Tax Client Intake Form

Thank you for choosing CDMH Tax Services! Please enter your information as accurately as possible. Please upload your required documents that are needed to process your tax return.

What tax years to do you need to file?*

First Name*

Last Name*

Primary Email*

Primary Phone*

Date of Birth*

Social Security Number*

Occupation*

Do you have an IRS IP Pin? If so, please provide the number.

Spouse First Name

Spouse Last Name

Spouse Date of Birth

Spouse Social Security Number

Address Line 1*

City*

State / Province*

ZIP / Postal Code*

Questionnaire

Answering these questions will toggle specific forms for your tax situation to keep you from answering irrelevant information and save time

Please select if this applies to you. On the last day of the year of 2025, were you?

unmarried or legally separated from your spouse

you are married & you and your spouse agree to file a joint return

you are married, but you are your spouse do not want to file your return together

you paid more than half the cost of keeping up a home for the year

a qualifying dependent lives in the home with you for more than half of 2025 year

your spouse died in 2025 and you planned to file a joint return

your spouse died and its within the 2 years to use the qualifying surviving spouse filing status

the taxpayer (you) can be claimed on someone else's return as a dependent

Did you, at any time this year: Receive digital assets (like cryptocurrency) as payment, a reward, or in exchange for goods/services? Sell, trade, or otherwise use digital assets?

A digital asset is anything of value stored online that can be bought, sold, or traded. It includes things like:

Cryptocurrency (e.g., Bitcoin, Ethereum)
Cash App, Venmo, or PayPal payments
NFTs (digital collectibles or art)

If you used or received any form of digital money (like crypto payments on Cash App), answer "Yes" above.

Yes to 1 or both

No to both

How many dependents do you have? (You can claim up to 3 on your return).

Dependent #1 Name

Date of birth of dependent #1.

Social Security Number of dependent #1.

What is the dependents relationship to you?

Is the dependent disabled?

Yes

Is the dependent a college student with at least 6 credit hours a semester?

Yes

Dependent #2 Name

Date of birth of dependent #2.

Social Security Number of dependent #2.

What is their relationship to you?

Is the dependent disabled?

Yes

Is the dependent a college student with at least 6 credit hours per semester?

Yes

Dependent #3 Name

Date of birth of dependent #3.

Social Security Number of dependent #3.

What is their relationship to you?

Is the dependent disabled?

yes

Is the dependent a college student with at least 6 credit hours per semester?

Yes

Do you owe student loans, taxes, or other entity that might offset your refund?*

Yes

Did you receive any public assistance? (Section 8, Food stamps, etc)*

Yes

Did you purchase insurance from the Healthcare.gov Marketplace OR have any premium credits from the Insurance company you use?*

Yes

If you have any credits that were disallowed or reduced, please enter here.

Are you filing a business/self employed/side job/cash job?*

Yes

How do you receive money from clients? (select all that apply)

Paypal/Cash App/Cash on Hand

Website or 3rd Party Payment Processor

Billing Company (Afterpay/Sezzle/Etc)

How much did you make in estimated tax payments in 2025? *Do not include taxes paid through W2 or 1099 withholdings.

Which type of documents can you provide if requested by IRS?

Paypal/CashApp/Invoices Receipts showing payments sent to vendors/contractors

Bank Account Statements Showing Payments MAde to Vendors/Stores

Records from Your CPA/Bookkeeper Showing Accounts Payable/Schedule of Liabilites

Lease/Utiity/Insurance Statements from Physical Location

Website Fees and/or Social Media Ads

Quickbooks/Freshbooks/Payroll Software/CRM

Did any of the following apply? (select if YES)

You received a 1099MISC for this business

You received a 1099NEC for this business

You used an automobile for this business?

You used a part of your home as an office and/or to do business?

You hired employees or paid contractors over $600?

You had insurance for this business?

You had a separate office space for this business?

Please fill out this business income and expense form: There are expenses on this form that may not apply to your business, only fill out what you know is relevant for you. If you need assistance with this, please don't hesitate to reach out. Please finish filling out this form before moving on to the expense form to avoid forgetting to submit this one. Thanks in advance!

