• 203-521-0089

  • proserve_mail

  • 161 Kings HWY E., Suite 206, Fairfield, CT

Welcome to the CLIENT PORTAL


Please authenticate to enter.

Client Portal

Choose Your Tax Year

  • Basic Info
  • Income
  • Deductions
  • Questions
  • Consent

Step 1 - 5

2019

TAX ORGANISER

Taxpayer Information

Last name
First name
Middle initial
Suffix
SSN
Occupation
Work phone
Ext
Cell phone
E-mail address
Date of birth

Licence Driver Details

Issuing state
Licence number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

State Identification card detail

Issuing state
Identification number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

Spouse Information

Last name
First name
Middle initial
Suffix
SSN
Occupation
Work phone
Ext
Cell phone
E-mail address
Date of birth

Licence Driver Details

Issuing state
Licence number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

State Identification card detail

Issuing state
Identification number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

Address
Apartment number
City
State
ZIP code
Home phone
Fax number

Dependent Information

( Swipe left to see more information )
First name
Last name
MI
Suffix
Social security number
Relationship
Date of birth Months Lived with Taxpayer Child Care Expense










Child and Dependent Care Provider Expenses

Name Address ID number Amount Paid

Education Tuition and Fees

Attach all Form 1098-Ts and list of your qualified education expenses.

Student Loan Interest Paid

Enter total 2019 qualified student loan interest


Step 2 - 5

2019

Income


Attach Form(s) W-2 - Wages, Salaries, Tips and Other Compensation

2018 Amount

Attach Form(s) 1099-R - Distributions from Pensions, Annuities, Retirement, Profit-Sharing, IRAs, etc

1099‑R Payer Name 2018 Amount

Attach Form(s) SSA-1099 - Social Security/Railroad Benefits

Taxepayer Spouse
Sosial Security Benefits from Form SSA-1099
Railroad Retirement Benefits from Form RRB-1099
Medicare B premiums withheld
Medicare C premiums withheld
Medicare D premiums withheld

Attach Form(s) 1099-MISC - Miscellaneous Income

1099-MISC Payer Name

Attach Form(s) 1099-INT - Interest Income

1099-INT Payer Name 2018 Amount

Attach Form(s) 1099-DIV - Dividend Income

1099-DIV Payer Name 2018 Amount

Attach Form(s) 1099-B, 1099-S - Sales of Stocks, Bonds, Real Estate, etc

Attach all stock sale transaction information, including initial cost information.

Other Government Forms to attach:

Form(s) 1099-G - Certain Government Payments, Schedule K-1s - Partnership, S-Corporation, Trust or Estate In Income, Form(s) W-2G - Gambling or Lottery Winnings, Forms(s) 1099-Q - Payments from Qualified Education Programs.

Other Income:

Alimony, jury duty, unreported tips, disability income, etc. Business, rentals, farms: Attach income and expenses for any business, rental or farm you own. Include a list of all new equiment acquired this year, including date of purchased and cost.

Retirement Plan Contributions

Taxpayer Spouse
Traditional IRA contributions made for 2019
Roth IRA contributions made for 2019
SEP, Keogh, Individual 401(k) or SIMPLE Contributions


Step 3 - 5

2019

Deductions


Medical and Dental Expenses

2019 Amount 2018 Amount
Prescription medications
Health insurance premiuns
Doctors, dentists, etc
Hospitals, clinics, etc
Eyeglasses and contact lences
Miles driven for medical purposes
Other medical and dental expenses:

Taxes

2019 Amount 2018 Amount
Real estate taxes paid on principal residence
Real estate taxes paid on additional homes or land
Auto licence registration fees based on the value of the vehicule
Other personal property taxes

Interest Expenses


Home mortgage interest paid - Attach Form(s) 1098
Lender's Name 2019 Amount 2018 Amount
Point paid on loan to buy, build or improve main home
Lender's Name
2019 Amount

Cash/Check/Credit Contributions

2019 Amount 2018 Amount

Noncash Charitable Contributions

Attach all reciepts with details listing the following information: Donee, donee address, description of donation, date acquired and date contributed, your cost, values at time of donation, and you acquired the property.

Miscellaneous Deductions

2019 Amount 2018 Amount
Union and professional dues
Professional subscriptions, books, supplies
Uniforms and protective clothing (including cleaning)
Job search cost
Taxpayer educator expenses
Spouse educator expenses
Tax return preparation fees
Safe deposit box rental
Gambling losses (to the extent of gamblling income)
Other expenses (list):


Step 4 - 5

2019 Questions

Yes

No

1.- Did a lender cancel any of your dept in 2019 (Attach any Form 1099-A or 1099-C)
2.- Did you make energy efficient improvements to your home or purchase any energy-saving property during 2019 ? If yes, please attach details
3.- Did you purchase a motor vehicle or boat during 2019?
If yes, attach documentation showing sales tax paid.
4.- Did you purchase a hybrid or electric vehicule in 2019? If yes, enter year, make, model, and date purchase
5.- Did you donate a vehicle in 2019 ? If yes, attach Form 1098C
6.- What was the sales tax rate in your locality in 2019 ?
%
7.- Did your marital status changes during 2019 ? If yes, explain
8.- Were you or your spouse permanently and totally disable in 2019
9.- Do you have dependents who must file ?
10.- Do you have children who are under age 19 or a full time student under age 24 with investment income greater than $2,200?
11.- Did you provide over half the support for any other person during 2019?
12.- Did you incur adoption expenses during 2019?
13.- Did you receive a total distribution from IRA or other qualified plan that was partially or totally rolled over into another IRA r qualified plan within 60 days of the distribution?
14.- Did you receive any disability payments in 2019?
15.- Did you receive any tip income not reported to your employer?
16a.- Did you buy, sell, refinance, foreclose or abandon a pricipal residence or other real property in 2019? If yes, attach closing or escrow statements, 1099-C or 1099-A forms
16b.- If you sold a home, did you claim the First-Time Homebuyer Credit when you purchased it?
17.- Did you incur any casualty or theft losses during 2019?
18.- Did you incur any non-business bad bedts?
19.- Did you pay any individual for domestic sevices in 2019?
20.- Did you buy or sell any stocks on bonds in 2019?
21.- Did you use the proceeds from Series EE or | U.S. savings bonds purchased after 1989 to pay for higher education expenses?
22.- Did you incur any moving expenses? If yes, atach details
23.- Did you receive any income not included in this Tax Organizer? If yes, please attach information.
24.- Do you expect your income and deductions in 2020 to be the same as 2019? If no, attach explanation of changes expected.
25.- Did you receive Forms 1095-A (Health Insurance Marketplace Statement), If so, please attach.
26.- At any time during 2019, did you sell, send, exchange, or otherwise acquire any financial interest in an virtual currency?
27.- If you paid any alimony, enter recipient's SSN ?
Alimony paid:
28.- Enter the state of residence

