Boss Ladies Taxes & Business Services

TAXPAYER

* Required Fields

Social Security Number*

First Name*

MI

Last Name*

Date of Birth

Date of Death

Work Phone

Cell/Other Phone

Email*

Occupation*

Legally Blind

Yes

No

Dependent of Other?

Yes

No

SPOUSE

Spouse Social Security Number

First Name

MI

Last Name

Date of Birth

Date of Death

Work Phone

Cell/Other Phone

Email

Occupation

Legally Blind

Yes

No

Dependent of Other?

Yes

No

DEPENDENTS

Name

Date of Birth

Social Security Number

Upload SSN image

Relationship

Name

Date of Birth

Social Security Number

Upload SSN image

Relationship

Name

Date of Birth

Social Security Number

Upload SSN image

Relationship

Name

Date of Birth

Social Security Number

Upload SSN image

Relationship

Name

Date of Birth

Social Security Number

Upload SSN image

Relationship

Name

Date of Birth

Social Security Number

Upload SSN image

Relationship

AFFORDABLE CARE ACT

REFUND TYPE

How do you want your refund? (Check one of the following)

7-14 days (RT Refund Transfer: Check)

(In about 7-14 days from the date your return is accepted electronically by the IRS, you receive a check for the amount your refund less filing fees. (Check will be available in our office))

7-14 days (RT Refund Transfer: Debit Card)

(In about 7-14 days from the date your refund is accepted electronically by the IRS, for the amount your refund less filing fees will be deposited onto the debit card we issued you.)

7-14 days (RT Refund Transfer: Direct Deposit)

(In about 7-14 days from the date your refund is accepted electronically by the IRS, for the amount your refund less filing fees will be deposited into your bank account.)

The Following products require fees paid at the time of the service

E-file:(Direct Deposit)

(Your refund will be deposited into your savings or checking account directly from IRS approximately 10-14 days after your return is accepted by IRS.)

3-4 Weeks(E-file: Check)

(Your refund will be mailed to you directly from IRS in approximately 3-4- weeks after your return is accepted electronically by the IRS.)

Mail a paper return

(Your refund will be mailed to you directly from IRS in approximately 6-8- weeks after your mail your return to the IRS.)

Signature*
(Sign here and click on save button to upload signature.)

Clear Save

Date

Tax Client Photo ID and Voided Check – Required!

Taxpayer Name

Taxpayer SSN

PHOTO ID*

1 Other Form of ID

Spouse Name

Spouse SSN

SPOUSE PHOTO ID

SPOUSE 1 Other Form of ID

Voided Check (* Required if you selected Direct deposit in Refund Type on page – 2)

Taxpayer Signature:

Date

Spouse Signature:
(Sign here and click on save button to upload signature.)

Clear Save

Date

Due Diligence Questionnaire

How many: people live with you?

Adults

Children

Did anyone else help support your during the year?

Yes

No

If yes, who?

How much? $

Are any of the Dependents being claimed NOT your Son or Daughter?

Yes

No

If Yes, Provide proof of financial responsibility or residency (i.e copy of lease, medical records, school records, food stamps or benefit statements) (* Required if you selected you selected 'Yes' in 'Are any of the Dependents being claimed NOT your Son or Daughter?'.)

If Yes, Why are parents not claiming the child? (Please explain and list the child’s name(s) if more than one listed on the return)

Did you have any other income during the year? (Child support, alimony)

Yes

No

If yes, Please specify

Other comments

Schedule – C – Form

Fill out COMPLETLEY or mark “N/A”. DO NOT leave blank. Use a separate worksheet for EACH SCH - C **Please Note: If possible, it is preferred a trial balance, P&L and balance sheet be provided by the client. If available, write “see next page” below and stuck under this page. If NOT AVAILABLE, Please use the input sheet below.

Business Info: (Required for all)

Taxpayer

Spouse

Name of Business (If any):

Address of Business:

Business EIN (If any):

Date Business Started:

Did you materially participate in the business?

Yes

No

Income Questions: (Required if no P&L or Trial Balance Available)

Total Sales:(in $)

Other Income:(in $)

General Expenses: (Required if no P&L or Trial Balance Available)

Expenses

Value (IN $)

Expenses

Value (IN $)

Advertising:

Repair & Maintenance:

Auto Expense:

Supplies:

Commissions:

Taxes & Licenses:

Contract Labor

Travel:

Depletion

Meals (Total):

Employee Benefit Program:

Utilities:

Insurance (other than health):

others:

Interest

a. Mortgage:

b. Other:

Legal & Professional:

Office Expense:

Pension & Profit Sharing:

Rent or Lease:

a. Vehicles:

b. Machinery

c. Other:

Total Expenses:

Net Income: Total Income – Total Expenses =

(Please attach any other supporting document(s) if available)

Client Signature:

Date

By signing above, I hereby certify the information given above is true and accurate.

Income Summary

MONTH

SERVICE

$ MADE

January

February

March

April

May

June

July

August

September

October

November

December

Total

Dependent Care Form

Student Acknowledgment Form

I, was a student during the school year, and attended . I certify that all of the information found on this form is true and to the best of my knowledge. I understand it is my responsibility to have all valid documents and or receipts, as required to apply for any type of school credit. Below is a recap of all information, status, and expenses I have encountered.