Please upload 1095A from your marketplace plan. If you have Insurance through your job (1095B) or Insurance through your state (Medicaid) (1095C) You do not need these forms in order to file only the 1095A

Please select each type of income/form that you received for the 2025 Year.*

Unemployment Income (1099G)

Self Employment (1099K, 1099NEC, 1099MISC)

Household Income (Home Health/Nanny)

1098-E Student loan interest payments

Interest Income

Alimony

Mortgage Credit Certificate (MCC)

Other

Upload all income documents for 2025.*

Please upload the front of your ID/DL if you have a new one*

Please upload a photo of your Social Security Card, as well as photos of any dependents you are claiming cards.*

Please upload proof of dependency SHOWING ADDRESS and DEPENDENT NAME

Acceptable documents:
report card, school or daycare enrollment form, snap benefits letter, medical benefit letter, health insurance info, shot record, doctor's note, 2023 1040 tax return

Please upload you and/or your dependents 1098-T

You have selected you have a 1098-T, please select which applies to you (not for your dependents).

enrolled at least half time for at least one academic period at the beginning of the tax year

have not finished 4 years of higher education at the beginning of the tax year

have not claimed the AOTC or the former Hope credit for more than 4 years

does NOT have a felony drug conviction at the end of the tax year

How did you hear about us?

Name of Referral

Refund Selection

Would you like to apply for a refund advance? (Returning Clients Only)

Would you like to apply for the advance up to $6000? (It all depends on the amount of your refund). There are two types of refund advances. PREACK (before the IRS OPENS Jan2 until the IRS opens) and INSEASON (when the IRS opens)

Whatever method you use for refund advance, you'll receive refund the same way! It can't be changed even if you're denied.

Preack- Harder look at credit, but not specifically credit based. Refund History for last 5 years. 2 out of 10 clients receive it. If you are denied, there is another opportunity for you to apply for the in-season loan.

In Season- Easier to get. Refund history from previous year. 4 out of 5 of my clients receive it. If you are denied, there is not any more funding.

**DISCLAIMER: DESPITE ODDS, REFUND ADVANCES ARE NOT GUARANTEED

THE BANK CAN APPROVE YOU FOR THE AMOUNT REQUESTED, DENY YOU, OR APPROVE YOU FOR A LESSER AMOUNT**

How much of an advance would you like?

Acknowledgement

I understand that the refund advance is not guaranteed and that loans over $1,000 will have small interest fee.

I do not agree, I opt out of refund advance

How would you like to receive your refund?*

Check (printed in our office and mailed/picked up)

Direct Deposit to your account

Direct Deposit Bank Name

Bank Account Type

Checking

savings

Bank Routing Number

Bank Account Number

Authorization for Use and Disclosure of Tax Return Information

Pursuant to IRC Section 7216

Tax Preparer Information

Preparer Name: Crystal Drakes

Company Name: Crystal Drakes Services LLC dba CDHM Tax Services

Phone: 727-282-5542

Thank you for choosing Crystal Drakes Services LLC dba CDHM Tax Services to assist you with your requested year taxes. This letter confirms the terms of our engagement with you and outlines the nature and extent of the services we will provide.

We will prepare your requested federal and state income tax returns. We will depend on you to provide the information we need to prepare complete and accurate returns. The law imposes penalties when taxpayers underestimate their tax liability. We may ask you to clarify some items but will not audit or otherwise verify the data you submit.

We will perform accounting services only as needed to prepare your tax returns.

Accordingly, our engagement should not be relied upon to disclose errors, fraud, or other illegal acts, though it may be necessary for you to clarify some of the information you submit. We will, of course, inform you of any material errors, fraud, or other illegal acts we discover.

I acknowledge that all information provided to Crystal Drakes Services LLC dba CDHM Tax Services is true and accurate to the best of my knowledge. I understand that I am required to have any supporting documentation to validate the information provided. Furthermore, I understand that knowingly providing false information on my tax return and reporting it to the IRS, that I am taking part in a potentially criminal penalty situation and is punishable by law including but not limited to: facing court dates, restitution, and possible imprisonment. I waive Crystal Drakes Services LLC dba CDHM Tax Services and the preparer of any error due to incorrect information provided by me. By signing below, I authorize Crystal Drakes Services LLC dba CDHM Tax Services to file my tax return.