Electronic Filing and Direct Deposit of Refund

Yes

No

If your tax return is eligible for Electronic Filing, would you like to file electronically?
The Internal Revenue Service is able to deposit many refunds directly into taxpayers' account. If you receive a refund, would you like derect deposit? If yes, plaese provide a voided check (not a deposit slip) if your bank account information ahs changed.
What type of account is this?
Checking Savings

Estimated Tax Paid

Federal State Local
Date Amount Date Amount ID Date Amount ID

Additional Information

(Enter any additional information here and attach any documents.)


Step 5 - 5


161 Kings Highway East, Suite 206
Fairfield, CT 06825

Consent/Acknowledgement Form

  1. I, (Print your name), hereby acknowledge that my identity has been verified satisfactorily, by use of my state or federal issued ID. I am the primary person on the attached tax return and have deemed myself in capacity to act on my own behalf. I also take full responsibility for the information and all supporting documents that I have provided for the preparation and filing of my tax return and I ascertain that they are accurate, valid, and true.

  2. I, , hereby acknowledge and agree that these services are not intended to determine whether I have filing requirements in other taxing jurisdictions than the one(s) I have listed above. The firm is available under the terms of a separate engagement letter to provide a nexus study that will enable us to determine whether any other state tax filings are required

  3. I, , hereby acknowledge that I am in agreement with the preparation service fee $ quoted to me and understand that it is my obligation to pay ALL SERVICE FEES UPFRONT (As instructed by the office), and ALL ADJUSTMENT FEES ARE OWED once my return is prepared based on the information I have provided, regardless of whether I opt not to file the return, for any reason. Should I fail to pay the full amount specified in any invoice before preparation and on the invoice’s date, a late fee of of $75.00 shall be added to the amount due, and interest of 10% percent per annum shall accrue from the 3rd business day following the invoice’s date.

    Should any tax authority, state(s) or IRS, decides or happens to audit the tax return in question as specified on this agreement, and should it NOT be any fault or error of the firm, or its representatives, an hourly rate of $150.00, at a minimum of two (2) hours, will be charged and payable to the firm to address the issue at hand. The term of this agreement would be still in place and enforce in addition to new fees.

  1. I, agree to pay or reimburse Prestige ProServe, LLC (The firm) for all agree to pay or reimburse Prestige ProServe, LLC (The firm) for all reasonable attorneys’ fees and costs in the event legal action is required to enforce any provision of this Agreement.

  2. I, , agree that regardless of where I am domiciled and regardless of where this Agreement is physically signed, it shall be deemed to have been entered into at Prestige ProServe’s office located at 161 Kings Highway East, Suite 206, Fairfield, CT 06825, and Fairfield County, CT shall be the exclusive jurisdiction for resolving disputes related to this Agreement. This Agreement shall be interpreted and governed in accordance with the Laws of CT.

  3. For Business Returns – I declare that I agree to pay the fees associated with the work performed to render any accounting and/or bookkeeping services. I understand that this service will be limited to those tasks deemed necessary for the preparation of the above mentioned tax returns (State and Federal). I am the person duly authorized and take explicit and implicit responsibility for the information provided in connection to these returns.

  4. ELECTRONIC SIGNATURE ACKNOWLEDGEMENT AND CONSENT

    I agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement. I further agree my signature on this document is as valid as if I signed the document in writing. This is to be used in conjunction with the use of electronic signatures on all forms regarding any and all future documentation with a signature requirement, should I elect to have signed electronically

    Under penalty of perjury, I herewith affirm that my electronic signature, and all future electronic signatures, were signed by myself with full knowledge and consent and am legally bound to these terms and conditions.

  5. Tax Payer / Client’s Signature     Date :



Step 1 - 5

2020

TAX ORGANISER

Taxpayer Information

Last name
First name
Middle initial
Suffix
SSN
Occupation
Work phone
Ext
Cell phone
E-mail address
Date of birth

Licence Driver Details

Issuing state
Licence number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

State Identification card detail

Issuing state
Identification number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

Spouse Information

Last name
First name
Middle initial
Suffix
SSN
Occupation
Work phone
Ext
Cell phone
E-mail address
Date of birth

Licence Driver Details

Issuing state
Licence number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

State Identification card detail

Issuing state
Identification number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

Address
Apartment number
City
State
ZIP code
Home phone
Fax number

Dependent Information

( Swipe left to see more information )
First name
Last name
MI
Suffix
Social security number
Relationship
Date of birth Months Lived with Taxpayer Child Care Expense










Child and Dependent Care Provider Expenses

Name Address ID number Amount Paid

Education Tuition and Fees

Attach all Form 1098-Ts and list of your qualified education expenses.

Student Loan Interest Paid

Enter total 2020 qualified student loan interest


Step 2 - 5

2020

Income


Attach Form(s) W-2 - Wages, Salaries, Tips and Other Compensation

2019 Amount

Attach Form(s) 1099-R - Distributions from Pensions, Annuities, Retirement, Profit-Sharing, IRAs, etc

1099‑R Payer Name 2019 Amount

Attach Form(s) SSA-1099 - Social Security/Railroad Benefits

Taxepayer Spouse
Sosial Security Benefits from Form SSA-1099
Railroad Retirement Benefits from Form RRB-1099
Medicare B premiums withheld
Medicare C premiums withheld
Medicare D premiums withheld

Attach Form(s) 1099-MISC - Miscellaneous Income

1099-MISC Payer Name

Attach Form(s) 1099-INT - Interest Income

1099-INT Payer Name 2019 Amount

Attach Form(s) 1099-DIV - Dividend Income

1099-DIV Payer Name 2019 Amount

Attach Form(s) 1099-B, 1099-S - Sales of Stocks, Bonds, Real Estate, etc

Attach all stock sale transaction information, including initial cost information.

Other Government Forms to attach:

Form(s) 1099-G - Certain Government Payments, Schedule K-1s - Partnership, S-Corporation, Trust or Estate In Income, Form(s) W-2G - Gambling or Lottery Winnings, Forms(s) 1099-Q - Payments from Qualified Education Programs.

Other Income:

Alimony, jury duty, unreported tips, disability income, etc. Business, rentals, farms: Attach income and expenses for any business, rental or farm you own. Include a list of all new equiment acquired this year, including date of purchased and cost.

Retirement Plan Contributions

Taxpayer Spouse
Traditional IRA contributions made for 2020
Roth IRA contributions made for 2020
SEP, Keogh, Individual 401(k) or SIMPLE Contributions


Step 3 - 5

2020

Deductions


Medical and Dental Expenses

2020 Amount 2019 Amount
Prescription medications
Health insurance premiuns
Doctors, dentists, etc
Hospitals, clinics, etc
Eyeglasses and contact lences
Miles driven for medical purposes
Other medical and dental expenses:

Taxes

2020 Amount 2019 Amount
Real estate taxes paid on principal residence
Real estate taxes paid on additional homes or land
Auto licence registration fees based on the value of the vehicule
Other personal property taxes

Interest Expenses


Home mortgage interest paid - Attach Form(s) 1098
Lender's Name 2020 Amount 2019 Amount
Point paid on loan to buy, build or improve main home
Lender's Name
2020 Amount

Cash/Check/Credit Contributions

2020 Amount 2019 Amount

Noncash Charitable Contributions

Attach all reciepts with details listing the following information: Donee, donee address, description of donation, date acquired and date contributed, your cost, values at time of donation, and you acquired the property.

Miscellaneous Deductions

2020 Amount 2019 Amount
Union and professional dues
Professional subscriptions, books, supplies
Uniforms and protective clothing (including cleaning)
Job search cost
Taxpayer educator expenses
Spouse educator expenses
Tax return preparation fees
Safe deposit box rental
Gambling losses (to the extent of gamblling income)
Other expenses (list):


Step 4 - 5

2020 Questions

Yes

No

1.- Did you receive an Economic Impact (Stimulus) Payment? yes, If yes, how much did you receive?
2.- Did a lender cancel any of your dept in 2020 (Attach any Form 1099-A or 1099-C)
3.- Did you make energy efficient improvements to your home or purchase any energy-saving property during 2020? If yes, please attach details
4.- Did you purchase a motor vehicle or boat during 2020?
If yes, attach documentation showing sales tax paid.
5.- Did you purchase a hybrid or electric vehicule in 2020? If yes, enter year, make, model, and date purchase
6.- Did you donate a vehicle in 2020 ? If yes, attach Form 1098C
7.- What was the sales tax rate in your locality in 2020 ?
%
8.- Did your marital status changes during 2020 ? If yes, explain
9.- Were you or your spouse permanently and totally disable in 2020
10.- Do you have dependents who must file ?
11.- Do you have children who are under age 19 or a full time student under age 24 with investment income greater than $2,200?
12.- Did you provide over half the support for any other person during 2020?
13.- Did you incur adoption expenses during 2020?
14.- Did you receive a total distribution from IRA or other qualified plan that was partially or totally rolled over into another IRA r qualified plan within 60 days of the distribution?
15.- Did you receive any disability payments in 2020?
16.- Did you receive any tip income not reported to your employer?
17a.- Did you buy, sell, refinance, foreclose or abandon a pricipal residence or other real property in 2020? If yes, attach closing or escrow statements, 1099-C or 1099-A forms
17b.- If you sold a home, did you claim the First-Time Homebuyer Credit when you purchased it?
18.- Did you incur any casualty or theft losses during 2020?
19.- Did you incur any non-business bad bedts?
20.- Did you pay any individual for domestic sevices in 2020?
21.- Did you take a retirement account distribution related to the corona virus or a natural disaster?
22.- Did you buy or sell any stocks on bonds in 2020?
23.- Did you use the proceeds from Series EE or | U.S. savings bonds purchased after 1989 to pay for higher education expenses?
24.- Did you incur any moving expenses? If yes, atach details
25.- Did you receive any income not included in this Tax Organizer? If yes, please attach information.
26.- Do you expect your income and deductions in 2021 to be the same as 2020? If no, attach explanation of changes expected.
27.- Did you receive Form 1095-A (Health Insurance Marketplace Statement)? If so, please attach
28.- At any time during 2020, did you sell, send, exchange, or otherwise acquire any financial interest in any virtual currency?
29 a.- Did you obtain a Paycheck Protection Program (PPP) loan?
29 b.- If yes, has any portion of that loan been forgiven?
30.- If you paid any alimony, enter recipient's SSN ?
Alimony paid:
31.- Enter the state of residence

Electronic Filing and Direct Deposit of Refund

Yes

No

If your tax return is eligible for Electronic Filing, would you like to file electronically?
The Internal Revenue Service is able to deposit many refunds directly into taxpayers' account. If you receive a refund, would you like derect deposit? If yes, plaese provide a voided check (not a deposit slip) if your bank account information ahs changed.
What type of account is this?
Checking Savings

Estimated Tax Paid

Federal State Local
Date Amount Date Amount ID Date Amount ID

Additional Information

(Enter any additional information here and attach any documents.)


Step 5 - 5


161 Kings Highway East, Suite 206
Fairfield, CT 06825

Consent/Acknowledgement Form

  1. I, (Print your name), hereby acknowledge that my identity has been verified satisfactorily, by use of my state or federal issued ID. I am the primary person on the attached tax return and have deemed myself in capacity to act on my own behalf. I also take full responsibility for the information and all supporting documents that I have provided for the preparation and filing of my tax return and I ascertain that they are accurate, valid, and true.

  2. I, , hereby acknowledge and agree that these services are not intended to determine whether I have filing requirements in other taxing jurisdictions than the one(s) I have listed above. The firm is available under the terms of a separate engagement letter to provide a nexus study that will enable us to determine whether any other state tax filings are required

  3. I, , hereby acknowledge that I am in agreement with the preparation service fee $ quoted to me and understand that it is my obligation to pay ALL SERVICE FEES UPFRONT (As instructed by the office), and ALL ADJUSTMENT FEES ARE OWED once my return is prepared based on the information I have provided, regardless of whether I opt not to file the return, for any reason. Should I fail to pay the full amount specified in any invoice before preparation and on the invoice’s date, a late fee of of $75.00 shall be added to the amount due, and interest of 10% percent per annum shall accrue from the 3rd business day following the invoice’s date.

