LC Financial Solutions Individual Intake-Zera M

For Individual Tax Returns:

IMPORTANT: UPON COMPLETION OF ALL APPLICABLE PARTS OF THIS FORM YOU MUST CLICK THE "SUBMIT" BUTTON AT THE BOTTOM OF THE FORM TO SEND THIS INFO TO OUR OFFICE. CLOSING YOUR BROWSER BEFORE CLICKING THE "SUBMIT" BUTTON WILL DELETE ALL INFO WITHOUT SENDING TO US. IT SHOULD BE NOTED THAT UPON CLICKING THE SUBMIT BUTTON YOU WILL GET A CONFIRMATION EMAIL THAT WE RECEIVED YOUR INFO.

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

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This questionnaire has been divided into sections and may take you upto 30 minutes to complete. Organize all your tax documents and save yourself time when completing this form.

Are you a new or returning client? *

New Client

Returning Client

What year are you filing your taxes for? *

First Name *

Last Name *

Address *

City *

Postal code *

State *

County *

Phone *

Occupation *

Email *

Is the taxpayer, spouse or depended(s) can be claimed on any other tax return? *

Yes

No

IP PIN

Date of birth *

Date of death

As of December 31, were you a US citizen or resident alien? *

Yes

No

Social Security Number *

Social Security Card *

Upload your Social Security Card

Driver's license or State ID *

Upload your Driver's License (front and back, not expired)

What was your marital status on Dec. 31 2024? *

Single

Married

Separated

Divorced

Did your spouse pass away in 2024 and you did not remarry?

Yes

No

N/A

Spouse Full Name *

Spouse Date of Birth

Spouse Occupation

Spouse IP PIN

Spouse SSN *

Spouse Documents

Please upload all spouse docs here: SSN, Income, etc.

Did you or your family have health insurance at any time in 2024 FROM THE MARKETPLACE? HEALTHCARE.GOV * *

Yes

No

1095A

Upload the 1095A

1095B

Upload the 1095B .pdf, .docx, .doc

Property Taxes

Amount You Paid
Total Cost

Mortgage Interest Expense

Amount You Paid
Total Cost

Additional Expenses Paid

Were you or your dependent attending college and received a 1098-T?

Yes

No

Did the student complete the first 4 years of post-secondary education before 2024?

Yes

No

Was the student convicted, before the end of 2024, of a felony for possession or distribution of a controlled substance?

Yes

No

If yes, was the student enrolled at least half-time?

Yes

No

Please upload 1098-t and other docs providing tuition expenses

Please upload 1098-T and other docs proving college expenses paid.

Bank Name *

Account Number *

Routing Number *

Please add proof of Direct Deposit Information. Example: Screenshot of bank information, PDF of Statement, Voided Check, or Deposit Form *

Please add proof of Direct Deposit Information. Example: Screenshot of bank information, PDF of Statement, Voided Check, or Deposit Form

How would you like to pay your tax prep fees? *

Upfront

Payment Plan ($100 upfront, rest due upon filing)

With refund if applicable (Additional Fees added)

Engagement Letter

SIGN IN BOX BELOW WITH YOUR MOUSE OR A STYLUS IF USING A TOUCHSCREEN ENABLED DEVICE

Please sign indicating agreement with the above engagement letter

Engagement Letter Signature *

Clear

CONSENT TO USE OF TAX RETURN INFORMATION

Consent Signature *

Clear

CONSENT FOR PAYMENT FORM

SIGN IN BOX BELOW WITH YOUR MOUSE OR A STYLUS IF USING A TOUCHSCREEN ENABLED DEVICE

Please sign indicating:

Information provided is true to best of my knowledge. I give permission to use information to process my 2024 tax return. I understand if, my refund is offset, I am still responsible for payment for services that have been provided, and will pay the amount owed immediately.

Signature *

Clear

Earn a CASH Referral by Recommending Our Tax Services to Your Network! At our company, our loyal customers are the driving force behind our growth. That's why we're offering you a CASH referral for every friend or family member you refer to us. If you know anyone who needs assistance preparing their taxes and getting the maximum refund they're entitled to, please share their name and phone number with us. We kindly ask that you provide at least one referral to help us continue providing the best possible service.

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