Client InformationClient Name (Preferred Contact if multiple taxpayers) REQUIRED *
Email Address:
Phone Number
Do you have a date by which you need your return (due to travel, FAFSA, other circumstances?) If yes, provide the date below.
Please indicate your preferred means of communication.def_rad_optEmailPhone
Annual Verifications Taxpayer Occupation:
Spouse Occupation:
Did your address change? If yes, provide your new address and move date below. REQUIRED *NoYes
Move date:
New address:
Did you receive an Identity Protection PIN from the IRS? If yes, please provide a copy of the PIN letter.def_rad_optNoYes; PIN letter will be provided.
Have you received any other letters from the state or IRS? If so, please provide copies of these letters.def_rad_optNoYes; letter(s) will be provided.
Is your banking information the same as last year?def_rad_optNo; I will provide the required details.Yes; I will confirm that information below.
Bank Name:
Last 4 digits of the Account Number:
Do you own or have signing authority over a foreign bank, brokerage or trust
account? REQUIRED *NoYes; I will provide the required details
Did you earn, sell, or exchange virtual currency (Bitcoin, etc.)? REQUIRED *NoYes; I will provide details.
Did you lose money investing in FTX virtual currency in 2022?def_rad_optNoYes, I will provide details
Did you make any gifts of more than $16,000 to any individual?def_rad_optNoYes
Did you purchase a qualified plug-in electric vehicle? def_rad_optNoYes; I will provide details.
Did you make energy efficient improvements to your main home? Lifetime limits are still in effect through 2022 - If you have received a credit in the past, check “no”. def_rad_optNoYes
Did you pay for child care? If yes, we will need the amount paid. For new
caregivers, provide their name, address and tax ID number.def_rad_optNoYes; I will provide details.
Do you have dependents who earned interest, dividends and/or capital gains income over $1,150?def_rad_optNoYes; I will provide details.
Changes to Personal InformationHave there been any changes to your personal information?def_rad_optNo; skip to the next sectionYes
Should we add or remove a spouse or dependent? Contact us with any questions. def_rad_optNoYes; I will provide details.
If you are divorced or separated with child(ren), are you the custodial parent?def_rad_optNo, I am not the custodial parentYes, I am the custodial parentNA
Do you have dependents who must file a tax return? If they filed a return,
forward a copy so we can verify that they did not claim themselves. def_rad_optNoYes; I will provide a copy of the return.
Self-Employed Credits and DeductionsAre you self employed?def_rad_optNo; skip to the next sectionYes
Did you pay health insurance for your employees this year? def_rad_optNoYes
Did you pay for your own health insurance premiums?def_rad_optNoYes
How much were your annual premiums?
Are you eligible for health insurance coverage through your spouse's employer?def_rad_optNoYes
Did you receive forgiveness of a Paycheck Protection Program (PPP) loan in 2022? If so, please provide details. def_rad_optNoYes
Did you use an area of your home solely and exclusively for business?def_rad_optNoYes
Did you pay any unincorporated entity $600 or more in cash or checks? def_rad_optNoYes; I will require Forms 1099.Yes; I have filed my Forms 1099.
Do you want us to compute your maximum SEP or Solo 401K contribution? def_rad_optNoYes
List the amount, if any, of SEP or Solo 401(k) retirement contributions made
in 2022 for the 2022 tax year:
Education and Education Savings Plans Is this section applicable to you?def_rad_optNo; skip to the next sectionYes
Did you, your spouse, and/or your child(ren) attend post-secondary school? If yes, provide Form 1098-T from the college. def_rad_optNoYes; I will provide the 1098-T.
Did you make any withdrawals from an education savings or 529 Plan account?
If yes, please provide Form 1099-Q. def_rad_optNoYes; I will provide the 1099-Q.
Did you make contributions to your resident state's education savings or 529
plan? If yes, provide details below.def_rad_optNoYes
2022 Contributions to resident state 529 plans: beneficiary name(s), account number(s) & amount(s)
Did you pay student loan interest? If yes, provide Form 1098-E.def_rad_optNoYes; I will provide Form 1098-E.
Itemized Deduction Information Which option applies to your situation?def_rad_optMarried, with deductions less than $25,900; skip to the next sectionSingle, with deductions less than $12,950; skip to the next sectionHead of Household, with deductions less than $19,400; skip to the next sectionNone of the above; continue to fill out this section
Did you pay real estate taxes on any of your properties? If yes,
provide details. def_rad_optNoYes; I will provide details.
Did you pay mortgage interest on your primary and/or secondary home? If yes,
provide Form 1098. Please provide year-end balances on all mortgages below.  def_rad_optNoYes; I will provide details.
2022 Year-End balances of mortgages. Note - The amount in Box 2 is the 2021 ending balance.
Did you purchase, sell, refinance, or take out an equity loan on real estate? If so, provide
the settlement statement. def_rad_optNoYes; I will provide the settlement statement.
Did you pay out-of-pocket medical expenses (including health insurance
premiums) that may exceed 7.5% of your income? If yes, provide details and keep all receipts for your records. def_rad_optNoYes; I will provide details.
Did you make cash charitable contributions? Provide letters from charities
for donations over $250. Keep all receipts or cancelled checks for your records. def_rad_optNoYes; I will provide details.
