New Individual Client Intake Form — JCox

New Individual Client Intake Form

Name

If joint return, spouse’s first name, middle initial, DOB, and SS#

First Name

Last Name

Date of Birth

Social Security Number

This field may be paced with 00-00-0000 if you have not signed your Engagement Letter.

Spouse's Name

If joint return, spouse’s first name, middle initial, DOB, and SS#

First Name

Last Name

Date of Birth

Social Security Number

This field may be paced with 00-00-0000 if you have not signed your Engagement Letter.

Email

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Select Services Needed

Most Recent Tax Return Filed

Are You Self-Employed?

Who prepared your most recent tax return for you?

Another CPA Firm

Enrolled Agent

Self-employed professional with a PTIN

Self-Prepared Using TurboTax

Self-Prepared Using H&R Block

H&R Block Tax Services

Jackson Hewitt Tax Services

Not Listed

Approximately how much did you pay for the preparation of your most recent tax return?

$

Approximately how much did you pay for your most recent accounting, advisory, or audit services?

$

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