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ATF Document Intake Form

2025 Tax Client Intake Form

How did you hear about our services?

Referral

Returning Client

Social Platform

If someone referred you, please list the name.

Select Tax Preparer

Select Income type (Select that apply) *

W-2

Unemployment

1099 NEC / Self-Employed

1099R

Select Language *

Taxpayer Information

Filing Status

Single (Yourself ONLY)

Head Of Household (You and Dependents)

Married Filling Separate

Married Filling Joint

Qualified Surviving Spouse

Taxpayer Name *

First & Last Name

Taxpayer Phone Number *

Example: 222/326/4444

Taxpayer Email *

Example: [email protected]

Taxpayer SSN *

example:000-00-0000

Taxpayer Occupation *

Example: job title

Taxpayer Date OF Birth *

example:12/31/2000

Address

Taxpayer Address

Street Address

City

State / Province

Country

Postal / Zip Code

Additional info for preparer

Taxpayer Spouse Information

Spouse Name *

Spouse SSN *

Spouse Date of Birth *

Spouse Phone Number *

Spouse Email *

Spouse Occupation *

Dependents

Do you have any Children/Dependents *

Yes

No

How many dependants do you have

1

2

3

Did dependents attend daycare?

Yes

No

Dependents # 1

Dependent #1 Name

Dependent #1 Date of Birth

Dependent #1 SSN#

Relationship to the dependent

How many months did dependent # 1 live with you in 2025?

Did you provide more than 50% of dependent 1’s total support in 2025?

Yes

No

Dependent # 2

Dependent #2 Name

Dependent #2 Date of Birth

Dependent #2 SSN#

Relationship to the dependent 2

How many months did dependent # 2 live with you in 2025?

Did you provide more than 50% of dependent 2’s total support in 2025?

Yes

No

Dependent # 3

3Dependent #3 Name

Dependent #3 SSN#

Dependent #3 Date of Birth

Relationship to the dependent 3

How many months did this dependent # 3 live with you in 2025?

Did you provide more than 50% of dependent 3’s total support in 2025?

Yes

No

Education

Were you or any of your dependents enrolled in college in 2025? *

Yes

No

Do you have a 1098-T?

Yes

No

Did you pay tuition/books/education expenses?

Yes

No

Health Insurance Questionnaire

Did you or your dependent receive health insurance through the Affordable Care Act (Marketplace-OBAMA)? *

Yes

No

Banking Information

How would you like to receive your refund? *

Direct Deposit

Check

Prepaid Card (FREE)

Which type of account would you like to your refund deposited into?*

Checking

Savings

Name Of Bank? *

Bank Routing Number *

Bank Account Number *

IRS Identity Pin Information

Were you issued an Identity Pin from the IRS *

Yes

No

Please list your pin here. *

Documents to be uploaded.

Please upload all the documents.

Please upload your marketplace insurance 1095-A form.

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Identity Verification (Taxpayer’s Drivers License, State ID, or Passport) *

Browse Files

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )Drop and drop files here

Identity Verification (Taxpayer’s Spouse Drivers License, State ID, or Passport) *

Browse Files

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )Drop and drop files here

Taxpayer's Social Security card *

Browse Files

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )Drop and drop files here

Taxpayer's Spouse Social Security card *

Browse Files

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )Drop and drop files here

Taxpayer’s W-2/1099-R /1099-G /1099-DIV /1099-INT *

Browse Files

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )Drop and drop files here

Taxpayer’s Spouse W-2 /1099-NEC /1099-R /1099-G /1099-DIV /1099-INT / ETC *

Browse Files

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )Drop and drop files here

1099 NEC/Self-Employed *

Browse Files

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )Drop and drop files here

Unemployment *

Browse Files

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )Drop and drop files here

Children/Dependent Social Security card *

Browse Files

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )Drop and drop files here

Dependent(s) Birth Certificate *

Browse Files

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )Drop and drop files here

Dependent Residency (Proof that child lived with you for more than 6 months out of the year) - School records, Daycare records, Medical records, Government or benefit letters, Notarized statement from parent or legal guardian (if applicable) *

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )

Household Cost & Support (Proof you paid or contributed to the cost of maintaining the household) - Lease agreement, mortgage statement, electric, gas, water, or internet bil property tax statement, rent receipts *

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 5 Files )

If you have your 1098-T form, please upload here. *

Browse Files

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 10 Files )Drag and drop files here

Marriage Certificate (This document is not required and is not mandatory to file your tax return. However, if you have access to it, uploading your marriage certificate is strongly recommended.Having this document on file can be helpful if the return is ever selected for review or audit, as it supports verification of legal marital status.)

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

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Your Taxes. Your Money. Your Future.

2210 Goldsmith Lane, Unit 221C

Louisville, KY 40218

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(502) 586-5755

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