Personal Identity

Taxpayer & Spouse Information

Taxpayer (Primary)

Full Legal Name

Date of Birth

Last 4 of SSN / ITIN

Occupation / Job Title

Employer / Business Name

Email Address

Phone Number

Spouse / Partner (if applicable)

Full Legal Name

Date of Birth

Last 4 of SSN / ITIN

Occupation / Job Title

Employer / Business Name

Residency

Primary home address as of December 31 of the tax year

Street Address

City

State

ZIP Code

County

Filing Status & Tax Year

Select the status and year that apply to this return

Tax Year

Dependents

List all dependents you are claiming on this return

Full Legal Name

Date of Birth

SSN Last 4

Relationship

More than 4 dependents? Add a note at the bottom.

Income Sources

Check all income types you received during the tax year

Income notes (optional)

Compliance & Disclosure

Required IRS disclosures — answer Yes or No for each item

Digital Assets / Cryptocurrency

Did you receive, sell, exchange, or otherwise dispose of any digital asset (crypto, NFT, staking rewards) during the year?

Yes No Not Sure

Foreign Bank & Financial Accounts (FBAR / FinCEN 114)

Did you have a financial interest in, or signature authority over, any foreign bank, securities, or other financial accounts with an aggregate value exceeding $10,000 at any point?

Yes No Not Sure

Foreign Trusts & Entities

Were you the grantor of, or transferor to, a foreign trust? Did you receive a distribution from, or were treated as an owner of, a foreign trust?

Yes No Not Sure

Deductions & Credits

Check all that may apply — eligibility and amounts are confirmed during your consultation

Potential Itemized Deductions (Schedule A)

Mortgage Interest (Form 1098) Real Estate / Property Taxes State & Local Income Tax (SALT) Unreimbursed Medical & Dental Expenses Charitable Contributions — Cash / Check Charitable Contributions — Non-Cash Charitable Contributions — Appreciated Securities Investment Interest Expense Casualty / Disaster Loss (federally declared)

Above-the-Line Adjustments

HSA Contributions (Form 8889) Student Loan Interest (Form 1098-E) Traditional IRA Contributions SEP-IRA / SIMPLE IRA Contributions Self-Employed Health Insurance Premiums Alimony Paid (pre-2019 divorce instrument) Educator Expenses (up to $300) Moving Expenses (active duty military only)

Potential Tax Credits

Child Tax Credit / Additional Child Tax Credit Child & Dependent Care Credit (Form 2441) American Opportunity Credit (AOTC) Lifetime Learning Credit Clean Vehicle / EV Purchase Credit (Form 8936) Energy Efficient Home Improvement Credit Retirement Savings Contributions (Saver's Credit) Foreign Tax Credit (Form 1116) Earned Income Tax Credit (EITC)

Life Events

Check any significant events that occurred during the tax year — each can affect your return

Prior Year & Additional Notes

Optional but helpful context for your CPA

Who prepared your prior year return?

Prior year result (approximate)

Additional Notes or Questions

Individual Tax Strategy Intake

Personal Identity

Residency

Filing Status & Tax Year

Dependents

Income Sources

Compliance & Disclosure

Deductions & Credits

Life Events

Prior Year & Additional Notes