Nikki Banks Remote Tax Prep

For Verification & Security purposes, please take a clear picture of yourself and upload it here *

For Verification & Security purposes, please take a clear picture of yourself and upload it here

Primary Taxpayer Full Name *

Phone *

Primary Taxpayer Social Security Number *

Email *

Primary Taxpayer Date of Birth *

Upload your Social Security Card *

Street Address *

City *

State *

Country *

Postal code *

Upload Proof of Address (Utility Bill) *

Primary Occupation *

Were you married as of 12/31? *

Yes

Can you be claim as another dependent on another tax return? *

Are you required to file taxes using an Identity Protection PIN (IPPIN)? *

Yes

Upload Identity Protection PIN letter

Did you file your 2024 Tax Return? *

If this is your first year filing with us? please Upload your 2024 Tax return

Have you ever had EARNED INCOME CREDIT DISALLOWED by the IRS? *

Was your tax return offset last year? *

Did you receive your expected refund ? *

Did you or anyone in your household receive Health Insurance through the Healthcare Marketplace?

Yes

Upload 1095-A

Spouse Date Of Birth

Spouse Social Security Number

Upload spouse Social Security Card

Spouse Full Name

Spouse’s Contact Number

Spouse Email

Is your address the same as primary?

If no, please list full address ( address city, state and zip code)

Spouse Occupation

Spouse Driver License

Spouse are you required to file taxes using an Identity Protection PIN (IPPIN)?

Spouse Upload Identity Protection PIN letter

Spouse did you file your 2024 Tax Return?

yes

Spouse,If this is your first year filing with us? please Upload your 2024 Tax return

yes

Spouse, Was your tax return offset last year?

Spouse, Did you receive your expected refund ?

Are you claiming any dependents that you provided MORE THAN HALF the support for? If so, fill out their information below:

Dependent Child 1

Dependent Full Name
Date of Birth (00/00/0000)
Social Security Number
Relationship to taxpayer
Full Legal Name(s) of Biological Parent(s):
# of months dependent live with you
Was this dependent disable?
Did Dependent lived with Taxpayer? (yes/no)
Dependent did not live with Taxpayer due to divorce/ other agreement? (yes/no)
Dependent is taxpayers parent? (yes/no)

Dependent Child 2

Dependent Full Name
Date of Birth (00/00/0000)
Social Security Number
Relationship to taxpayer
Full Legal Name(s) of Biological Parent(s):
# of months dependent live with you
Was this dependent disable?
Did Dependent lived with Taxpayer? (yes/no)
Dependent did not live with Taxpayer due to divorce/ other agreement? (yes/no)
Dependent is taxpayers parent? (yes/no)

Dependent Child 3

Dependent Full Name
Date of Birth (00/00/0000)
Social Security Number
Relationship to taxpayer
Full Legal Name(s) of Biological Parent(s):
# of months dependent live with you
Was this dependent disable?
Did Dependent lived with Taxpayer? (yes/no)
Dependent did not live with Taxpayer due to divorce/ other agreement? (yes/no)
Dependent is taxpayers parent? (yes/no)

Dependent Child 4

Dependent Full Name
Date of Birth (00/00/0000)
Social Security Number
Relationship to taxpayer
Full Legal Name(s) of Biological Parent(s):
# of months dependent live with you
Was this dependent disable?
Did Dependent lived with Taxpayer? (yes/no)
Dependent did not live with Taxpayer due to divorce/ other agreement? (yes/no)
Dependent is taxpayers parent? (yes/no)

Upload Social Security Card(s) for each dependent

If you have joint custody do you have a signed IRS Form 8332?

Per IRS is now requiring us for an explanation on the other parent or Non Custodial Parent? Please provide a brief description of the other parent (Non Custodial, Incarcerated, Non Involve, Child is Solely in my care)

Are the dependents your claiming your biological child

If No, Why are the parents not claiming the child?

If yes, who? and how much?

Did anyone else help you support your dependents during the year?

Will you claim the CHILDCARE DEDUCTION for this tax year?

Upload Daycare Statement.

Do you receive ANY supplemental, nontaxable income such as Child Support,Food Stamps, Medicaid/ Medicare, TANF, Social Security, or Disability

If yes, how much?(Please list each type that applies along with the amount)

Did your dependent attend college?

Upload 1098-T Form.

