Thank you for taking the time to complete our intake package. For our new clients, this information is critical to ensure an accurate filing of your tax returns. We request that new clients submit at least prior year tax return (preferably two), to be used as comparison for your upcoming filing. For our existing clients, while we may have some of this information from past engagements, we kindly request you provide it again so we can make sure our records are 100% accurate and up to date. IRS compliance is crucial, and for those who have worked with us before you know that we work extrememly hard to get y0u every dollar that you deserve.

IMPORTANT: You are now able to create a login to submit your documents! This is meant to add to the convenience that our tax office provides. You can save and return at your leisure if you need to gather some of your documents. Upon completion of ALL parts of this form, you must click the "SUBMIT" button at the bottom of the form to transmit to our office. Closing your browser before clicking "SUBMIT" will delete all info without sending it to us. You will receive a confirmation email after submission to ensure that we received your info.

Please also note that our firm will ask for a valid government-issued photo identification during your engagement to comply with federal and state identity theft protection efforts.

***We use industry-leading technology Secured Socket Layer (SSL) to keep your information safe. All sensitive information is securely transmitted, encrypted, and can not be compromised.

Terms and Conditions *

You consent to receive communications from us electronically. We will communicate with you by e-mail or phone. You agree that all agreements, notices, disclosures and other communications that we provide to you electronically satisfy any legal requirement that such communications be in writing.

Client Engagement Letter

Engagement Letter for Tax Return Amendment Services

JBH Financial Services

Jasmine Boney-Henderson, Tax Practitioner

Email: tax@jbhfinancialservices.com

Dear Valued Client,

This letter is to detail the terms of our engagement with you, and to clarify the nature and extent of the services we will provide. To ensure an understanding of our mutual responsibilities, we ask all clients for whom returns are prepared to confirm the following arrangements.

By providing us with your signature, you are accepting the terms and conditions specified in this letter.

We will amend your federal and state income tax returns from the information you supply. We will not audit or otherwise verify the data you submit, however it may be necessary to ask you to clarify some of the information that you have submitted. We will supply you with guides to assist you in gathering the information required to accurately complete your return. We reserve the right to assess additional bookkeeping charges if necessary.

It is your responsibility to provide all of the information required for the preparation of complete and accurate returns. You should retain all documents that form the basis of income, expenses, credits, and deductions. These may be necessary to prove the accuracy and completeness of the returns to a taxing authority. We will keep a copy of all documents as a precaution, so as to be readily available in the event that they must be submitted on your behalf.

Ultimately, you are responsible for the filing of your income tax returns and, therefore, you should review them carefully before you signing and approving for IRS transmission.

Our work in connection with the preparation of your income tax returns does not include any procedures designed to discover defalcations and/or irregularities, should any exist. We will render such bookkeeping assistance as necessary to prepare your income tax return.

There are various penalties that may be imposed when taxpayers understate their tax liability. If you would like information on the amount or the circumstances of these penalties, please review the IRS website.

Your returns may be selected for review by the taxing authorities. Any proposed adjustments by the examining agent are subject to certain rights of appeal. We offer optional audit protection at an additional cost.

You attest that you understand that this information is being provided to the IRS and state tax authorities. You attest that your tax preparer advised that any false and misleading information that you provide for income tax filing purposes is against the law and is subject to penalties. You understand that JBH Financial Services is only liable for any errors and omissions on their part and responsible for any interest and penalties and not tax due.

If you are in agreement with the conditions set forth above, please sign this letter in the space indicated. This letter will apply for all tax returns prepared for you by our tax preparers.

We want to express our appreciation for this opportunity to work with you.

Sincerely,

JBH Financial Services

Please sign affirming your agreement to the statement(s) above: *

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Client Status

For which tax year are you submitting documents? *

Do not attach documents that are not for the tax year you have selected. If you need more than one year amended, please create a separate submission for each year.

Were you referred by someone? *

Yes

No

Please list referrer's name *

Upload Tax Return

Attach Filed Tax Return

Taxpayer Demographic Info

Primary Taxpayer's
Social Security Number *

First Name *

MI

Last Name *

Street Address *

Apt Number (if applicable)

City *

State *

Zip Code *

Phone Number *

Secondary Phone Number

Email Address *

Date of Birth * +

Occupation *

Please upload a copy of your driver's license/ID *

Amendment Details

Please list the reason(s) for amending your return *

Do you need to change your filing status? *

Yes

No

Do you file married on your original return? *

Yes

No

Do you need to change the number of dependents on your tax return? *

Yes

No

Spouse's Demographic Information

First Name *

Middle Initial

Last Name *

Email Address *

Date of Birth * +

Occupation *

Spouse's
Social Security Number *

Please upload a copy of your spouse's driver's license/ID *

Household Demographic Information

Please check ALL that apply: *

Taxpayer can be claimed as a dependent on someone else's return.

Taxpayer was over age 18 and a full-time student at an eligible educational institution.

Taxpayer was affected by a natural disaster during the current tax year.

Taxpayer has received, sold, sent, exchanged, or otherwise acquired financial interest in virtual currency during the current tax year.

N/A

Please check ALL that apply: *

Taxpayer/spouse withdrew money from 401k (1099-R)

Taxpayer/spouse received unemployment benefits (1099-G)

Taxpayer/spouse made payments on student loans (1098-E)

Taxpayer/spouse paid medical or dental expenses

Taxpayer/spouse received income from rental property

Taxpayer/spouse received gambling winnings (W2-G)

Taxpayer/spouse received taxable social security earnings (SSA-1099)

Taxpayer/spouse received interest income (1099-INT)

N/A

Do you receive any form of government assistance (SNAP/Food Stamps, TANF. Section 8/Housing Assistance, Utility Assistance, Medicaid/Medicare)? *

Yes

No

Please select form(s) of assistance received:

Please list monthly award amount for each government assistance program:

	Amount
SNAP/Food Stamps	Amount
TANF	Amount
Section 8/Housing Assistance	Amount
Utility Assistance	Amount
Medicaid/Medicare	Amount

Please upload government assistance award letters (if available)

Are you adding dependents to your tax return? *

Yes

No

Dependent Information

How many dependents will you be adding to your tax return?

1

2

3

4

Dependent Information

First Name *

Middle Initial

Last Name *

Date of Birth * +

Social Security Number *

Is this dependent a U.S. citizen, U.S. national, or U.S. resident alien? *

Yes

No

Relationship to
Taxpayer *

Number of Months Dependent Lived
in the Household * 🛈

Please select any that apply to this dependent:

This person was over age 18 and a full-time student at an eligible educational institution.

Check if this person was disabled.

This dependent made over $4,300 of income

Childcare/Dependent Care Expenses for this dependent

Upload Social Security Card, Birth Certificate, Proof of Guardianship, etc. for this dependent (If available)

Amount of Childcare/
Dependent Care Expenses

Child/Dependent Care Provider Information

Did you pay an individual or a business for child/dependent care?

Individual

Business

Child/Dependent Care Provider's Name

Street Address

City

State

Zip Code

Phone Number

SSN (Individual)/EIN (Business)

Amount of Childcare/
Dependent Care Expenses

Has anyone listed on your tax return been issued an IRS Identity Protection PIN? *

Yes

No

Stimulus & Advance Child Tax Credit Payments

Please make sure this information is accurate. If what you report differs from what the IRS has on file, your refund will be delayed 8-10 weeks and there is nothing our office can do to expedite processing. Attach a photo of your IRS notice or a screenshot of your Tax Record from the IRS online account.

If you have not yet set up an account using idME, please do so: https://www.irs.gov/payments/your-online-account

Amount of Childcare/
Dependent Care Expenses

Income Information

Upload ALL NEW Income Documents (W-2, 1099-G Unemployment Income, 1099-NEC Contract Income, Self-Employment Income, 1099-INT, etc.) *

Are you filing business/self-employment/side job/cash job income? *

Yes

No

Amount of Childcare/
Dependent Care Expenses

Self-Employment/Business Income and Expenses

How many businesses or sources of extra income will you be claiming on your return? *

Business Name (ONLY if you operate under a business name i.e. DBA, LLC, etc.)

Does your business have an EIN? *

Yes

No

EIN *

Would you like assistance applying for an EIN? *

Yes

No

Business Structure *

Business Type/Description *

Business Address (if different from your home address)

City

Upload Childcare/Dependent Expense Documentation for all dependents

State

Zip Code

If available, Please upload business registration documents (EIN Letter, DBA Assumed Name Certificate, Articles of Incorporation, Business License, etc.)

Business Income Information

Please upload copy of each PIN document

Amount of Gross Receipts/ Sales for Business *

If available, upload income documents (Paid Invoices, Bank Statements, Copies of Checks, etc.)

