313-551-1946

Email: [email protected]

Site: www.savyytaxprofessionals.com

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