2026 Tax Client Intake Form

Client Engagement Letter

Thank you for choosing D&R Tax Service. Before we begin preparing your tax return, please review and sign this engagement letter.

We will prepare your federal and state individual income tax returns based on the information you provide. We do not audit documents, but we may ask for clarification. You are responsible for maintaining all supporting records.

We provide services only after you have completed and signed the Client Intake Form and this Engagement Letter, acknowledging and agreeing to the terms.

Once your return is completed and sent to you for signature, it is no longer considered a quote. Preparation fees are due whether or not you choose to sign or file the return with us.

If we do not receive all of your tax information by March 31, we can file a complimentary extension upon request. An extension provides more time to file, but not more time to pay any taxes owed. Information received after March 31 may incur additional fees if completion is required by April 15. For extended returns, all information must be received by September 30.

Our fees do not include responding to IRS or state inquiries or representing you in an audit. Representation services are available under a separate engagement unless you are enrolled in our Audit Protection Program.

Backend Fees: Your return may include additional backend fees such as service bureau fees, transmitter fees, technology fees, bank fees, e-file fees, and other related processing charges. These fees are standard industry fees and will be outlined clearly in your final tax return documents.

Completed returns are provided through the customer portal. An email copy can be provided upon request. Additional copies beyond the second copy may incur a fee.

Payment is due when services are rendered. While we cannot guarantee the outcome of your return, we work to ensure you receive all deductions and credits to which you are entitled.

If you agree to these terms, please sign and return this letter. We look forward to serving you.

D&R Tax Service

Today's Date: *

Please Choose Your Tax Professional: *

Robyn Davis
Samantha Cook
Natasha White
Keamber Victoria
Dorian Jenkins
Durell Cole
Phillip Thompson
Theresa Jacob
Jonathan Sims
Victoria Haley
Cassandra Schneider
Dominique Roper
Frances Martinez
Carley Morrison
Angelique Bryan
Aaliyah Anglin
Latina Hollingshed
Chasittie Tanner
Stephanie Kem
Elizabeth Neal
Roneeca Kelly
Alzeez Hamzat
Hailyn Renfro
Olivia Lowden
Jamylah Miller
Darren Disroe
Shanterica Williamson
Nicole Brantley
Taborah Pullen
Satoya Smith
Ninita Fletcher
Arnasia Kelly
Type an Option
No elements found. Consider changing the search query.
List is empty.

Please Select The Tax Pro You're Currently Working With To Continue.

How did you hear about us? *

Facebook

Instagram

Referral

Returning Client

If someone referred, you please list the name.

Did you file a tax return last year? *

Yes

No

Please Upload a Copy of Previous Year Tax Return (2025) *

A copy of your previous tax return is required to receive services from D&R Tax Service..

Taxpayer Information

Filing Status *

Single

Head Of Household

Married Filling Separate

Married Filling Joint

Qualifying Widower

Taxpayer Name *

First Name

* *

Last Name

Taxpayer SSN *

example:000-00-0000

Taxpayer Date OF Birth *

example:12/31/2000

Taxpayer Phone Number *

Example: 222/326/4444

Address

Taxpayer Address *

Street Address

*

City

*

State / Province

*

Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Cote D"Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic Of
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea People's Democratic Republic
Republic of Korea
Kuwait
Kyrgyzstan
Land Islands
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macao
North Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Federated States of Micronesia
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Eswatini
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
UK
Ukraine
United Arab Emirates
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
No elements found. Consider changing the search query.
List is empty.

Country

*

Postal / Zip Code

Taxpayer Occupation *

Example: job title

Taxpayer Email *

Example: [email protected]

Spouse Name

Spouse SSN

Spouse Date of Birth

Spouse Email

Spouse Occupation

Income Information

What Income Documents Are You Submitting? *

W2 Form(s)

Any 1099 Forms

Self-Employment Documents

Household Employee

Unemployment Income

Select all that apply.

Gross Business Income Received in 2025: *

Example: $15,000.00

Please list all your business expenses here. *

Example: Advertisement $25.00, Office Supplies $100 etc.

Due Diligence Questionnaire

Did you and your spouse live apart this year? *

Yes

No

NA / No Spouse

Did you pay over half the expenses to maintain your home for the entire year? *

Yes

No

Did you support a child(ren)or family member at least 6 months out the year? *

Yes

No

If yes, did you live together at any time after June 30,2025? *

Yes

No

Have you ever been denied the Earn Income Tax Credit or Child Tax Credit? *

Yes

No

Did you receive any government assistance?

Section 8

Rental Assistance

Can someone else claim you as a dependent? *

Yes

No

Dependent Information

Dependent #1 Name *

First Name

Last Name

Dependent #1 Date of Birth *

Dependent #1 SSN# *

Relationship to the dependent *

Dependent #2 Name *

First Name

*

Last Name

Dependent #2 SSN# *

Dependent #2 Date of Birth *

Relationship to the dependent

Dependent #3 Name

First Name

Last Name

Dependent #3 SSN#

Relationship to the dependent

Dependent #4 Name

First Name

Last Name

Dependent #4 SSN#

Dependent #4 Date of Birth

Relationship to the dependent

If you have additional dependents, please list them here. Name, Date of Birth, Social Security Numbers and Relationship.

How many months did the dependent(s) live in the same home as you? *

Are any dependent(s) in daycare? If yes, please upload the form that was provided to you from the daycare provider. *

Yes

No

Please upload a copy of your daycare form here. *

Browse Files

Drag and drop files here

Health Insurance Questionnaire

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

Yes

No

Please upload your marketplace insurance 1095-A form.

Browse Files

Drag and drop files here

College Questionnaire

Were you or any of your dependents enrolled in college in 2024?

Yes

No

Do you have the 1098-T form for either you or your dependent(s)?

Yes

No

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

Browse Files

Drag and drop files here

Banking Information

How would you like to receive your refund? *

Direct Deposit

Check

Prepaid Card

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

Checking

Savings

Name Of Bank? *

Routing Number *

Account Number *

Services Offered

Are you interested in the cash advance loan up to $7500.00 upon bank approval?

Yes

No

Are you interested in Audit Protection for $92.00?

Yes

No

Are you interested in Identity Theft Protection $39.95?

Yes

No

Are you interested in a free life insurance quote?

Yes

No

Tell me more about the service

IRS Identity Pin Information

Were you issued an Identity Pin from the IRS *

Yes

No

Please list your pin here.

Taxpayer’s Signature

Primary Taxpayers Signature *

Clear

Date *

Taxpayers Spouse Signature if applicable

Clear

Date *

Additional Information:

Do you have any questions? If so type here.

Documents to be uploaded. Please upload all the documents.

Taxpayer’s Drivers License *

Browse Files

Drop and drop files here

Taxpayer and dependent(s) Social Security card(s) *

Browse Files

Drop and drop files here

Taxpayer’s W-2 /1099’s *

Browse Files

Drop and drop files here

Self-Employment only! Expenses log,Summary of income etc *

Browse Files

Drop and drop files here

Dependent(s) Birth Certificate *

Browse Files

Drop and drop files here

Proof of Residency *

Browse Files

Drop and drop files here

Pathward Financial