My scholar status:

Full Time Student

Part Time Student

DID receive a 1098-T Form

DID NOT receive a 1098-T Form (Please visit 1098T.com to download your 1098T in order to claim the credit)

Below are my total educational expenses:

IN ($)

Books:

Supplies (On campus):

Supplies (Off campus):

Other expenses:

Total:

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. Any and all disputes regarding this matter shall be forwarded to me with the information found on my tax returns forms.

Student Signature:
(Sign here and click on save button to upload signature.)

Clear Save

Date

Schedule - A – Information

MEDICAL EXPENSES

CURRENT YEAR (IN $)

Medical & Dental Expenses

Medical Insurance Premiums Paid (Other than Social Security Medicare Payments)

Long Term care Premiums

Prescription Drugs & Medications

Medical Miles Driven

TAX EXPENSES

CURRENT YEAR (IN $)

State & Local Income Taxes Paid (Other than those on W-2’s, 1099’s, etc.)

Income Taxes paid

Real Estate Taxes

Personal Property Taxes

Other taxes:

Qualified New Vehicle Taxes

Additional State/ Local Taxes

INTEREST EXPENSE

CURRENT YEAR (IN $)

Home Mortgage Interest reported on Form 1098

Home Mortgage Interest paid to others

Refinancing Points Paid i

Investment Interest (other than K-1)

CONTRIBUTIONS

CURRENT YEAR (IN $)

Cash Contributions (If over $500 please provide detailed list)

Non Cash Contributions (If over $500 please provide detailed list)

Volunteer Mileage Driven

Miscellaneous

CURRENT YEAR (IN $)

Unreimbursed Business Expenses

Union Dues

Tax Prep Fees (Paid for Previous Return)

Safe Deposit Rental

Other Expenses:

Investment Expenses (Other than K-1)

Gambling Losses (Due to extent of winnings)

CASUALTY & THEFT LOSSES

If you had any casualty or theft losses during the year, please provide detail below, including date, description, amount of casualty or loss, any insurance reimbursement & basis in the property.

Client Signature:

Date

Affordable Care Details:

	Mar	Apr	Jun
TAXPAYER:
Insured through Marketplace
Coverage from other source
Exempt from Mandate
SPOUSE:
Insured through Marketplace
Coverage from other source
Exempt from Mandate
DEPENDENT 1
Insured through Marketplace
Coverage from other source
Exempt from Mandate
REQUIRED TO FILE A RETURN?	YES NO
DEPENDENT 2
Insured through Marketplace
Coverage from other source
Exempt from Mandate
REQUIRED TO FILE A RETURN?	YES NO
DEPENDENT 3
Insured through Marketplace
Coverage from other source
Exempt from Mandate
REQUIRED TO FILE A RETURN?	YES NO

If employer sponsored health coverage was declined:
		TAXPAYER:	SPOUSE:
What would cost of SELF coverage have been		$	$
What would cost of FAMILY coverage have been?		$	$
Would FAMILY policy have covered spouse?		YES NO
OTHER CALCULATION QUESTIONS
Did you pay for health coverage for anyone not on your return?		YES NO
Did anyone else pay for health coverage for someone on your return?		YES NO

Tax Intake Form

TAXPAYER

SPOUSE

FILING STATUS

ADDRESS

DEPENDENTS

AFFORDABLE CARE ACT

REFUND TYPE

Tax Client Photo ID and Voided Check – Required!

Due Diligence Questionnaire

Schedule – C – Form

Business Info: (Required for all)

Income Questions: (Required if no P&L or Trial Balance Available)

General Expenses: (Required if no P&L or Trial Balance Available)

Expenses

Value (IN $)

Expenses

Value (IN $)

Advertising:

Repair & Maintenance:

Auto Expense:

Supplies:

Commissions:

Taxes & Licenses:

Contract Labor

Travel:

Depletion

Meals (Total):

Employee Benefit Program:

Utilities:

Insurance (other than health):

others:

Interest

a. Mortgage:

b. Other:

Legal & Professional:

Office Expense:

Pension & Profit Sharing:

Rent or Lease:

a. Vehicles:

b. Machinery

c. Other:

Total Expenses:

Net Income: Total Income – Total Expenses =

(Please attach any other supporting document(s) if available)

By signing above, I hereby certify the information given above is true and accurate.

Income Summary

MONTH

SERVICE

$ MADE

January

February

March

April

May

June

July

August

September

October

November

December

Total

Dependent Care Form

STANDARD DEPENDANTS

1

2

3

4

NON STANDARD DEPENDENTS (Grandchild, niece, nephew, stepchild, foster child, etc.):

ADULT DEPENDANTS

By signing above, I hereby certify the information given above is true and accurate to the best of my knowledge.

Student Acknowledgment Form

My scholar status:

Below are my total educational expenses:

IN ($)

Books:

Supplies (On campus):

Supplies (Off campus):

Other expenses: