Client Intake Form

Client Engagement Letter

We are looking forward to working with you this year in preparing your taxes! To minimize the possibility of a misunderstanding between us, we are setting forth pertinent information about the services we will perform for you. Please note that we must receive a signed copy of this engagement letter before we are able to work on your tax return. Also attached are tax data forms that we have specially created to help you in organizing your tax information. Please return these along with any supporting documents in person, via email, or using our App. Keep a copy for your records. We will prepare your federal and state individual income tax returns for information you furnish to us. While we will not audit what you submit, we may verify your information and the data you submit and ask you to clarify some of the information.

Once the tax return has been completed in full and sent to you for your signature, it is no longer considered a quote. Preparation fees will be due regardless of whether you decide not to sign or proceed with D&R Tax Service filing the return.

If we have not received ALL your information by March 31st of the current filing year, we will be happy to file an extension for you. Filing an extension is a complimentary service and will only be provided upon request. If an extension is filed, we must receive ALL tax information by September 30th of the current filing year. While an extension provides additional time to file your return, it does NOT provide an extension of time to pay taxes that may be due on your tax return. Information received after March 31st of the current tax year will be subject to additional fees if the return is expected to be completed by the April 15th deadline.

It is your responsibility to maintain in your records the supporting documentation necessary to support your tax returns. If you have any questions as to the type of records required, please asks us for advice regarding that.

We are responsible for preparing only the returns referred to in this letter. Our fee does not include responding to inquiries from the IRS or state received after the return is filed, or examination by taxing authorities. However, we are available to represent you should such a need develop, and this would be covered under a separate engagement letter unless you opted into our Audit Protection Program. Should we encounter instances of unclear tax law, or of potential conflicts in the interpretation of the law, we will outline the reasonable courses of action and the risk and consequences of each. We will ultimately adopt, on your behalf, the alternative you select. If the IRS should contest the position taken, disallow doubtful deductions, or inadequately supported documentation, there may be an assessment of additional tax, plus interest and penalties or assessments. Federal law has extended the attorney-client privilege to some, but not all, communications between a client and the client's tax preparer. Communications solely concerning the preparation of a tax return will not be privileged.

To protect sensitive data, client copies of tax returns will be delivered in person or via email, which will allow you to download an electronic copy of your tax return and print an unlimited number of copies any time needed. A paper copy can be requested. We will not be held liable for any lost or stolen mail. You may also pick up a copy of your tax return from our office, which will require you to show a photo id. Please keep your paper copy in a secured location, as replacement paper copies are $25 per year requested.

We are dedicated and determined to get you all the deductions that you are entitled to. Since your return is unique to your circumstances, we cannot guarantee the outcome or whether you will view it as good or bad. This does not relieve you of the obligation to pay our fees. Payment for service is due when rendered, fees are not. If the above sets forth your understanding, please sign a copy of this letter and return it to us. We are pleased to have you as a client and look forward to a long, mutually satisfying professional relationship with you.

D&R Tax Service

Client Signature *

Clear

Taxpayer Information

Social Security Number *

Driver's License or Government ID Number *

If you have an Identity Protection Pin, (IP PIN), list it here.

Did you, your spouse, or dependents have health insurance through the Marketplace (Obamacare)? If so you will need the 1095-A form to file.

Did you, or your spouse, receive unemployment in 2023? *

If so, do you have your 1099-G Form?

Please choose a filing status. *

Spouse Social Security

Spouse Address (If Different)

Spouse's Phone Number

Spouse's Date of Birth

Spouse's Date of Death

Dependent Information

Did the dependent live in your home for more than 6 months?

Can the taxpayer, spouse, or any dependents be claimed on another tax return?

Did anyone help support you during the year?

If yes, please explain.

Were any credits disallowed or reduced in a previous year?

If so, please explain.

In case of an audit can you prove financial responsibility and residency for the dependents being claimed?

Which documents can you provide?

Are any of the dependents being claimed NOT your son or daughter?

If yes, why are the parents not claiming the child? Please list the dependent's name if more than one child listed on the return.

Do you have document proving relationship to the child?

Are any of the dependents disabled?

If yes, what is the nature of the disability? Permanently and totally disabled, or temporarily.

By signing below, I hereby certify the information given above is true and accurate to the best of my knowledge. Taxpayer has been informed that claiming a dependent for EITC/CTC/AOTC/HOH or other can result in an audit, fines, and other consequences if the information provided is incorrect.

Clear

Generally, in about 7-21 business days from the date your return is electronically accepted by the IRS, you should receive your refund via the method you choose below. However, we cannot guarantee that your return will be processed in 7-21 business days as processing procedures and times are solely based on the IRS.

Refund Type Selection

How do you want your refund?

Financial Institution Name

Type of Account

The following services are also provided to file your return. However, these require the fees to be paid at the time of the service, therefore no fees will be deducted from tax refund. If you prefer to NOT use our bank products, please select an option below.

E-file: Direct Deposit-Refund will be deposited into your savings or checking account directly from IRS approximately 10-14 days after your return is accepted by IRS.

E-file: Check-Refund will be mailed to you directly from IRS approximately 3-4 weeks after it is electronically accepted by the IRS.

Mail a Paper Return: Refund will be mailed directly from IRS in approximately 6-8 weeks after the IRS has received your return.

Taxpayer agrees that if he/she owes taxes, all fees will have to be paid upfront before the return is filed. Failure to pay balances in full will result in the company taking legal action against the taxpayer. *

Yes

The advance loans range from $500-7,000 same day approvals. If approved, the amount advanced is deducted from your tax refund. You must file in order to apply for a refund cash advance with D&R Tax Service.

Cash Advance via Refund Transfer *

By signing below, I understand that I have received an explanation of all refund methods and cash advance options available to me, and I have selected the option that I feel is the best delivery method for my refund. *

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AOTC Student Acknowledgement

Name & Year Attended Post-Secondary Education

Scholar Status

Full-Time Student

Part-Time Student

Do you have a 1098-T Form from the school?

List Educational Expenses

Tuition
Room & Board
Books
Supplies
Other

By signing below, I certify all information is true, valid, and to the best of my knowledge. I accept full responsibility of the statements mentioned above.

Clear

You may be able to claim the credit if you pay someone to care for your dependent who is under age 13, or for your spouse or dependent who is not able to care for himself or herself. To qualify, you must pay these expenses so you can work or look for work

Dependent Cared For/Relationship to Taxpayer

List Additional Provider Information Here.

By signing below, I certify all information is true and to the best of my knowledge. I accept full responsibility of the statements mentioned above.

Clear

By signing below, I certify all information provided on each form for the completion of my tax return is true, valid, and to the best of my knowledge. I accept full responsibility of the statements mentioned above. All disputes regarding this matter shall be forwarded to me with the information found on my tax returns forms. I also attest that I can provide supporting documents upon request from the IRS and/or my state representation. *

Clear

Referred By Person or List How Did You Hear About Us (Radio, Google, Facebook, Instagram, etc): *

Check all Supporting Documents

Did you, your spouse, or a dependent have insurance under the Affordable Care Act? *

Please upload supporting documents. You can upload multiple files in one section or one file in each section.

Please upload supporting documents and any proof of payments received for advanced child tax credit here.

Upload all supporting documents

Upload supporting documents here.

Document Upload

Additional documents can be uploaded here.

Additional space to upload documents.

Additional Space

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