    Should any tax authority, state(s) or IRS, decides or happens to audit the tax return in question as specified on this agreement, and should it NOT be any fault or error of the firm, or its representatives, an hourly rate of $150.00, at a minimum of two (2) hours, will be charged and payable to the firm to address the issue at hand. The term of this agreement would be still in place and enforce in addition to new fees.

  1. I, agree to pay or reimburse Prestige ProServe, LLC (The firm) for all agree to pay or reimburse Prestige ProServe, LLC (The firm) for all reasonable attorneys’ fees and costs in the event legal action is required to enforce any provision of this Agreement.

  2. I, , agree that regardless of where I am domiciled and regardless of where this Agreement is physically signed, it shall be deemed to have been entered into at Prestige ProServe’s office located at 161 Kings Highway East, Suite 206, Fairfield, CT 06825, and Fairfield County, CT shall be the exclusive jurisdiction for resolving disputes related to this Agreement. This Agreement shall be interpreted and governed in accordance with the Laws of CT.

  3. For Business Returns – I declare that I agree to pay the fees associated with the work performed to render any accounting and/or bookkeeping services. I understand that this service will be limited to those tasks deemed necessary for the preparation of the above mentioned tax returns (State and Federal). I am the person duly authorized and take explicit and implicit responsibility for the information provided in connection to these returns.

  4. ELECTRONIC SIGNATURE ACKNOWLEDGEMENT AND CONSENT

    I agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement. I further agree my signature on this document is as valid as if I signed the document in writing. This is to be used in conjunction with the use of electronic signatures on all forms regarding any and all future documentation with a signature requirement, should I elect to have signed electronically

    Under penalty of perjury, I herewith affirm that my electronic signature, and all future electronic signatures, were signed by myself with full knowledge and consent and am legally bound to these terms and conditions.

  5. Tax Payer / Client’s Signature     Date :



Step 1 - 5

2021

TAX ORGANISER

Taxpayer Information

Last name
First name
Middle initial
Suffix
SSN
Occupation
Work phone
Ext
Cell phone
E-mail address
Date of birth

Licence Driver Details

Issuing state
Licence number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

State Identification card detail

Issuing state
Identification number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

Spouse Information

Last name
First name
Middle initial
Suffix
SSN
Occupation
Work phone
Ext
Cell phone
E-mail address
Date of birth

Licence Driver Details

Issuing state
Licence number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

State Identification card detail

Issuing state
Identification number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

Address
Apartment number
City
State
ZIP code
Home phone
Fax number

Dependent Information

( Swipe left to see more information )
First name
Last name
MI
Suffix
Social security number
Relationship
Date of birth Months Lived with Taxpayer Child Care Expense










Child and Dependent Care Provider Expenses

Name Address ID number Amount Paid

Education Tuition and Fees

Attach all Form 1098-Ts and list of your qualified education expenses.

Student Loan Interest Paid

Enter total 2021 qualified student loan interest


Step 2 - 5

2021

Income


Attach Form(s) W-2 - Wages, Salaries, Tips and Other Compensation

2020 Amount

Attach Form(s) 1099-R - Distributions from Pensions, Annuities, Retirement, Profit-Sharing, IRAs, etc

1099‑R Payer Name 2020 Amount

Attach Form(s) SSA-1099 - Social Security/Railroad Benefits

Taxepayer Spouse
Sosial Security Benefits from Form SSA-1099
Railroad Retirement Benefits from Form RRB-1099
Medicare B premiums withheld
Medicare C premiums withheld
Medicare D premiums withheld

Attach Form(s) 1099-MISC - Miscellaneous Income

1099-MISC Payer Name

Attach Form(s) 1099-INT - Interest Income

1099-INT Payer Name 2020 Amount

Attach Form(s) 1099-DIV - Dividend Income

1099-DIV Payer Name 2020 Amount

Attach Form(s) 1099-B, 1099-S - Sales of Stocks, Bonds, Real Estate, etc

Attach all stock sale transaction information, including initial cost information.

Other Government Forms to attach:

Form(s) 1099-G - Certain Government Payments, Schedule K-1s - Partnership, S-Corporation, Trust or Estate In Income, Form(s) W-2G - Gambling or Lottery Winnings, Forms(s) 1099-Q - Payments from Qualified Education Programs.

Other Income:

Alimony, jury duty, unreported tips, disability income, etc. Business, rentals, farms: Attach income and expenses for any business, rental or farm you own. Include a list of all new equiment acquired this year, including date of purchased and cost.

Retirement Plan Contributions

Taxpayer Spouse
Traditional IRA contributions made for 2021
Roth IRA contributions made for 2021
SEP, Keogh, Individual 401(k) or SIMPLE Contributions


Step 3 - 5

2021

Deductions


Medical and Dental Expenses

2021 Amount 2020 Amount
Prescription medications
Health insurance premiuns
Doctors, dentists, etc
Hospitals, clinics, etc
Eyeglasses and contact lences
Miles driven for medical purposes
Other medical and dental expenses:

Taxes

2021 Amount 2020 Amount
Real estate taxes paid on principal residence
Real estate taxes paid on additional homes or land
Auto licence registration fees based on the value of the vehicule
Other personal property taxes

Interest Expenses


Home mortgage interest paid - Attach Form(s) 1098
Lender's Name 2021 Amount 2020 Amount
Point paid on loan to buy, build or improve main home
Lender's Name
2021 Amount

Cash/Check/Credit Contributions

2021 Amount 2020 Amount

Noncash Charitable Contributions

Attach all reciepts with details listing the following information: Donee, donee address, description of donation, date acquired and date contributed, your cost, values at time of donation, and you acquired the property.

Miscellaneous Deductions

2021 Amount 2020 Amount
Union and professional dues
Professional subscriptions, books, supplies
Uniforms and protective clothing (including cleaning)
Job search cost
Taxpayer educator expenses
Spouse educator expenses
Tax return preparation fees
Safe deposit box rental
Gambling losses (to the extent of gamblling income)
Other expenses (list):


Step 4 - 5

2021 Questions

Yes

No

1.- Did you receive an Economic Impact (Stimulus) Payment? yes, If yes, how much did you receive?
2.- Did you receive any Advanced Child Tax Credit payments? If yes, If yes, how much did you receive?
3.- Did a lender cancel any of your dept in 2021 (Attach any Form 1099-A or 1099-C)
4.- Did you make energy efficient improvements to your home or purchase any energy-saving property during 2021? If yes, please attach details
5.- Did you purchase a motor vehicle or boat during 2021?
If yes, attach documentation showing sales tax paid.
6.- Did you purchase a hybrid or electric vehicule in 2021? If yes, enter year, make, model, and date purchase
7.- Did you donate a vehicle in 2021 ? If yes, attach Form 1098C
8.- What was the sales tax rate in your locality in 2021 ?
%
9.- Did your marital status changes during 2021 ? If yes, explain
10.- Were you or your spouse permanently and totally disable in 2021
11.- Do you have dependents who must file ?
12.- Do you have children who are under age 19 or a full time student under age 24 with investment income greater than $2,200?
13.- Did you provide over half the support for any other person during 2021?
14.- Did you incur adoption expenses during 2021?
15.- Did you receive a total distribution from IRA or other qualified plan that was partially or totally rolled over into another IRA r qualified plan within 60 days of the distribution?
16.- Did you receive any disability payments in 2021?
17.- Did you receive any tip income not reported to your employer?
18a.- Did you buy, sell, refinance, foreclose or abandon a pricipal residence or other real property in 2021? If yes, attach closing or escrow statements, 1099-C or 1099-A forms
18b.- If you sold a home, did you claim the First-Time Homebuyer Credit when you purchased it?
19.- Did you incur any casualty or theft losses during 2021?
20.- Did you incur any non-business bad bedts?
21.- Did you pay any individual for domestic sevices in 2021?
22.- Did you take a retirement account distribution related to the corona virus or a natural disaster?
23.- Did you buy or sell any stocks on bonds in 2021?
24.- Did you use the proceeds from Series EE or | U.S. savings bonds purchased after 1989 to pay for higher education expenses?
25.- Did you incur any moving expenses? If yes, atach details
26.- Did you receive any income not included in this Tax Organizer? If yes, please attach information.
27.- Do you expect your income and deductions in 2022 to be the same as 2021? If no, attach explanation of changes expected.
28.- Did you receive Form 1095-A (Health Insurance Marketplace Statement)? If so, please attach
29.- At any time during 2020, did you sell, send, exchange, or otherwise acquire any financial interest in any virtual currency?
30 a.- Did you obtain a Paycheck Protection Program (PPP) loan?
30 b.- If yes, has any portion of that loan been forgiven?
31.- If you paid any alimony, enter recipient's SSN ?
Alimony paid:
32.- Enter the state of residence
33- Do you want to change the language with which the IRS communicates with you? If yes, which language?

Electronic Filing and Direct Deposit of Refund

Yes

No

If your tax return is eligible for Electronic Filing, would you like to file electronically?
The Internal Revenue Service is able to deposit many refunds directly into taxpayers' account. If you receive a refund, would you like derect deposit? If yes, plaese provide a voided check (not a deposit slip) if your bank account information ahs changed.
What type of account is this?
Checking Savings

Estimated Tax Paid

Federal State Local
Date Amount Date Amount ID Date Amount ID

Additional Information

(Enter any additional information here and attach any documents.)


Step 5 - 5


161 Kings Highway East, Suite 206
Fairfield, CT 06825

Consent/Acknowledgement Form

  1. I, (Print your name), hereby acknowledge that my identity has been verified satisfactorily, by use of my state or federal issued ID. I am the primary person on the attached tax return and have deemed myself in capacity to act on my own behalf. I also take full responsibility for the information and all supporting documents that I have provided for the preparation and filing of my tax return and I ascertain that they are accurate, valid, and true.

  2. I, , hereby acknowledge and agree that these services are not intended to determine whether I have filing requirements in other taxing jurisdictions than the one(s) I have listed above. The firm is available under the terms of a separate engagement letter to provide a nexus study that will enable us to determine whether any other state tax filings are required

  3. I, , hereby acknowledge that I am in agreement with the preparation service fee $ quoted to me and understand that it is my obligation to pay ALL SERVICE FEES UPFRONT (As instructed by the office), and ALL ADJUSTMENT FEES ARE OWED once my return is prepared based on the information I have provided, regardless of whether I opt not to file the return, for any reason. Should I fail to pay the full amount specified in any invoice before preparation and on the invoice’s date, a late fee of of $75.00 shall be added to the amount due, and interest of 10% percent per annum shall accrue from the 3rd business day following the invoice’s date.

    Should any tax authority, state(s) or IRS, decides or happens to audit the tax return in question as specified on this agreement, and should it NOT be any fault or error of the firm, or its representatives, an hourly rate of $150.00, at a minimum of two (2) hours, will be charged and payable to the firm to address the issue at hand. The term of this agreement would be still in place and enforce in addition to new fees.

  1. I, agree to pay or reimburse Prestige ProServe, LLC (The firm) for all agree to pay or reimburse Prestige ProServe, LLC (The firm) for all reasonable attorneys’ fees and costs in the event legal action is required to enforce any provision of this Agreement.

  2. I, , agree that regardless of where I am domiciled and regardless of where this Agreement is physically signed, it shall be deemed to have been entered into at Prestige ProServe’s office located at 161 Kings Highway East, Suite 206, Fairfield, CT 06825, and Fairfield County, CT shall be the exclusive jurisdiction for resolving disputes related to this Agreement. This Agreement shall be interpreted and governed in accordance with the Laws of CT.

  3. For Business Returns – I declare that I agree to pay the fees associated with the work performed to render any accounting and/or bookkeeping services. I understand that this service will be limited to those tasks deemed necessary for the preparation of the above mentioned tax returns (State and Federal). I am the person duly authorized and take explicit and implicit responsibility for the information provided in connection to these returns.

  4. ELECTRONIC SIGNATURE ACKNOWLEDGEMENT AND CONSENT

    I agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement. I further agree my signature on this document is as valid as if I signed the document in writing. This is to be used in conjunction with the use of electronic signatures on all forms regarding any and all future documentation with a signature requirement, should I elect to have signed electronically

    Under penalty of perjury, I herewith affirm that my electronic signature, and all future electronic signatures, were signed by myself with full knowledge and consent and am legally bound to these terms and conditions.

