Before You Begin:

Please ensure you have all necessary information ready to complete the form thoroughly and accurately.

If you have any questions or need assistance, don’t hesitate to reach out:
Email: taxes@911financialsolutions.com
Text: (470) 748-6768

At 911 Financial Solutions, we’re here to ensure your experience is seamless and stress-free.

How did you hear about us or who referred you?

First Name *

Middle Name *

Last Name *

Suffix

Date of birth *

Are you a new or returning client?

New

Returning Client

Address

Address *

City

State *

Country

Postal code *

Occupation *

TAX ID/SSN# *

Email *

Phone *

Driver's License # *

Driver's License Expiration Date

State Driver's License Was Issued

Driver's License Issued Date

Photo of Social Security Card & Driver's License *

Photo of Social Security Card & Driver's License

Are you filing an eligible spouse on your tax return? *

Yes

What is your filing status? *

Are you married?

Spouse Full Name *

Spouse - TAX ID/SSN# *

Spouse - Occupation *

Spouse - Date of Birth *

Spouse - Phone *

Spouse - Email *

Spouse - Address

Spouse - Address line 2

Spouse - City

Spouse - State

Spouse - Zip Code

Spouse - Date Driver's License Was Issued *

Spouse - State Driver's License Was Issued *

Spouse - Driver's License # *

Spouse - Driver's License Expiration Date *

Spouse - Photo of Social Security Card & Driver's License *

Spouse - Photo of Social Security Card & Driver's License

Dependents

Should only be listed if you take care of the dependent over half of the year.

Dependent(s) - Photo of all Social Security Card(s) *

Dependent(s) - Photo of all Social Security Card(s)

1. Dependent Information

D1 - Gender of Dependent & Dependent Relationship to You

D1 - First Name

D1 - Middle Name

D1 - Last Name

D1 - Suffix

D1 - Date of Birth

D1 - Social Security Number

2. Dependent Information

D2 - Gender of Dependent & Dependent Relationship to You

D2 - First Name

D2 - Middle Name

D2 - Last Name

D2 - Suffix

D2 - Date of Birth

D2 - Social Security Number

3. Dependent Information

D3 - Gender of Dependent & Dependent Relationship to You

D3 - First Name

D3 - Middle Name

D3 - Last Name

D3 - Suffix

D3 - Date of Birth

D3 - Social Security Number

4. Dependent Information

D4 - Gender of Dependent & Dependent Relationship to You

D4 - First Name

D4 - Middle Name

D4 - Last Name

D4 - Suffix

D4 - Date of Birth

D4 - Social Security Number

Do you have Dependent Daycare Expenses?

Yes

No, all dependents are entered

Child and Dependent Daycare Expenses

If the provider is a person, enter the care provider's SSN.

Child Name

Amount Paid

Provider Phone Number

Provider

Provider Name

Tax ID# / SSN

Provider Address

Provider City

Provider State

Provider Zip Code

Do you want to enter another child care provider?

Yes

What type of employee were you in 2024?

W2 Hourly/Salaried Employee

Self-Employed/Small Business Owner

1099 Contractor

Household Employee (Ex: Babysitter, Gardener, Housekeeper, Maid, etc.)

Upload W2

Upload all tax documents

Upload photos of your W-2, 1099, and ALL other documents.

Upload 1099/ Business Income Here

Attach photos of all documents that can be used to assist your tax preparer with the preparation of your tax return.

Enter any additional information or comments that you would like to include for your tax preparer.

If you did not file your tax return with us last year, we recommend uploading a copy of your previous year's tax return.

Do you owe from previous years? *

Yes

I have not filed previous years

Do you have a business that you would like to be included in your return? *

Yes

Business Owners Data Sheet

Schedule C

Business Name

Employer ID Number

What is the legal structure of your business?

Business Address

Amount Paid ($)

Business Income

All income received during the fiscal year.

Total Income

Business Expenses

Complete to the best of your ability. In each field, enter the approximate amount you spent for each category.

Advertising

Contract Labor

Insurance

Interest

Legal & Professional Services

Office Expenses

Rent & Lease

Repairs & Maintenance

Supplies

Taxes & Licenses

Travel, Meals, & Entertainment

How much did you spend ?

Utilities

Other Expenses

Are there any other information, questions, or concerns pertaining to your business that you want to include for your tax preparer?

Attach any photos or documents that you want us to have on file.

Consent to Use Of Tax Return Information

Consent to Use of Tax Return Information

Federal law requires this consent form be provided to you ("you" refers to each taxpayer, if more than one). Unless authorized by law, we cannot use, without your consent, your tax return information for purposes other than the preparation and filing of your tax return.

You are not required to complete this form. If we obtain your signature on this form by conditioning our services on your consent, your consent will not be valid. If you agree to the use of your tax return information, your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year.

In order to provide you with tax-related services, we must use your 2023/2024 tax return information.

If you will allow us to use your tax return information for this purpose, sign and date your consent to the use of your tax return information.

By signing below, you (including each of you if there is more than one taxpayer) authorize 911 Financial Solutions Financial Hospital LLC to use your 2023/2024 tax return information to provide you with additional tax-related services beyond the preparation and filing of your return.

If you are not willing to authorize us to use your tax information for these purposes, you can still choose to have your tax return prepared and filed by us for a fee.

What Tax year are you filing

Printed Full Name of Taxpayer *

Taxpayer Signature *

Clear

Date *

Printed Full Name of Joint Taxpayer

Joint Taxpayer Signature

Clear

If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by email at complaints@tigta.treas.gov.

Consent to Disclosure of Tax Return Information

Consent to Disclosure of Tax Return Information

Federal law requires this consent form be provided to you ("you" refers to each taxpayer, if more than one). Unless authorized by law, we cannot disclose, without your consent, your tax return information to third parties for purposes other than the preparation and filing of your tax return. If you consent to the disclosure of your tax return information, Federal law may not protect your tax return information from further use or distribution.

You are not required to complete this form. If we obtain your signature on this form by conditioning our services on your consent, your consent will not be valid. If you agree to the disclosure of your tax return information, your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year.

In order to process your return, we must disclose all of your 2023/2024 tax return information to 911 Financial Solutions Financial Hospital LLC, which we utilize in order to provide certain services.

If you will allow us to disclose your 2023/2024 tax return information to 911 Financial Solutions Financial Hospital LLC for this purpose, sign and date your consent to the disclosure of your tax return information.

By signing below, you (including each of you if there is more than one taxpayer) authorize us to disclose to 911 Financial Solutions Financial Hospital LLC all of your 2023/2024 tax return information. If you are not willing to authorize us to share your tax information with the other firms, you can still choose to have your tax return prepared and filed by us for a fee.

Printed Name of Taxpayer *

Taxpayer's Signature *

Clear

Signing Date *

Printed Name of Joint Taxpayer

Joint Taxpayer's Signature

Clear

I agree to terms & conditions provided by 911 Financial Solutions Financial Hospital LLC.

Promo Code

E-Signature Below *

Clear

Authorization, Accuracy Confirmation & Payment Agreement

By filling out this form, you are giving 911 Financial Solutions Financial Hospital LLC consent to disclose and transmit the information entered above on your behalf.

By signing above, you confirm that the information provided is true and accurate to the best of your knowledge.

You also acknowledge and understand that any outstanding tax preparation fees will be auto-debited from the listed account if payment is not received by the agreed-upon date.

If you have any questions or need assistance, don’t hesitate to reach out:
Email: taxes@911financialsolutions.com
Call/Text: (470) 748-6768

We’re here to ensure your experience is seamless and stress-free.