Please complete this form to provide us with the information to best serve you and click SUBMIT. Upload all documents at the end of the form. Note: If claiming dependents, be sure to upload their social security cards and an item that shows their addresses matches yours (e.g. school records, medical records, doctor bill, Medicaid statement, social services records, or anything that shows your child's name and current address). If you have any questions, please email spumphrey@hopefinancialsolutions.net. We look forward to serving you!
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Alternative Phone Number
Please enter a valid phone number.
Did someone refer you? Type their name or type "no"
Tax Payers Date of Birth
Tax Payers Social Security Number
How many W2's Does The Tax Payer Have?
How would you like your refund?
Direct Deposit
Check
Name of Bank
Routing Number
Bank Account Number
Spouse's Full Name
Spouse's Phone Number
Spouse's Date of Birth
Spouse's Social Security Number
How many W2's Does Your Spouse have?
Spouse's Email Address
Preferred Method of Contact
Please Select
phone call
text
email
Do you own a business and/or were you self employed?
Yes
No
How much profit was made in 2021 for your business?
Do you certify the profit made in 2021 is true, accurate and is given to use as a source of income for your 2020 Federal and State return?
Yes
No
N/A
Did you incur material expenses to operate your business in 2021?
Yes
No
N/A
Did you and your spouse live apart during 2021?
Yes
No
N/A
What was your filing Status as of Dec 2021?
Single
Married filing separately
Married filing jointly
Head of Household
Did you pay over half the expenses of maintaining your residence for the entire year?
Yes
No
N/a
Can anyone claim you as a dependent?
Yes
No
Did you support a child or family member for more than 6 months out of the year?
Yes
No
How many dependents are you claiming?
One
Two
Three
Four
N/A
Dependent #1 Full Name
Dependent # 1 Date of Birth
Dependent # 1 Social Security Number
What is the relationship to dependent # 1?
How many months did dependent #1 live with you in 2021?
Dependent # 2 Full Name
Dependent # 2 Date of Birth
Dependent # 2 Social Security Number
What is the relationship to dependent # 2?
How many months did dependent # 2 live with you in 2021?
Dependent # 3 Full Name
Dependent # 3 Date of Birth
Dependent # 3 Social Security number
What is the relationship to dependent # 3?
How many months did dependent # 3 live with you in 2020?
Are there any dependents in daycare? If so, please upload the form you receive from the daycare provider.
Did you have health insurance for the entire year in 2020?
Yes
No
Did your spouse have health insurance for the entire year in 2020?
Yes
No
Did your dependents have health insurance for the entire year in 2020?
Yes
No
N/A
If you had insurance through the marketplace, did you receive a 1095A Health Insurance Marketplace statement? (Not providing form IRS could delay your refund)
Have you ever been denied the Earned Income Tax Credit (EITC)?
Yes
No
Did you attend college in 2020?
Yes
No
Did your spouse attend college in 2020?
Yes
No
N/a
Do you have a Form 1098T (Tuition Statement) for either you, your spouse and/or dependents?
Yes
No
Did you receive the first round of stimulus payment?
Yes
No
Did you receive the second round of stimulus payment?
Yes
No
If you were self employed in 2020, were you unable to perform services because of certain corona virus related circumstances?
Yes
No
N/A
Please upload taxpayer/spouse driver license and all important documents needed to file your taxes.
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I am giving HOPE Financial Solutions permission to prepare all forms related to my tax return and I have signed all necessary forms to file my income tax return electronically. I take full responsibility for the accuracy of this client intake form and understand that HOPE Financial Solutions holds no responsibility for any misrepresentation or false claims.
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