Do you own or rent? *

Own

Rent

Upload Mortgage Interest Statement (Form 1098)

Did you pay Mortgage Interest for your home in 2025?

yes

Did you have any MEDICAL/DENTAL expenses in 2025

(Please provide detailed list)

Upload Expenses

Cash Contributions (If over $500 )

(Please provide detailed list Cash Contributions (If over $500 )

Upload Cash Contributions (If over $500 )Expenses

Non- Cash Contributions (If over $500 )

Miscellaneous Expenses, Unreimbursed Business Expense

(Please provide detailed list Miscellaneous Expenses, Unreimbursed Business Expense)

Upload Miscellaneous Expenses, Unreimbursed Business Expense

Volunteer Mileage Driven

Are you, your spouse, or any dependent listed on your tax return disabled?

If yes, what is the nature of the disability?

Has this dependent been declared disabled by a physician?

If yes, can you provide documentation?

Are you or your spouse listed as the Social Security Representative Payee for this dependent?

Is this the dependent(s) expected to recover in the next year?

Will you claim the DEPENDENT CARE DEDUCTION for the disabled dependent

If yes, full legal name, social security (TAXID), address and amount per disabled dependent paid:

Did you pay out of pocket for any uncovered Medical Expenses for the disabled dependent,

If yes, enter the amount for 2025?

Were you employed during 2025? *

Upload W2

Were you self-employed during 2025? *

At any time during 2025, did you or your spouse: (a) receive ( as a reward, award, or payment for property or services); or (b) sell, exchange, gift, or otherwise dispose of a digital asset ( of a financial interest in a digital asset)?

Upload Form 1099-B.

Did you receive unemployment compensation during 2025? *

Upload Form 1099-G.

Did you, spouse, OR dependent attend college? *

Upload 1098-T and/or 1098-E

Did you, spouse, OR dependent have additional educational expenses

If yes, please (Please provide amount and detailed list)

Did you or anyone in your household receive SSI ?

Yes

Upload SSA-1099

Self-employed Name:

Business Name

Employer Identification Number (IF applicable) or SSN

Upload EIN documentation

Check appropriate box for federal tax classification

Is your business registered with the Secretary of State?

Business Full Address

Business Code https://www.irs.gov/pub/irs-pdf/i1040sc.pdf

Do you have any documents to substantiate your business (formation documents, bills incompany name, etc)?

Upload documentation showing proof of entity

Number of employees or contractors, not including you (If applicable)

How long have you owned your business?

Did you materially participate in the business in 2025?

Accounting Method

Did you make any payment in 2025 that would require you to file form 1099

If yes, did you or will you be filing all required 1099 forms?

Upload 1099 Form

Was your business disposed during the year?

Do you have a Profit and Loss Statement for your business?

Upload Profit and Loss Statement

If you were not able to upload Profit and Loss Statement. Can you provide proof of income and expenses?

File Upload receipts

Business Expenses Amount

Advertising
Car and truck
Commissions and fees
Contract labor (1099's)
Depletion
Depreciation and section 179
Employee benefit programs
Insurance (other than health)
Mortgage interests
Other Interest
Legal and professional services
Office expense
Pension and profit-sharing plans
Rent or Lease: Vehicles, machinery, and equipment
Rent or Lease: Other business property
Repairs and maintenance
Job Supplies
Taxes and licenses
Travel
Meals
Utilities
Wages (less employment credits)
Miscellaneous

What was your business gross income for 2025?

What was your business expenses for 2025?

Simplified method filers only sq ft

Enter the total square footage of (a) your home:
Enter the total square footage of the room used for business

Do you have a business vehicle? If so when was the vehicle purchased and the Make and Model? (MMDDYYYY)

Did you have to place your vehicle in service for business purposes? (MMDDYYYY)

Please put the name of Expense and the total amount. Example Phone $3,201.20List of other expenses

File Upload supporting documents

Signed your name for Affidavit for No Receipts OR Profit and Loss Statement *

Clear

Who Referred You?

CLIENT NON PAYMENT/OFFSET CLAUSE, we strive to assist all of our clients in their tax needs, however we understand that situations arise. If your refund is offset by the IRS, student loans, child support or your check is mailed, you are still obligated to pay our company the fees associated with filing your tax return. By signing this agreement you acknowledge that if payment is not made in full with in 30 days legal actions will be sought to resolve payment. I am giving Locked In Tax Services and/or associated affiliates permission to prepare all forms related to my tax return and I have signed all necessary forms to file my income tax return electronically. I take full responsibility for the accuracy of this client intake form and understand that Locked In Tax Services and/or associated affiliates hold no responsibility for any misrepresentation or false claims.

Primary Signature for CLIENT NON PAYMENT/OFFSET CLAUSE *

Clear

Spouse Signature for CLIENT NON PAYMENT/OFFSET CLAUSE

Clear