Tax Advance Cash Services
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Wheres My Amended Return
Where is my Refund
X
In Take Form
Intake Form
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Step
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Personal Information
First Name
Middle Name
Last Name
Address
Apartment/Unit
City
State
Zip Cde
Cell Phone
Home Phone
Email
Birth Date
MM slash DD slash YYYY
Social Security Number
Driver License/I.D.#
Issued Date
MM slash DD slash YYYY
Expiration Date
MM slash DD slash YYYY
You’re filing status
Single
Married Filing Joint
Married Filing Separate
Head of Household
Qualifying Widow/Widower
Taxpayer Employer
Taxpayer Work Phone
Spouse’s First Name
Spouse’s Middle Name
Spouse’s Last Name
Address
Apartment/Unit
City
State
Zip Code
Cell Phone
Home Phone
Spouse’s Email
Spouse’s Birth Date
MM slash DD slash YYYY
Social Security Number
Spouse’s Driver License/I.D.#
Spouse’s Issued Date
MM slash DD slash YYYY
Spouse’s Expiration Date
MM slash DD slash YYYY
Residence State (List the state you resided in)
Non-Residence State (List any states in which you had taxes withheld, but were not a resident)
In case your contact information changes; we can contact you regarding your refund.
Facebook
Email
Yes
No
Did you live at your above listed address 6 months or more?
Did you file your taxes last year?
If so, did you receive a refund?
How did you file your taxes last year, Self-Employment or W-2?
Can you get a copy of your prior years return if needed?
Do you need to file FORM 8862 (stating that you were disallowed EIC previously)?
Did you have health insurance ?
Did your dependents have health insurance through your employer, state, or Obamacare?
Yes
No
Dependent Information
First Name
Middle Name
Last Name
Birth Date
Social Security Number
Relationship To You
Add
Remove
(If you have any dependents, list them in the area below. If you have more than four dependents, list the remainder on the reverse side. If any if your dependents did not live with you in 2016, please notify your preparer.)
Yes
No
Did all of your dependents stay with you at least 6 months?
Did you file these same dependents last year?
Do you have child care expenses?
Yes
No
Child Care Provider
Child Care Provider
Address
City/ State/ Zip
Add
Remove
SOCIAL SECURITY # OR FED ID NUMBER
Amount Paid
Add
Remove
How many jobs did you work this year?
Yes
No
Did you receive unemployment income?
Did you attend college, night school, internet schooling, or any post-secondary educational facility to gain a skill or degree?
Do you have a 1098-T form from your school?
Are you currently paying or owe student loans?
Do you own your home?
Do you owe for home buyers credits?
Did you pay church tithes and offerings?
Do you owe back child support?
Do you owe the IRS?
How would you like your IRS refund issues?
Paper
Check
Direct Deposit
Comments
ALTERNATE ELIGIBILTY RECORD (Due Diligence)
In accordance with Internal Revenue Service (IRS) Bulletin 97-65 and Internal Revenue Code (IRC), this form serves as Alternate Eligibility Checklist, and may be used IN LIEU of other forms of Due Diligence, including form 8867. Maintain this form with your client files.
HEAD OF HOUSEDHOLD ELIGIBILITY
You may file Head of Household if you can answer YES to ALL the following questions. (See Publication 17, Chpt 2&3)
Yes
No
You are unmarried, or are considered unmarried on the last day of the year.
You paid more than half the cost of keeping up a home for the year.
A qualifying person (definition below) lived with you in the home for more than half the year (except temporary absences, such as school), and you can claim an exemption for him/her except as noted under Category 3 below.
A qualifying person requirements are: (See Table 2-1, Publication 17)
A qualifying relative such as parent, grandparent, brother, sister, stepbrother, stepsister, stepmother, stepfather, father-in-law, half-brother, half-sister, brother-in-law, sister-in-law, daughter-in-law, uncle, aunt, nephew, or niece who is related to you by blood and lived with you for the entire year. Child, grandchild, stepchild, or adopted child. Eligible foster child. (Note: For eligibility for dependent only a foster child is a child who is in your care, that you care for as your own child, and who lived with you the entire year. It does not matter how the child became a member of the household)
EARNED INCOME CREDIT (EIC) ELIGIBILTY
You may claim the EIC if you can answer YES to ALL 4 tests below. (See publication 17, Chapter 36)
Yes
No
Your child/ children is/are one of the following: a son, daughter, adopted child, stepchild, grandchild, or eligible foster child or is your brother, sister, stepbrother, stepsister (or the child or grandchild of your brother, sister, stepbrother, or stepsister), and you care for it/them as you would your own child.
Your child/children is/are under 19 years of age at the end of the year, or is under 24 years of age at the end of the year and is a full-time student, or was permanently and totally disabled at any time during the tax year, regardless of age.
Your child/ children lived with you for more than half the year (or the whole year if an eligible foster child)
Your home is in the United States
If your child/ children is/are the qualifying child/ children of another individual, you are the only person claiming the credit for that/ those child/children during the tax year. (Note: If the answer is NO, refer to the tiebreaker rule. You may still be able to take the credit.
FOSTER CHILD ELIGIBILTY
The definition of a foster child has changed. For establishing eligibility for dependency, see above. For establishing eligibility for the Child Tax Credit and Earned Income Credit you must be able to answer YES to ALL the questions below.
Yes
No
You cared for the child/ children as you would your own child.
The child/ children lived with you for the entire year, except for temporary absences.
The child/ children was/ were placed in your care by a State, one of its subdivision, or placement agency.
Were you self-employed?
Yes
No
Self-Employment Form
Client Name
Tax Year
Sales/ Receipts
Professional Fees
Office Expenses
Cost of Goods for Sale
Advertising
Equipment Rent/ Lease
Auto Mileage or Cost
Property Rent
Commissions & Fees
Contacts Labor
General Repair’s
Taxes/ Licenses
Employee Benefits
Travel
Insurance
Meals/ Entertainment
Mortgage Interest
Utilities
Wages
Supplies
Other Expenses
Real Estate & Equipment Purchased
Description
Date
Cost
Add
Remove
Did you work a job & do anything to make extra money on the side?
Yes
No
What type of work?
Everything I am signing is true to the best of my knowledge
Upload Document
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Max. file size: 512 MB.
Upload Spouse’s Document
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Max. file size: 512 MB.
(Required)
I (we) have reviewed the information in this questionnaire (including the business and rental data sheets, if applicable) and to the best of my (our) knowledge it is accurate, correct and complete. Anything that is false or inaccurate may be prosecuted or their taxes may be forfeited/rejected. By signing this affidavit, you are stating that everything above and on previous forms is the truth and accurate and MegaCash Tax Services is not responsible for anything that is falsified on your client tax information sheets. We agree to hold Mega Cash Tax Services harmless for any errors that they may make on my/our tax return. I (we) also understand that error on my/our return will cause a delay/audit in the processing of the return and the receipt of the refund, if any.
Signature
Date
MM slash DD slash YYYY