Is this your first year filing income on this business? *

Yes

No

Business Expense Information

Did you receive
the third stimulus payment
issued by the IRS
($1400 for you and dependents)? *

Yes

No

Did you make payments that require you to issue a 1099? *

Yes

No

How much was your payment? *

Have you already filed 1099 forms? *

Yes

No

If available, upload Notice 1444 from the IRS or copy of bank document showing deposit

Do you need help filing 1099 forms for this business? *

Yes

No

Did you receive
the first stimulus payment
issued by the IRS
($1200 for you and $600 for
dependents)? *

Yes

No

Is your business home-based? *

Yes

No

How much was your payment? *

Please list expenses related to your business (if you have a home-based business, these figures will be in relation to your home expenses)

	Amount
Advertising	Amount
Contract Labor	Amount
Commission and fees	Amount
Insurance (other than health)	Amount
Mortgage interest	Amount
Other interest	Amount
Legal and professional services	Amount
Office expense	Amount
Rent or lease of equipment	Amount
Rent or lease of property	Amount
Repairs and maintenance	Amount
Supplies	Amount
Taxes and licenses	Amount
Travel	Amount
Utilities	Amount

If available, upload Notice 1444 from the IRS or copy of bank document showing deposit

Do you use a vehicle to conduct business functions? *

Yes

No

Did you receive
the second stimulus payment
issued by the IRS
($600 for you and $600 for
dependents)? *

Yes

No

Do you have evidence to support business mileage? *

Yes

No

How much was your payment? *

Is this evidence written? *

Yes

No

If available, upload Notice 1444 from the IRS or copy of bank document showing deposit

Please list vehicle details below:

	Detail
Year of Vehicle	Detail
Make	Detail
Model	Detail
Mileage Used for Business Purposes	Detail

Did you receive advance child tax credit payments in 2021? *

Yes

No

N/A

If available, please upload any expense documents (i.e. receipts, invoices you've paid, 1099s issued for contract work, paid check items, mileage reports, etc.)

Amount of advance child tax credit payments you (and your spouse if filing jointly) received for 2021 *

By signing below I am attesting that the financial information provided to JBH Financial Services is true and accurate. The information listed on the Business Owner Worksheet is information given to the paid tax preparer to complete the return. I release the tax preparer from any negligence or responsibility pertaining to this return. I acknowledge that all information provided to JBH Financial Services is true and accurate to the best of my knowledge. I understand that I am required to have any supporting documentation to validate the information provided. Furthermore, I understand that knowingly providing false information on my tax return and reporting it to the IRS, that I am taking part in a potentially criminal penalty situation and is punishable by law including but not limited to: criminal charges, restitution, and possible imprisonment. I waive JBH Financial Services and the preparer of any error due to incorrect information provided by me. *

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Number of qualifying children accounted for in determining child tax credit amount you received for 2021 *

Business Name (ONLY if you operate under a business name i.e. DBA, LLC, etc.)

Upload IRS letter 6417 or screenshot of tax transcript showing payment disbursements

Does your business have an EIN? *

Yes

No

EIN *

Would you like assistance applying for an EIN? *

Yes

No

Business Structure *

Additional Tax Credit/Deduction Info

Do you plan to purchase a home within the next 12 months? * 🛈

Yes

No

Did you receive a 1098-T form from your educational institution? *

Yes

No

Would you like information on credit repair enrollment? *

Yes

No

Did you, your spouse, or a dependent purchase health insurance via HealthCare.gov or a State Marketplace? *

Yes

No

Please upload 1095-A form

Please upload any additional documents for credits/deductions (i.e. 1098-T school expenses, charitable donations, mortgage interest documents, 1099 documents, etc.)

Did you receive PPP funding? *

Yes

No

How much PPP funding did you receive? *

Has your PPP loan been forgiven? *

Yes

No

I would like to acknowledge tax-exempt income resulting from the forgiveness of my PPP loan. *

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Do you know of any potential offsets/garnishments to your tax refund (i.e. student loans, child support, past tax debt, etc.)? *

Yes

No

I give express written permission for a representative of JBH Financial Services to contact the IRS Offset Line to assess possible offsets that will affect disbursement of my tax refund. *

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Financial Information

Would you like to have preparation fees withheld from your refund, or would you like to pay upfront for tax preparation? *

I would like to pay preparation fees upfront

I would like to have my fees automatically withdrawn from my bank account as an authorized ACH

Bank Account Information

Bank Name *

Routing Number *

Account Number *

Upload copy of direct deposit form (if available)

Tax Credit Due Diligence Questionnaire

We ask that you compltete this due diligence questionnaire to ensure you are eligible to claim at least one of several valuable tax credits. While the questions may seem to be a little intrusive, they are questions that we are required to ask under the due diligence requirements of the new tax laws. We will keep your responses and documents on file, in the event the IRS should ever ask for them. Please complete them in as much detail as possible. Not all questions will apply to all taxpayers. If a question does not apply to you, please select the N/A (not applicable) option. This will ensure you reviewed the question.

FOR NEW CLIENTS with Dependents: Please remember to submit copies of social security cards, birth certificates and proof of residency (possibly school records or medical records showing the dependents name and your address)

FOR TAXPAYERS CLAIMING EDUCATIONAL CREDITS: Please remember to submit copies of the 1098-T issued from your institution, fee bill from of the bursar's office, and receipts for any other related educational expenses.

