Tax Client Intake Form

Thank you for choosing JC Multi Services for your tax filing needs! We’re excited to serve you. Please complete the intake form as thoroughly as possible. If you have any questions or need assistance, feel free to email us at [email protected] or call +1 407-205-6448.

Tax Payer Information

First Name *

Last Name *

Phone *

Email *

Address

Home Address *

State *

Country *

Postal Code *

Do you have an IRS Identity Protection PIN (IP PIN)? *

Yes

No

Social Security Number *

Picture of Social Security Card (SSN) *

Picture of Social Security Card (SSN)

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )

Picture of ID Card/License (one) *

Picture of ID Card/License (one)

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )

Tax Documents (W-2 Forms, 1095-A forms etc) *

Tax Documents (W-2 Forms, 1095-A forms etc)

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )

Filing Status *

Single

Head of Household (Single with Dependents)

Married Filing Joint

Married Filing Separate

Are You Claiming Dependents? *

Yes

No

Bank Information

Bank Name *

Routing Number *

Account Number *

Account Type *

Checking

Savings

Void Check

Void Check.

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )

Upload Any Additional Documents

Please Upload Any Additional Documents

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )

JC Multi Services will use the information you provide to prepare your 2025 individual tax return. As the taxpayer, you are solely responsible for the accuracy and filing of your tax return.

I, the taxpayer listed above, confirm that I have provided JC Multi Services with all required tax information, and to the best of my knowledge, the information submitted is true, accurate, and complete.

Tax Payer Signature *

Clear

Spouse Signature

Clear

Date Signed *

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Tax Client Intake Form

Tax Payer Information

Spouse Information

Information of Dependents

Dependant 1

Dependant 2

Dependant 3

Dependant 4

Bank Information

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