I acknowledge by signing this form if I and/or my spouse owes a federal/government debt such as IRS, child support, student loans etc., I/we are still responsible for tax preparation fees due to Crystal Drakes Services LLC dba CDHM Tax Services at the time of service. Also, if the federal refund amount is mailed, I/we are still responsible for the tax preparation fees stated on the invoice. If you for some reason decide that you no longer want the tax preparation service after we have completed the return, you will be responsible for a $100 non filing fee. This fee is due immediately upon discovery that tax preparation from Crystal Drakes Services LLC dba CDHM Tax Services will not submit the tax return. If the fees are not paid immediately, you will need to pay the full tax preparation fee on your invoice attached to tax return.

If the tax preparation fees are not paid, I understand Crystal Drakes Services LLC dba CDHM Tax Services will take legal action to collect the unpaid tax preparation fees. This includes reporting to all credit bureaus immediately. I also agree that client won't dispute tax preparation fees for services rendered due to IRS delays.

Invoices are due and payable upon presentation. We will return your original records to you at the end of this engagement. You should securely store these records, along with all supporting documents, canceled checks, etc., as these items may later be needed to prove accuracy and completeness of a return. We will retain copies of your records and our work papers for your engagement for three years, after which these documents will be destroyed. Paper copies of the tax return and other documents will be available for a fee.

Our engagement to prepare your tax returns will conclude with the delivery of the completed returns to you (if paper-filing), or your signature and our subsequent submittal of your tax return (if e-filing). If you have not selected to e-file your returns with our office, you will be solely responsible to file the returns with the appropriate taxing authorities. Review all tax-return documents carefully before signing them. You agree to allow Crystal Drakes Services LLC dba CDHM Tax Services to file your tax return and understand we do not give quotes to be comparable to DIY tax software. By signing this agreement your signature is now transferrable to the forms 1040, 8879, 7216, and all other applicable form in the finalized tax return from this document, for submission.

You also agree to receive text messages and emails from Crystal Drakes Services LLC dba CDHM Tax Services about your tax return and future opportunities with Crystal Drakes Services LLC dba CDHM Tax Services.

By signing this form you agree that the bank account on file will be drafted a processing fee of $100 (1) in the event your return is rejected due to you already filing or applying for a loan with another tax firm, (2) in the event our office completes your return, and you do not sign your return within 24 hours of us notifying you that your return is ready for signature (we will consider your return filing abandoned and that you have filed elsewhere, and deactivate your return in our system).

By submitting this application, I acknowledge and agree to provide my personal information, including but not limited to my full name, date of birth, social security number, current address, banking information, and any other necessary details. I understand that this information is required for verification purposes, accurate tax return preparation, and to ensure the timely processing of any refunds, credits, or payments I may be eligible to receive.l confirm that all the information provided is accurate and up-to-date. I further consent to the use of this information solely for the purposes outlined above and acknowledge that it will be handled with the utmost confidentiality and in compliance with applicable laws. By checking "I agree" and signing below, I confirm my understanding and consent.

To affirm that this letter correctly summarizes your understanding of the arrangements for this work, you agree to allow Crystal Drakes Services LLC dba CDHM Tax Services to file your tax return and not just give a quote and your signature is transferrable to the tax return from this document, please sign this letter in the space below.

taxpayer signature

Tax Payer Signature (Must be legible)

taxpayer signature

By signing below, I confirm that the information provided is accurate and complete to the best of my knowledge. I understand that this information will be used to prepare my tax filings and authorize CDHM Tax Services to process my documents accordingly

spouse signature

Spouse Signature

spouse signature

Quote Disclaimer

Must sign to accept

Quote Disclaimer

Disclaimer: CDHM Tax Services Quote Policy

At CDHM Tax Services, we prioritize efficiency and accuracy in providing our services. We do not offer tax quotes, as the time required to generate a quote is equivalent to the time needed for the preparation of a comprehensive tax return. Our commitment is to deliver precise and thorough tax solutions, and we believe that dedicating our resources directly to the preparation process ensures the highest quality of service for our clients. If you are in the process of shopping around for quotes, please note that our focus is on delivering comprehensive and accurate tax solutions rather than providing standalone quotes. We encourage you to consider the value of our commitment to thorough tax preparation, ensuring that your financial needs are met with precision and expertise. Thank you for considering CDHM Tax Services for your tax requirements. Additionally, please be aware that if you submit the intake form and later decide not to file, there will be a $100 fee associated with us preparing your return, and this amount will automatically be debited from your account. We appreciate your understanding and look forward to assisting you with your tax requirements. Thank you for considering CDHM Tax Services.