FOR TAXPAYERS CLAIMING HEAD OF HOUSEHOLD FILING STATUS:

Please include a copy of your lease, utility bills, etc. to substatiate your head of household claim.

Was the Earned Income Credit (EIC/EITC), Child Tax Credit (CTC), Additional Child Tax Credit (ACTC), or American Opportunity Credit (AOC) claimed by you disallowed or reduced by the IRS on a past tax return? *

Yes

No

What tax year was it disallowed? *

If you are a single parent, does you child(ren)'s other parent intend to claim them on their return?

Yes

No

N/A

Why is the child's other parent not claiming the child? *

COVID-19 Impact

Were you unable to work, or did you have to provide care for your children/dependents due to COVID-19 (i.e. school closure, quarantining, closures due to local/state regulations, unable to work due to lack of childcare, etc.) *

Yes

No

I/we, or my child(ren), have documentation to substantiate the credit(s) being claimed (you are responsible for keeping this documentation and providing it to the IRS if you are audited or questioned) *

Yes

No

Attestations & Disclaimers

Consent To Use
Federal law requires this consent form be provided to you (“you” refers to each taxpayer, if more than one). Unless authorized by law, we cannot use your tax return information for purposes other than the preparation and filing of your tax return without your consent. 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. 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 an arrangement with certain companies to offer an Electronic Refund Disbursement Service and/or Loan product. To determine whether these offerings may be of interest to you, we will need to use your tax return information. If you would like us to use your tax return information to determine whether these offerings are relevant to you while we are preparing your return, please sign and date this consent to the use of your tax return information. By signing below, you authorize us to use the information you provide to us during the preparation of your 2021 tax return to determine whether to offer you an opportunity to apply for the Electronic Refund Disbursement Service and/or Loan product. *

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Consent to Disclosure of Tax Return Information
Federal law requires this consent form be provided to you (“you” refers to each taxpayer, if more than one). Unless authorized by law, we cannot 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 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 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. You have indicated that you are interested in utilizing the Electronic Refund Disbursement Service and/or Loan product from Santa Barbara Tax Products Group. To provide you with the opportunity to apply for and/ or receive the Electronic Refund Disbursement Service and/or Loan product, we must disclose all of your 2021 tax return information to Refund Advantage (a division of MetaBank). You may request a more limited disclosure of tax return information, but you will not be eligible to submit an application for the Electronic Refund Disbursement Service and/or Loan product. If you would like us to disclose your 2021 tax return information to Refund Advantage for this purpose, please sign and date your consent to the disclosure of your tax return information.

By signing below, you authorize us to disclose to Refund Advantage all of your 2021 tax return information so that it can evaluate and process your application for the Electronic Refund Disbursement Service and/or Loan product. You understand that if you are not willing to authorize us to share your tax information with Refund Advantage, you will not be able to obtain the Electronic Refund Disbursement Service and/or Loan product, but you can still choose to have your tax return prepared and filed by us for a fee. If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by email at complaints@tigta.treas.gov.
*

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Consent for Payment
JBH Financial Services is not responsible in the event the taxpayer omits or provides incorrect information (i.e. social security numbers, names, dates of birth, etc.). These errors may delay your refund. JBH Financial Services does not control whether or not the IRS randomly selects your return for an audit, however all clients are welcome to purchase Audit Protection and we will always keep all necessary documents on file to dispute an audit on your behalf. All information obtained from the taxpayer and/or spouse must be submitted if the IRS audits your tax return.

JBH Financial Services is not responsible for any incorrect tax figures provided by the taxpayer and/or spouse. If your tax figures change you will need to submit an amendment. JBH Financial Services offers amendment preparation for an additional fee. If you have any overdue debts (i.e. school loans, child support, DPP, DFCS, etc….) that are scheduled to offset your refund, you will be required to pay your tax preparation fees upfront. You are able to call the IRS offset department at 1-800-304-3107 or 1-800-829-7650 to check the status of any scheduled offsets. If you are unaware of a potential offset and your refund is completely garnished, your prep fee will be drafted from the bank account you have on file with our office.

JBH Financial Services provides the taxpayer with ONE complimentary copy of their tax return. Should you need additional copies, there is a $15 fee per copy (federal and state included). Your tax return will always be available in the client portal for you to access when necessary. JBH Financial Services is not responsible for any changes the IRS or receiving bank may make on disbursement dates. JBH Financial Services is not responsible for any glitch issues that the IRS experiences that may cause a delay in receiving your tax refund. We DO NOT reimburse any bank fees in the event of this occurrence. *

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