  5. Tax Payer / Client’s Signature     Date :



Step 1 - 5

2022

TAX ORGANISER

Taxpayer Information

Last name
First name
Middle initial
Suffix
SSN
Occupation
Work phone
Ext
Cell phone
E-mail address
Date of birth

Licence Driver Details

Issuing state
Licence number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

State Identification card detail

Issuing state
Identification number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

Spouse Information

Last name
First name
Middle initial
Suffix
SSN
Occupation
Work phone
Ext
Cell phone
E-mail address
Date of birth

Licence Driver Details

Issuing state
Licence number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

State Identification card detail

Issuing state
Identification number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

Address
Apartment number
City
State
ZIP code
Home phone
Fax number

Dependent Information

( Swipe left to see more information )
First name
Last name
MI
Suffix
Social security number
Relationship
Date of birth Months Lived with Taxpayer Child Care Expense










Child and Dependent Care Provider Expenses

Name Address ID number Amount Paid

Education Tuition and Fees

Attach all Form 1098-Ts and list of your qualified education expenses.

Student Loan Interest Paid

Enter total 2022 qualified student loan interest


Step 2 - 5

2022

Income


Attach Form(s) W-2 - Wages, Salaries, Tips and Other Compensation

2021 Amount

Attach Form(s) 1099-R - Distributions from Pensions, Annuities, Retirement, Profit-Sharing, IRAs, etc

1099‑R Payer Name 2021 Amount

Attach Form(s) SSA-1099 - Social Security/Railroad Benefits

Taxepayer Spouse
Sosial Security Benefits from Form SSA-1099
Railroad Retirement Benefits from Form RRB-1099
Medicare B premiums withheld
Medicare C premiums withheld
Medicare D premiums withheld

Attach Form(s) 1099-MISC - Miscellaneous Income

1099-MISC Payer Name

Attach Form(s) 1099-INT - Interest Income

1099-INT Payer Name 2021 Amount

Attach Form(s) 1099-DIV - Dividend Income

1099-DIV Payer Name 2021 Amount

Attach Form(s) 1099-B, 1099-S - Sales of Stocks, Bonds, Real Estate, etc

Attach all stock sale transaction information, including initial cost information.

Other Government Forms to attach:

Form(s) 1099-G - Certain Government Payments, Schedule K-1s - Partnership, S-Corporation, Trust or Estate In Income, Form(s) W-2G - Gambling or Lottery Winnings, Forms(s) 1099-Q - Payments from Qualified Education Programs.

Other Income:

Alimony, jury duty, unreported tips, disability income, etc. Business, rentals, farms: Attach income and expenses for any business, rental or farm you own. Include a list of all new equiment acquired this year, including date of purchased and cost.

Retirement Plan Contributions

Taxpayer Spouse
Traditional IRA contributions made for 2022
Roth IRA contributions made for 2022
SEP, Keogh, Individual 401(k) or SIMPLE Contributions


Step 3 - 5

2022

Deductions


Medical and Dental Expenses

2022 Amount 2021 Amount
Prescription medications
Health insurance premiuns
Doctors, dentists, etc
Hospitals, clinics, etc
Eyeglasses and contact lences
Miles driven for medical purposes
Other medical and dental expenses:

Taxes

2022 Amount 2021 Amount
Real estate taxes paid on principal residence
Real estate taxes paid on additional homes or land
Auto licence registration fees based on the value of the vehicule
Other personal property taxes

Interest Expenses


Home mortgage interest paid - Attach Form(s) 1098
Lender's Name 2O22 Amount 2O21 Amount
Point paid on loan to buy, build or improve main home
Lender's Name
2O22 Amount

Cash/Check/Credit Contributions

2022 Amount 2021 Amount

Noncash Charitable Contributions

Attach all reciepts with details listing the following information: Donee, donee address, description of donation, date acquired and date contributed, your cost, values at time of donation, and you acquired the property.

Miscellaneous Deductions

2022 Amount 2021 Amount
Union and professional dues
Professional subscriptions, books, supplies
Uniforms and protective clothing (including cleaning)
Job search cost
Taxpayer educator expenses
Spouse educator expenses
Tax return preparation fees
Safe deposit box rental
Gambling losses (to the extent of gamblling income)
Other expenses (list):


Step 4 - 5

2022 Questions

Yes

No

1.- Did a lender cancel any of your dept in 2022 (Attach any Form 1099-A or 1099-C)
2.- Did you make energy efficient improvements to your home or purchase any energy-saving property during 2022? If yes, please attach details
3.- Did you purchase a motor vehicle or boat during 2022?
If yes, attach documentation showing sales tax paid.
4.- Did you purchase a hybrid or electric vehicule in 2022? If yes, enter year, make, model, and date purchase
5.- Did you donate a vehicle in 2022 ? If yes, attach Form 1098C
6.- What was the sales tax rate in your locality in 2022 ?
%
7.- Did your marital status changes during 2022 ? If yes, explain
8.- Were you or your spouse permanently and totally disable in 2022
9.- Do you have dependents who must file ?
10.- Do you have children who are under age 19 or a full time student under age 24 with investment income greater than $2,300?
11.- Did you provide over half the support for any other person during 2022 ?
12.- Did you incur adoption expenses during 2022 ?
13.- Did you receive a total distribution from IRA or other qualified plan that was partially or totally rolled over into another IRA r qualified plan within 60 days of the distribution?
14.- Did you receive any disability payments in 2022 ?
15.- Did you receive any tip income not reported to your employer?
16a.- Did you buy, sell, refinance, foreclose or abandon a pricipal residence or other real property in 2022 ? If yes, attach closing or escrow statements, 1099-C or 1099-A forms
16b.- If you sold a home, did you claim the First-Time Homebuyer Credit when you purchased it?
17.- Did you incur any casualty or theft losses during 2022 ?
18.- Did you incur any non-business bad bedts?
19.- Did you pay any individual for domestic sevices in 2022 ?
20.- Did you take a retirement account distribution related to the corona virus or a natural disaster?
21.- Did you buy or sell any stocks on bonds in 2022 ?
22.- Did you use the proceeds from Series EE or | U.S. savings bonds purchased after 1989 to pay for higher education expenses?
23.- Did you incur any moving expenses? If yes, atach details
24.- Did you receive any income not included in this Tax Organizer? If yes, please attach information.
25.- Do you expect your income and deductions in 2023 to be the same as 2022? If no, attach explanation of changes expected.
26.- Did you and your dependents have health insurance coverage for the full year?
27.- Did you receive any of the following IRS documents ? Forms 1095-A (Health Insurance Marketplace Statement), Form 1095-B (Health Coverage) or Form 1095-C (Employer Provided Health Insurance Offer and Coverage)? Is so, please attach.
28 a.- Did you obtain a Paycheck Protection Program (PPP) loan?
28 b.- If yes, has any portion of that loan been forgiven?
29.- If you paid any alimony, enter recipient's SSN ?
Alimony paid:
30.- Enter the state of residence
31- Do you want to change the language with which the IRS communicates with you? If yes, which language?