Did you make non-cash charitable contributions? Provide lists of items and
their thrift-shop values. For donated vehicles, provide Form 1098-C. def_rad_optNoYes; I will provide details.
Retirement and Retirement Accounts Is this section applicable to you?def_rad_optNo; skip to the next sectionYes
Did you receive Social Security or Retirement income this year? For Social
Security, provide Form 1099-SA. For other retirement plans, provide 1099-R. def_rad_optNoYes; I will provide the form(s.)
If this was the first year receiving social security benefit payments, how many months of payments did you receive in 2022?
Did you make any IRA contributions to retirement accounts that were not made through an employer? If so, provide details. def_rad_optNoYes; I will provide details.
IRA contributions amount (indicate Traditional or Roth IRA.)
Did you contribute to charity directly through an IRA? Provide details.def_rad_optNoYes; I will provide details.
Do you want us to compute your maximum Regular or Roth IRA contribution?def_rad_optNoYes
Healthcare and Healthcare Accounts Is this section applicable to you?def_rad_optNo; skip to the next sectionYes
Did you obtain Marketplace health insurance through healthcare.gov? If yes,
provide Form 1095-A. def_rad_optNoYes; I will provide the Form 1095-A.
Did you or did you employer make contributions to your Health Savings
Account (HSA)? If so, provide Form 5498-SA. (This does not apply to Flexible
Savings Accounts, or FSAs, which must be spent during the year.)def_rad_optNoYes; I will provide the Form 5498-SA.
Did you use funds from your Health Savings? If so, provide Form 1099-SA.
(This does not apply to Flexible Savings Accounts.) def_rad_optNoYes; I will provide the Form 1099-SA.
Are you a Maryland resident who purchased a new Long-Term Care policy this
year? Please provide details. (Maryland credit is only for the first year of
the policy.)def_rad_optNoYes; I will provide the details.
Head of Household, Child Tax Credit, or Earned Income Credit. If you have no dependents, check "no" and skip to the next section.def_rad_optNo; skip to the next sectionYes
Have any of the above credits been denied in a previous year? def_rad_optNoYes
Can anyone else (other than your spouse) claim your child as a dependent?def_rad_optNoYes
Did your child live with you for over half the year?def_rad_optNoYes
Are you single and claiming Head of Household in 2022? Contact us with
questions regarding eligibility.def_rad_optNoYes
Looking Forward to Next Year Do you expect a large fluctuation in income, deductions or withholding next year? If so, please explain below. REQUIRED *NoYes; details provided below.
Expected fluctuations in income, deductions or withholding for 2023.
Do you need quarterly estimated tax payment vouchers for 2023? def_rad_optNoYes
Will you be taking out a Required Minimum Distribution in 2023?def_rad_optNoYes; details in the following questions
If you will be taking out a Required Minimum Distribution in 2023,
please provide the estimated amount:
If you will be taking out a Required Minimum Distribution in 2023,
please provide the percentage of Federal tax withholding:
If you will be taking out a Required Minimum Distribution in 2023,
please provide the percentage of State tax withholding:
Will 2023 be the first year you will start collecting social security
benefits?def_rad_optNoYes; details in the following questions
If 2023 will be the first year you will start collecting social security
benefits, please provide estimated date to start:
If 2023 will be the first year you will start collecting social security
benefits, please provide estimated monthly amount:
If 2023 will be the first year you will start collecting social security
benefits, please provide estimated Federal withholding:
If you are entitled to a refund, would you like to have some or all of it
applied to your 2023 estimated tax liability?def_rad_optNoYes
2022 Quarterly Estimates Is this section applicable to you?def_rad_optNo; skip to the next sectionYes; details in the following questions
Federal; 1st Quarter Date:
1st Quarter Amount:
2nd Quarter Date:
2nd Quarter Amount:
3rd Quarter Date:
3rd Quarter Amount:
4th Quarter Date:
4th Quarter Amount:
Your State; 1st Quarter Date:
1st Quarter Amount:
2nd Quarter Date:
2nd Quarter Amount:
3rd Quarter Date:
3rd Quarter Amount:
4th Quarter Date:
4th Quarter Amount:
Additional State, if any; State Name & 1st Quarter Date:
1st Quarter Amount:
2nd Quarter Date:
2nd Quarter Amount:
3rd Quarter Date:
3rd Quarter Amount:
4th Quarter Date:
4th Quarter Amount:
When we have completed your 2022 returnsChoose a method to receive your copy of your completed 2022 tax returns:def_rad_optPick upMailElectronic copy
Choose a method to have your original
documents returned:def_rad_optPick upMailElectronic Copy
Please list any unusual tax events for this or the upcoming year, or include any details you'd like to share.
For our scheduling purposes for 2023 returns, please choose the earliest week that
you will be ready for return preparation: REQUIRED *Week 6 - 2/2/2024Week 7 - 2/9/2024Week 8 - 2/16/2024Week 9 - 2/23/2024Week 10 - 3/1/2024Week 11 - 3/8/2024Week 12 - 3/15/2024Week 13 - 3/22/2024Week 14 - 3/29/2024Week 15 - 3/29/2024
Electronic Signature Agreement REQUIRED *I agree that my electronic signature below is the legal equivalent of my manual signature on this form. Leaving the following field blank is a refusal to sign this form.
Electronic Signature

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