Secure Client Organizer

Client Intake Form

Complete the sections below so we can prepare an accurate return and identify every deduction and credit available to you. All information is transmitted securely and kept confidential.

1. Filing Information

Filing Status *

Marital Status *

Tax Year *

2. Taxpayer Information

First Name *

Last Name *

Date of Birth

Social Security Number *

Occupation *

Phone

Email *

Street Address

City

State

ZIP

3. Spouse Information (if applicable)

Spouse First Name

Spouse Last Name

Spouse Date of Birth

Spouse SSN

Spouse Occupation

4. Dependents

No dependents added. Click below to add one.

5. Income (enter approximate annual amounts in USD)

Wages / Salaries (W-2)

Interest Income (1099-INT)

Dividends (1099-DIV)

Self-Employment (1099-NEC)

Rental Income

Retirement Distributions (1099-R)

Social Security Benefits (SSA-1099)

Capital Gains / Losses (1099-B)

Other Income (describe)

6. Deductions & Credits

Home Mortgage Interest (1098)

Property Taxes

State & Local Income Taxes

Charitable Contributions

Medical & Dental Expenses

Student Loan Interest (1098-E)

Childcare / Dependent Care

Education Expenses (1098-T)

Other Deductions (describe)

7. Business Information (if self-employed or business owner)

Business / DBA Name

Entity Type

EIN

Gross Revenue

Total Business Expenses

8. Refund Direct Deposit (optional)

Account Type

Routing Number

Account Number

9. Notes & Signature

Additional notes for your CPA

I certify that the information provided is true and complete to the best of my knowledge, and I authorize S&S CPA INC to use it to prepare my tax return and related filings. *

Electronic Signature (type full legal name) *

Date: 7/22/2026

By submitting, you agree that S&S CPA INC may contact you regarding your return.