Taxes – Black Wealth Financial

Our goal is to help you pay the least amount of taxes legally possible. To help us achieve this goal, we are continuing to partner with Complete Tax Plus for all of your tax filing needs. To ensure optimum tax service and to maintain accurate records, please complete the following:
Taxpayer Full Name*
Taxpayer Social Security Number:*
Date of Birth:*
Date Format: MM slash DD slash YYYY
Spouse/Joint Filer Full Name
Social Security Number:
Date of Birth:
Date Format: MM slash DD slash YYYY
Home Address*
City*
State*
Zip Code*
Email Address*
Phone*
Dependents Information:
First Name MI Last Name Date of Birth SSN Relationship
Tax Preparation Service*
- Personal Tax Preparation
- Business Tax Preparation- Single Member LLC/Sole Proprietorship
- Business Tax Preparation- Form 1065 (Partnership/2+Member LLC)
- Business Tax Preparation- Form 1120s (S-Corp)
- Business Tax Preparation- Form 1120s (Corporation)
Filing Status:*
- Single
- Married Filing Jointly
- Head of Household
- Married filing Separately
- Qualifying Widower with Dependent Child
Your Occupation:*
Employer:*
Spouse Occupation:
Employer:
Did you have health insurance during the tax filing year?*
- Yes
- No
Please upload all applicable forms below:
Work:W2, 1099, 1099K, etc.
Drop files here or
Insurance: Yearly Statement
Drop files here or
Unemployment/Government:1099G
Drop files here or
Retirement:1099R
Drop files here or
School:1098T, 1098E
Drop files here or
Driver License/ Government Issued ID
Drop files here or
Charitable Giving: Receipt/Statement
Drop files here or
Property Taxes
Drop files here or
The most common items needed for filing have been listed above. You may have received additional forms/items not listed above that are required for filing. Please upload any additional form(s)/notice(s) pertaining to your 2019 income or taxes below:
Additional forms:
Mortgage Interest
Drop files here or
Additional forms
Drop files here or
Additional forms
Drop files here or
Additional forms
Drop files here or
Additional forms
Drop files here or
Additional forms
Drop files here or
If you are filing business income, please complete the following:
Business Income
- Yes
- No
Business Name:
Business Address:
Business Gross Income:
Advertising Expenses:
Office Expenses:
Cell Phone Annual Expense:
Commissions & Fees:
Rent or Lease:
Repair & Maintenance amount:
Travel:
Meals:
Vehicles, Machinery, Equipment:
Office Expenses:
Utilites:
Wages:
Legal & Professional Services:
If work from home, office square footage:
Upload Receipts:
Drop files here or
Additional Notes/Additional Info
If you are due an income tax refund, how would you like it to be received?*
- Check
- Deposit
- Card
If you would like to have your income tax direct deposited, enter your info below:
Bank Name:
Routing #:
Account #:
Account Type
- Checking
- Saving
I attest that all information provided on this intake form is true and accurate to the best of my knowledge and is subject to possible IRS and/or State review. You will receive a cost estimate for income tax filing fees prior to filing. I understand that I am solely responsible for all tax filing fees due at the time of service no later than 30 days after transmission of information to the IRS. Complete Tax Plus, LLC will take all necessary steps to collect unpaid filing fees and outstanding debts (including reporting to our collection department).
Name:*
Date:*
Date Format: MM slash DD slash YYYY
Phone
This field is for validation purposes and should be left unchanged.

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First Name	MI	Last Name	Date of Birth	SSN	Relationship

Please upload all applicable forms below:

Additional forms:

If you are filing business income, please complete the following:

If you would like to have your income tax direct deposited, enter your info below: