Tax Preparation | Dallas, NC

Address: 4739 Dallas High Shoals Highway Dallas, NC 28034

CALL US! (704) 922-7020

Address: 4739 Dallas High Shoals Highway Dallas, NC 28034

CALL US! (704) 922-7020

Xpress Tax & Accounting, Inc

HOME
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GALLERY

CLIENT DOCUMENTS

New Client Intake Form

The below form has been prepared to assist you in gathering information for your upcoming tax return. Review the entire form and answer any questions that apply.

State and city refunds and other government payment (Form 1099-G)

Unemployment and compensation

Credit card, debit card, and third party network transactions (Form 1099-K)

Reportable payment transactions

Other Income (Provide supporting documentation for income received from the following items)

Sale of assets or property

Cancellation of debt

Other Income

Please list other income if applied

Payments (provide supporting documentation for payments made for the following items)

Educator classroom expenses

Employee business expenses

Contributions to a Health Savings Account

Expenses related to work relocation with the military

Alimony

Student Loan Interest

Refunded Student Loan Interest Payments

Student Loan forgiveness

Tuition and fees for higher education

Expenses related to child or dependent care

Contributions to Retirement Savings Account

Medical and dental expenses

Real estate taxes

Other state and local taxes

Investment Interest

Cash Contributions

Noncash Contributions

Unreimbursed employee expenses

Investment Expenses

Gambling Losses

Other

Please list other if applied

Personal Information

Personal Information

Did your marital status change during the year?

YES

NO

If “YES” explain

If your filing status is married but you are filing separate from your spouse, did you and your spouse live apart for the last six months of 2022?

YES

NO

Can you or your spouse be claimed as a dependent by someone else?

YES

NO

Did your address change during the year?

YES

NO

Were you, your spouse or any dependents a victim of identity theft?

YES

NO

If “YES” explain

Were you, your spouse, or any dependents issued an identity protection pin?

YES

NO

If “YES”, provide Notice CP01A from the IRS

Dependent Information

Dependent Information

Did you have any changes in dependents during the year?

YES

NO

If “YES’ explain

Can another person quality to claim any of your dependents?

YES

NO

Did you have any childcare expenses during the year?

YES

NO

Did you have any adoption expenses during the year?

YES

NO

Did you have any children under age 19 or a full time student age 24 with more than $2,300 of unearned income?

YES

NO

Please provide documentation for proof of dependent credits (school records, daycare records, etc).

Health Care Information

Health Care Information

Did any member of your household have healthcare coverage through the marketplace (Obamacare)?

YES

NO

If “YES” please provide copies of Form 1095-A

If “YES” please provide copies of Form 1095-A

Did you receive any distributions from a Health Savings Account (HAS), Archer MSA, or Medicare Advantage MSA during the year?

YES

NO

Income, Purchases, Sales and Debt Information

Income, Purchases, Sales and Debt Information

Did you receiver any tips not reported by your employer?

YES

NO

Did you receive any disability income during the year?

YES

NO

Did you cash in any U.S. Savings bonds during the year?

YES

NO

Did you start a new business or purchase any rental property during the year?

YES

NO

Did you sell an existing business, rental property, or other property during the year?

YES

NO

Did you purchase any business assets or convert any assets to business use?

YES

NO

If YES, please provide the cost of the asset, the date it was placed and service, and the business use percentage

Did you purchase any gasoline, diesel, or special fuels for offroad business use?

YES

NO

Did you buy any stocks, bonds or other investments during the year?

YES

NO

Did you sell a principle residence during the year?

YES

NO

If YES, provide closing documentation for the purchase and sale of the home

Did you have a principle residence or a piece of real property foreclosed on during the year?

YES

NO

Did you abandon a principle residence or a piece of real property during the year?

YES

NO

Did you refinance your principle home or second home or take out a home equity loan during the year?

YES

NO

If YES please provide all escrow, closing and other pertinent documentation and information

Did you receive any principle or interest during this year from property sold in prior years?

YES

NO

Did you rent our your home or use it for business?

YES

NO

Did you sell, exchange, or purchase any real estate during the year?

YES

NO

Did you acquire a new or additional intertest in a partnership or S corporation

YES

NO

Did you have any depts canceled of forgiven this year?

YES

NO

Does anyone owe you money that has become uncollectable?

YES

NO

Did you purchase a new hybrid, alternative motor, or electric motor energy efficient vehicle during the year?

YES

NO

If YES please provide year, make, model, VIN and date the vehicle was placed in service

Did you receive income or incur expense associated with a fantasy sport league?

YES

NO

IF YES provide documentation

Did you receive any other income you have not provided information for with this organizer?

YES

NO

IF YES explain

Itemized Deduction Information

Itemized Deduction Information

Did you pay out-of-pocket medical or dental expenses (premiums, prescriptions, mileage, etc.) during the year?

YES

NO

Did you pay any long-term care premiums for yourself, our spouse, or a dependent during the year?

YES

NO

Did you receive any state or local income tax refunds from the prior years?

YES

NO

Did you make any major purchases (vehicle, boat, etc.) during the year?

YES

NO

Did you pay any real estate property taxes or personal taxes during the year?

YES

NO

Did you pay mortgage interest during the year?

YES

NO

Did you make cash donations to charity during the year?

YES

NO

Did you donate a boat or vehicle during the year?

YES

NO

IF YES, attach form 1098-C

Did you have gambling winnings or losses during the year?

YES

NO

Did you have any job related expenses that were not reimbursed by your employer?

YES

NO

Did you use your vehicle on the job other than commuting to work?

YES

NO

Did you work out of town at any time during the year?

