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BOSS Coaching

Elite 8 Client Intake

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Privacy Notice:

As tax advisors, we have always protected the right to privacy and will continue to do so. The law now requires us to inform you of our policy regarding privacy.

We receive and collect nonpublic personal information from various forms and statements that you provide. We do not disclose such information unless you instruct us to do so, except as required by law. We maintain physical, electronic, and procedural safeguards that comply with Federal regulations to guard your nonpublic personal information.

We retain records relating to professional services that we have provided so that we are better able to assist you with your tax and financial needs, and to comply with professional guidelines. Please do not hesitate to call us if you have any questions. Your privacy, our professional ethics and the ability to provide you with quality financial services are very important to us.

Financial Liability:

Initials*

All first time clients must have a credit card on file at the time of services if electing to use a bank product or service with other deferred payment options. All payments are due as invoiced unconditioned by outcome of engagement. Any deferred payment arrangements not paid on time or bank products intercepted by third party debt, will result in an attempt to charge the credit card on file. If credit card payment is not accepted there will be a $25 fee assessed along with a 5% late fee charge.

Initials*

If payment is not made within thirty (30) days of fees being assessed the liability will be assigned to collections, and a collection fee of $150 will be assessed to the account in addition to the late fee penalty charge of 5%. Client will assume all court cost, legal and administration fees if collection of balance has to go to court.

hereby agree to engage Elite 8 Tax & Financial Services for the services described as invoiced and accept the terms and conditions of the Financial Liability Statement.

Client Signature*

Date*

Client Signature

Date

Client Tax Intake/Checklist Tax Year*

Client Name*

Spouse Name

SSN#*

Spouse SSN#

D.O.B.*

Spouse D.O.B.

Address*

Day Phone*

City*

State*

Zip*

Alt Phone

Client Email*

Spouse Email

Did you change your name, address or marital status in the current tax year?*

Please select

Please select
Yes
No

List ALL Dependants

Full Name*

Date of Birth*

SSN*

Full Name*

Date of Birth*

SSN*

Full Name

Date of Birth

SSN

Full Name

Date of Birth

SSN

Full Name

Date of Birth

SSN

Can you or your spouse be claimed as a dependent on someone else’s tax return this year?*

Please select

Please select
Yes
No

Client Occupation*

Spouse Occupation

Income Checklist

Please provide the following documents/information if applicable in your personal portal:*

W2 forms for wages salaries and tips

Forms 1099 for interest, dividends and pension payments

K-1 forms from partnerships, S corporations, estates, and trusts

Self-employment income and expense summary

Rental Income and expense summary

Healthcare

Did EVERYONE on this tax return have health insurance ALL 12 MONTHS last year?*

Please select

Please select
Yes
No

If NO, were you exempt?*

Please select

Please select
Yes
No
N/A

If YES, was your insurance purchased through a state exchange or marketplace?*

Please select

Please select
Yes
No
N/A

IF PURCHASED THROUGH MARKETPLACE FORM 1095A IS REQUIRED TO COMPLETE THE RETURN. PLEASE UPLOAD TO YOUR SECURE PORTAL.

Have you sold or traded crypto currency in the tax year engaged?*

Please select

Please select
Yes
No

INTERVIEW SHEET

To prevent any delays in processing your engagement, please complete all questions accurately and sign below.

1. Do you have any student loans in default, arrearages in child support or any other third party debt that may be intercepted through tax funds?*

Please select

Please select
Yes
No
N/A

2. Do you have any prior year unresolved tax debt or installment agreement not in compliance?*

Please select

Please select
Yes
No
N/A

3. Do you have any prior year unfiled taxes?*

Please select

Please select
Yes
No
N/A

If yes will you be filing them now?*

Please select

Please select
Yes
No
N/A

4. Did you have health insurance in the year for which you are filing?*

Please select

Please select
Yes
No
N/A

5. Are you a Business Owner?*

Please select

Please select
Yes
No
N/A

6. Was the current year the first year in business for which you are filing a return?*

Please select

Please select
Yes
No
N/A

7. What is your business entity ? (Sole Prop, LLC, S-Corp etc.)*

8. Check one.*

Did you maintain proper accounting?

Are you relying on bank statements?

Did you only retain receipts?

Will you need your accounting reconstructed?

9. Did you have employees?*

Please select

Please select
Yes
No
N/A

If yes did you timely issue W2’s or 1099’s?*

Please select

Please select
Yes
No
N/A

10. Are you in need of a bookkeeper?*

Please select

Please select
Yes
No
N/A

Do you need payroll services?*

Please select

Please select
Yes
No
N/A

11. Do you have Life Insurance for yourself and all dependents?*

Please select

Please select
Yes
No
N/A

12. List two (2) people that could use our services*

Phone*

Name*

Phone*

COMPLETE THIS SECTION IF YOU CHOOSE TO ITEMIZE OR WANT TO COMPARE ITEMIZED TO STANDARD DEDUCTION.

Itemized Deductions

Medical

Prescription Drugs*

Health Premiums*

Dental Premiums*

Dr.’s/ Dentist*

Lab/X-Ray*

Glasses/Hearing Aid*

Contributions

Church*

Clothing*

Charitable Miles*

Dr.’s/ Dentist*

Lab/X-Ray*

Glasses/Hearing Aid*

Taxes

Real Estate Taxes*

State Income Tax*

State Sales Tax*

Auto Excise Tax*

Boat Property Tax*

Other Taxes*

Interest Paid

Home mortgage 1st*

Home mortgage 2nd*

Student Loan Interest*

Investment Interest*

Miscellaneous

Union Dues*

Tax Prep Fees*

Educational Expenses*

Professional Licenses*

Job Seeking Expenses*

Uniforms & Laundry*

Work Tools*

Alimony Payments*

Safe Deposit Box*

Lottery/Gambling*

Cash Contributions*

Non-Cash Contrib*

Volunteer Mileage*

Casualty & Theft Losses

If you had any casualty or theft losses during the year, please provide detail below, including date(s), description, amount of casualty or loss, any insurance reimbursement and basis (cost) in the property. Attach additional forms if necessary.

Schedule C Intake

If you are a business owner or receive 1099 MISC income with unreimbursed expenses, please upload all business book income and expenses to your portal.

Authorization for Credit Card Use

COMPLETE THIS AUTHORIZATION
All information will remain confidential

Cardholder Name*

Billing Address*

Credit Card Type:*

Visa

Mastercard

Discover

AmEx

Card Number*

Expiration Month*

Please Select

Please select
January
February
March
April
May
June
July
August
September
October
November
December

Expiration Year*

Please Select

Please select
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
2046
2047
2048
2049
2050

CVC*

Amount to Charge:*

Check if recurring payment.

Check if applying for refund product.

(If this authorization is for use with a bank refund application,
your card will not be charged unless your anticipated refund is offset by the IRS.)

I authorize Elite 8 Tax & Financial Services to charge the amount listed above to the credit card provided herein. I agree to pay for this purchase in accordance with the issuing bank cardholder agreement.

Cardholder – Please Sign and Date

Print Name*

Signature*

Date*

Internal Revenue Code Section 6695(g) Due Diligence Requirements

All questions will be asked and this form shall be filled out by tax payer.

You can send one or more of the following documents to prove the child lived with you for more than half of the year:

School records (you may need to send one or more school records)
Medical records from doctors, hospital or medical clinic. (Immunization records may not include all the necessary information
Adoption or child placement documents
Court records

Or, send dated statements on letter head from:

The child’s school
The child’s childcare provider (not relative)
The child’s health care provider, doctor, nurse or clinic
A social service agency
A placement agency official
Your employer
An Indian tribal official
Your landlord or property manager
A place of worship

HEAD OF HOUSEHOLD (H/H) ELIGIBILITY

You may file Head of Household if you can answer YES to ALL the following questions. (See Publication 17, Chapter 2 & 3)

You are unmarried, or are considered unmarried on the last day of the year.*

Please select

Please select
Yes
No

You paid more than half the cost of keeping up a home for the year.*

Please select

Please select
Yes
No

A qualifying person (see definition below) lived with you in the home for more than half the year (except for temporary absences, such as school), and you can claim an exemption for him/her except as noted under Category 3 below.*

Please select

Please select
Yes
No

A qualifying person is your (See Table 2-1, Publication 17)

A qualifying relative such as a parent, grandparent, brother, sister, stepbrother, stepsister, stepmother, stepfather, motherin-law, father-in-law, half-brother, half-sister, son-in-law, daughter-in-law, uncle, aunt, nephew, or niece who is related to you by blood and lived with you for the entire year.
Child, grandchild, stepchild, or adopted child. (Note: Is a qualifying child even if you cannot claim an exemption for the child)
Eligible foster child. (Note: For eligibility for dependency only a foster child is a child who is in your care, that you care for as your own child, and who lived with you the entire year. It does not matter how the child became a member of the household.

EARNED INCOME CREDIT (EIC) ELIGIBILITY

You may claim the EIC if you can answer YES to ALL 4 tests below. (See Publication 17 Chpt 36)

Relationship Test

Your child/children is/are one of the following; a son, daughter, adopted child, stepchild, grandchild, or eligible foster child, or is your brother, sister, stepbrother, stepsister or the child or grandchild of of your brother, sister, stepbrother, or stepsister, and you care it/them as you would your own child.t*

Please select

Please select
Yes
No
N/A

Age Test

Your child/children is/are under 19 years of at the end of the year, or is under 24 years of age at the end of the year and is a full-time student, or was permanently and totally disabled at any time during the tax year, regardless of age.*

Please select

Please select
Yes
No
N/A

Residency Test

Your child/children lived with you for more than half the year (or the whole year if an eligible foster child)*

Please select

Please select
Yes
No
N/A

Your home is in the United States.*

Please select

Please select
Yes
No
N/A

Qualifying Child of Another Test

If your child/children is/are the qualifying child/children of another individual, you are the only person claiming the credit for that/those child/children during the tax year. (Note: If the answer to this test is NO, refer to the tiebreaker rule. You may still be able to take the credit.

Please select

Please select
Yes
No
N/A

ADDITIONAL EIC DUE DILIGENCE

If you are claiming this child only, why is the other parent not claiming the child?

If you are claiming this child only, why is the other parent not claiming the child?*

Can you provide copies of the dependents Birth Certificate or Social Security card?*

Please select

Please select
Yes
No
N/A

Does the other parent live in same residence as the Mother/Father that is claiming the child?elect*

Please select

Please select
Yes
No
N/A

If it is a Niece, Nephew, Brother or Sister that is being claimed, and Mother/Father live at the same address, why are they not claiming them?*

If it is a Niece, Nephew, Brother or Sister, and the parent is not claiming them then the IRS may ask for documentation, do you have any proof the children lived with you, such as school or doctor records?*

Please select

Please select
Yes
No
N/A

Who is keeping the child while you are at work?*

Client Signature*

Date*

(By signing this form, I attest that all information included/ attached if correct and I am responsible for any errors/omissions and resulting consequences thereof)

COMPLETE THE FOLLOWING FORM ONLY IF YOU ARE RECEIVING A REFUND AND INTEND TO PAY FOR SERVICES FROM YOUR TAX RETURN

ELITE 8 TAX & FINANCIAL SERVICES

CONSENT TO USE AND DISCLOSURE OF TAX RETURN INFORMATION

Federal law requires this consent form be provided to you. Unless authorized by law, we cannot use or disclose your tax return information to third parties for purposes other than the preparation and filing of your tax return without your consent. If you consent to the use and disclosure of your tax return information, federal law may not protect your tax return information from further use or distribution.

You are not required to complete this form to engage our tax return preparation services. If we obtain your signature on this form by conditioning our tax return preparation services on your consent, your consent will not be valid. If you agree to the use and disclosure of your tax return information, your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature.

For your convenience, we have entered into arrangements with certain financial institutions and their partners regarding the provision of settlement products, card services and related banking services. You have indicated that you are interested in obtaining and applying for a refund settlement product, NetSpend Visa® Prepaid Card, and other banking services. To apply for and obtain any of these products or services, we must forward your tax return information to these companies, financial institutions and/or their affiliates.

If you would like us to disclose your tax return information to the companies and financial institutions providing these services, please check the corresponding box(es) for the services in which you are interested, and sign and date your consent to the disclosure. You understand that if you are not willing to authorize us to share your tax information with certain financial institutions, including their affiliated companies, you will not be able to obtain a refund settlement product form them, but you can still choose to have your tax return prepared and filed by Elite 8 Tax & Financial Services for a fee at time of service.

I, the taxpayer signing this consent, authorize Elite 8 Tax & Financial Services to use the information I provide during the preparation of my tax return to determine whether I am eligible for refund settlement products, card services and related banking services.

I, the taxpayer signing this consent, authorize Elite 8 Tax & Financial Services to disclose all of my tax return information to ensure that any refund settlement products, card services, and related banking services that I request, obtain or apply for can be issued, processed delivered and verified.2

I, the taxpayer signing the consent, authorize Elite 8 Tax & Financial Services to disclose to certain financial institutions, my mailing and email address for the purpose of marketing the NetSpend Visa® Prepaid Card.