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Client Intake Form
Full Name
(required)
Telephone Number
(required)
Alternative Telephone Number
Email Address
(valid email required)
Complete Address
(required)
Filing Status
Single
Married
Head of Household
Have you ever been denied the Earned Income Tax Credit?
Yes
No
Can anyone else claim you as a dependent?
Yes
No
Deductions for Schedule A
Do you have any dependents?
Yes
No
Name, Birthday, Social Security Numbers of all dependents
Do you own a business?
Yes
No
Do you own your own home?
Yes
No
Have you made any charitable donations?
Yes
No
Do you have medical and/or dental premiums?
Yes
No
How do you prefer to receive your refund? Check or Direct Deposit
In order to consent to having your Taxes filed by FIG Tax Group, please type your full name.
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