YES

NO

Retirement Information

Retirement Information

Did you make any contributions to an IRA, Roth, Keough, SIMPLE, SEP, 401(k), or other qualified retirement plan during the year?

YES

NO

Did you make any withdrawal or receive distributions from a pension or profit-sharing plan, IRA, Roth, Keough, SIMPLE, SEP, 401(k), or other qualified retirement plan during the year?

YES

NO

Did you execute any rollovers from an IRA, Roth, Keough, SIMPLE, SEP, 401(k), or other qualified retirement plan during the year?

YES

NO

Did you receive any Social Security Benefits during the year?

YES

NO

Education Information

Education Information

Did you pay tuition expenses that were required for attending college, university or vocational school for yourself, your spouse, or a dependent during the year? (even if classes were attended in another year)?

YES

NO

Did anyone in your household attend a post-secondary school during the year

YES

NO

Did you make a contribution or receive a distribution from an Education Savins Account or Qualified Tuition Program during the year?

YES

NO

Did you pay a student loan interest for yourself, your spouse, or your dependents during the year?

YES

NO

If YES, provide the amount of interest that was refunded

Did you receive forgiveness on a qualifying federal student loan?

YES

NO

Refund, Withholding, and Estimated Tax Information

Refund, Withholding, and Estimated Tax Information

If you have an overpayment of 2022 taxes, do you want the refund applied to your 2023 estimated taxes?

YES

NO

Did you make any estimated payments toward your 2022 taxes?

YES

NO

Did you apply an overpayment of your 2021 taxes to your 2022 estimated taxes?

YES

NO

Did you want to have any refund or balance due directly deposited or withdrawn?

YES

NO

IF YES, please provide a cancelled checking or savings slip

Did you anticipate your income or withholdings to be different for 2023?

YES

NO

Miscellaneous Information

Miscellaneous Information

Did you receive, sell, exchange, gift, or otherwise dispose of any digital asset or financial interest in any digital asset?

YES

NO

Did you incur a gain or loss due to damaged or stolen property, while living in a federally declared disaster area?

YES

NO

Did you pay wages to any household employees (babysitter, nanny, housekeeper, etc.)?

YES

NO

Did you make gifts to any one person in excess of $16,000 during the year?

YES

NO

IF YES are you splitting the gift with your spouse?

YES

NO

Did you incur moving expenses with the military during the year?

YES

NO

Did you make any energy efficient improvements to your main home during the year?

YES

NO

Are you a business owner who paid health insurance premiums for your employees during the year?

YES

NO

Do you own interest or shares in or did you dispose of a Qualified Opportunity Fund during the year?

YES

NO

Did you make any purchases subject to Use Tax during the year?

YES

NO

IF YES provide details

Did you receive any notices from the IRS or state taxing authority?

YES

NO

IF YES explain

May the IRS discuss your tax return with your preparer? Would you like a copy of your tax return sent electronically instead of receiving a printed copy?

May the IRS discuss your tax return with your preparer?

Would you like a copy of your tax return sent electronically instead of receiving a printed copy?

Tax Organizer Personal Information

Tax Organizer Personal Information

Taxpayer Name

Date of Birth

Spouse Name

State Address, City, State and ZIP

Taxpayer Occupation

Daytime Phone Number

Evening Phone Number

Cell Phone Number

Spouse Occupation

Daytime Phone Number

Evening Phone Number

Cell Phone Number

Taxpayer Email

Spouse Email

Filing Status at the end of the previous year

If widowed and your spouse died in the previous year, enter the date of death

If married but filing separately, did you live apart from your spouse for the last six months of 2022?

YES

NO

New Field:

YES

NO

Are you or your spouse disabled?

YES

NO

Are you or your spouse a full time student

YES

NO

Do you or your spouse want to designate $3 to go to the presidential Election Campaign Fund?

YES

NO

At any time during the previous year did you

At any time during the previous year did you

Receive (as a reward, award, or payment for property or service) a digital asset?

YES

NO

Sell, exchange, gift, or otherwise dispose of a digital asset (pr a financial interest in a digital asset)

YES

NO

Dependent and Other Information

Dependent and Other Information

First and Last Name

Has IP PIN

Relationship

Months in Home

Date of Birth

Disabled

Full Time Student

Childcare Expenses

List Dependents required to file a return

Child and Other Dependent Care Expenses

Address

Amount Paid

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Xpress Tax & Accounting, Inc

Browse Our Website

HOME
SERVICES
TESTIMONIALS
RESOURCES
CLIENT DOCUMENTS
CONTACT
GALLERY

Contact Information

Address: 4739 Dallas High Shoals Highway Dallas, NC 28034

Office: (704) 922-7020

Text Us: (704) 420-2491

Fax: (704) 922-5899

Email: r.hollifield@xpresstax.com

Business Hours

Mon - Fri: 8:00 am - 5:00 pm
Sat - Sun: Closed

For after-hours document delivery, please use our secure drop box.

Payment Options:

Cash Payment Accepted

Check Payment Accepted

Xpress Tax & Accounting, Inc

Browse Our Website

HOME
SERVICES
TESTIMONIALS
RESOURCES
CLIENT DOCUMENTS
CONTACT
GALLERY

Contact Information

Address: 4739 Dallas High Shoals Highway Dallas, NC 28034

Office Phone: (704) 922-7020

Text Us: (704) 420-2491

Fax: (704) 922-5899

Email: r.hollifield@xpresstax.com

Business Hours

Mon - Fri: 8:00 am - 5:00 pm
Sat - Sun: Closed

For after-hours document delivery, please use our secure drop box.

Payment Options:

Cash Payment Accepted

Check Payment Accepted

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