Electronic Filing and Direct Deposit of Refund

Yes

No

If your tax return is eligible for Electronic Filing, would you like to file electronically?
The Internal Revenue Service is able to deposit many refunds directly into taxpayers' account. If you receive a refund, would you like derect deposit? If yes, plaese provide a voided check (not a deposit slip) if your bank account information ahs changed.
What type of account is this?
Checking Savings

Estimated Tax Paid

Federal State Local
Date Amount Date Amount ID Date Amount ID

Additional Information

(Enter any additional information here and attach any documents.)


Step 5 - 5


161 Kings Highway East, Suite 206
Fairfield, CT 06825

Consent/Acknowledgement Form

  1. I, (Print your name), hereby acknowledge that my identity has been verified satisfactorily, by use of my state or federal issued ID. I am the primary person on the attached tax return and have deemed myself in capacity to act on my own behalf. I also take full responsibility for the information and all supporting documents that I have provided for the preparation and filing of my tax return and I ascertain that they are accurate, valid, and true.

  2. I, , hereby acknowledge and agree that these services are not intended to determine whether I have filing requirements in other taxing jurisdictions than the one(s) I have listed above. The firm is available under the terms of a separate engagement letter to provide a nexus study that will enable us to determine whether any other state tax filings are required

  3. I, , hereby acknowledge that I am in agreement with the preparation service fee $ quoted to me and understand that it is my obligation to pay ALL SERVICE FEES UPFRONT (As instructed by the office), and ALL ADJUSTMENT FEES ARE OWED once my return is prepared based on the information I have provided, regardless of whether I opt not to file the return, for any reason. Should I fail to pay the full amount specified in any invoice before preparation and on the invoice’s date, a late fee of of $75.00 shall be added to the amount due, and interest of 10% percent per annum shall accrue from the 3rd business day following the invoice’s date.

    Should any tax authority, state(s) or IRS, decides or happens to audit the tax return in question as specified on this agreement, and should it NOT be any fault or error of the firm, or its representatives, an hourly rate of $150.00, at a minimum of two (2) hours, will be charged and payable to the firm to address the issue at hand. The term of this agreement would be still in place and enforce in addition to new fees.

  1. I, agree to pay or reimburse Prestige ProServe, LLC (The firm) for all agree to pay or reimburse Prestige ProServe, LLC (The firm) for all reasonable attorneys’ fees and costs in the event legal action is required to enforce any provision of this Agreement.

  2. I, , agree that regardless of where I am domiciled and regardless of where this Agreement is physically signed, it shall be deemed to have been entered into at Prestige ProServe’s office located at 161 Kings Highway East, Suite 206, Fairfield, CT 06825, and Fairfield County, CT shall be the exclusive jurisdiction for resolving disputes related to this Agreement. This Agreement shall be interpreted and governed in accordance with the Laws of CT.

  3. For Business Returns – I declare that I agree to pay the fees associated with the work performed to render any accounting and/or bookkeeping services. I understand that this service will be limited to those tasks deemed necessary for the preparation of the above mentioned tax returns (State and Federal). I am the person duly authorized and take explicit and implicit responsibility for the information provided in connection to these returns.

  4. ELECTRONIC SIGNATURE ACKNOWLEDGEMENT AND CONSENT

    I agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement. I further agree my signature on this document is as valid as if I signed the document in writing. This is to be used in conjunction with the use of electronic signatures on all forms regarding any and all future documentation with a signature requirement, should I elect to have signed electronically

    Under penalty of perjury, I herewith affirm that my electronic signature, and all future electronic signatures, were signed by myself with full knowledge and consent and am legally bound to these terms and conditions.

  5. Tax Payer / Client’s Signature     Date :



Step 1 - 5

2023

TAX ORGANISER

Taxpayer Information

Last name
First name
Middle initial
Suffix
SSN
Occupation
Work phone
Ext
Cell phone
E-mail address
Date of birth

Licence Driver Details

Issuing state
Licence number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

State Identification card detail

Issuing state
Identification number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

Spouse Information

Last name
First name
Middle initial
Suffix
SSN
Occupation
Work phone
Ext
Cell phone
E-mail address
Date of birth

Licence Driver Details

Issuing state
Licence number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

State Identification card detail

Issuing state
Identification number
Issue date
Expiration date
Does not expire
NY Doc number(first 3 chars)*

Address
Apartment number
City
State
ZIP code
Home phone
Fax number

Dependent Information

( Swipe left to see more information )
First name
Last name
MI
Suffix
Social security number
Relationship
Date of birth Months Lived with Taxpayer Child Care Expense










Child and Dependent Care Provider Expenses

Name Address ID number Amount Paid

Education Tuition and Fees

Attach all Form 1098-Ts and list of your qualified education expenses.

Student Loan Interest Paid

Enter total 2023 qualified student loan interest


Step 2 - 5

2023

Income


Attach Form(s) W-2 - Wages, Salaries, Tips and Other Compensation

2022 Amount

Attach Form(s) 1099-R - Distributions from Pensions, Annuities, Retirement, Profit-Sharing, IRAs, etc

1099‑R Payer Name 2022 Amount

Attach Form(s) SSA-1099 - Social Security/Railroad Benefits

Taxepayer Spouse
Sosial Security Benefits from Form SSA-1099
Railroad Retirement Benefits from Form RRB-1099
Medicare B premiums withheld
Medicare C premiums withheld
Medicare D premiums withheld

Attach Form(s) 1099-MISC - Miscellaneous Income

1099-MISC Payer Name

Attach Form(s) 1099-INT - Interest Income

1099-INT Payer Name 2022 Amount

Attach Form(s) 1099-DIV - Dividend Income

1099-DIV Payer Name 2022 Amount

Attach Form(s) 1099-B, 1099-S - Sales of Stocks, Bonds, Real Estate, etc

Attach all stock sale transaction information, including initial cost information.

Other Government Forms to attach:

Form(s) 1099-G - Certain Government Payments, Schedule K-1s - Partnership, S-Corporation, Trust or Estate In Income, Form(s) W-2G - Gambling or Lottery Winnings, Forms(s) 1099-Q - Payments from Qualified Education Programs.

Other Income:

Alimony, jury duty, unreported tips, disability income, etc. Business, rentals, farms: Attach income and expenses for any business, rental or farm you own. Include a list of all new equiment acquired this year, including date of purchased and cost.

Retirement Plan Contributions

Taxpayer Spouse
Traditional IRA contributions made for 2023
Roth IRA contributions made for 2023
SEP, Keogh, Individual 401(k) or SIMPLE Contributions


Step 3 - 5

2023

Deductions


Medical and Dental Expenses

2023 Amount 2022 Amount
Prescription medications
Health insurance premiuns
Doctors, dentists, etc
Hospitals, clinics, etc
Eyeglasses and contact lences
Miles driven for medical purposes
Other medical and dental expenses:

Taxes

2023 Amount 2022 Amount
Real estate taxes paid on principal residence
Real estate taxes paid on additional homes or land
Auto licence registration fees based on the value of the vehicule
Other personal property taxes

Interest Expenses


Home mortgage interest paid - Attach Form(s) 1098
Lender's Name 2O23 Amount 2O22 Amount
Point paid on loan to buy, build or improve main home
Lender's Name
2O23 Amount

Cash/Check/Credit Contributions

2023 Amount 2022 Amount

Noncash Charitable Contributions

Attach all reciepts with details listing the following information: Donee, donee address, description of donation, date acquired and date contributed, your cost, values at time of donation, and you acquired the property.

Miscellaneous Deductions

2023 Amount 2022 Amount
Union and professional dues
Professional subscriptions, books, supplies
Uniforms and protective clothing (including cleaning)
Job search cost
Taxpayer educator expenses
Spouse educator expenses
Tax return preparation fees
Safe deposit box rental
Gambling losses (to the extent of gamblling income)
Other expenses (list):


Step 4 - 5

2023 Questions

Yes

No

1.- Did a lender cancel any of your dept in 2023 (Attach any Form 1099-A or 1099-C)
2.- Did you make energy efficient improvements to your home or purchase any energy-saving property during 2023? If yes, please attach details
3.- Did you purchase a motor vehicle or boat during 2023?
If yes, attach documentation showing sales tax paid.
4.- Did you purchase a hybrid or electric vehicule in 2023? If yes, enter year, make, model, and date purchase
5.- Did you donate a vehicle in 2023 ? If yes, attach Form 1098C
6.- What was the sales tax rate in your locality in 2023 ?
%
7.- Did your marital status changes during 2023 ? If yes, explain
8.- Were you or your spouse permanently and totally disable in 2023
9.- Do you have dependents who must file ?
10.- Do you have children who are under age 19 or a full time student under age 24 with investment income greater than $2,500?
11.- Did you provide over half the support for any other person during 2023 ?
12.- Did you incur adoption expenses during 2023 ?
13.- Did you receive a total distribution from IRA or other qualified plan that was partially or totally rolled over into another IRA or qualified plan within 60 days of the distribution?
14.- Did you receive any disability payments in 2023 ?
15.- Did you receive any tip income not reported to your employer?
16a.- Did you buy, sell, refinance, foreclose or abandon a pricipal residence or other real property in 2023 ? If yes, attach closing or escrow statements, 1099-C or 1099-A forms
16b.- If you sold a home, did you claim the First-Time Homebuyer Credit when you purchased it?
17.- Did you incur any casualty or theft losses during 2023 ?
18.- Did you incur any non-business bad bedts?
19.- Did you pay any individual for domestic sevices in 2023 ?
20.- Did you buy or sell any stocks on bonds in 2023 ?
21.- Did you use the proceeds from Series EE or | U.S. savings bonds purchased after 1989 to pay for higher education expenses?
22.- Did you incur any moving expenses? If yes, atach details
23.- Did you receive any income not included in this Tax Organizer? If yes, please attach information.
24.- Do you expect your income and deductions in 2024 to be the same as 2023? If no, attach explanation of changes expected.
25.- Did you and your dependents have health insurance coverage for the full year?
26.- Did you receive any of the following IRS documents ? Forms 1095-A (Health Insurance Marketplace Statement), Form 1095-B (Health Coverage) or Form 1095-C (Employer Provided Health Insurance Offer and Coverage)? Is so, please attach.
27 a.- Did you obtain a Paycheck Protection Program (PPP) loan?
27 b.- If yes, has any portion of that loan been forgiven?
28.- If you paid any alimony, enter recipient's SSN ?
Alimony paid:
29.- Enter the state of residence
30- Do you want to change the language with which the IRS communicates with you? If yes, which language?

Electronic Filing and Direct Deposit of Refund

Yes

No

If your tax return is eligible for Electronic Filing, would you like to file electronically?
The Internal Revenue Service is able to deposit many refunds directly into taxpayers' account. If you receive a refund, would you like derect deposit? If yes, plaese provide a voided check (not a deposit slip) if your bank account information ahs changed.
What type of account is this?
Checking Savings

Estimated Tax Paid

Federal State Local
Date Amount Date Amount ID Date Amount ID

Additional Information

(Enter any additional information here and attach any documents.)


Step 5 - 5


161 Kings Highway East, Suite 206
Fairfield, CT 06825

Consent/Acknowledgement Form

  1. I, (Print your name), hereby acknowledge that my identity has been verified satisfactorily, by use of my state or federal issued ID. I am the primary person on the attached tax return and have deemed myself in capacity to act on my own behalf. I also take full responsibility for the information and all supporting documents that I have provided for the preparation and filing of my tax return and I ascertain that they are accurate, valid, and true.

  2. I, , hereby acknowledge and agree that these services are not intended to determine whether I have filing requirements in other taxing jurisdictions than the one(s) I have listed above. The firm is available under the terms of a separate engagement letter to provide a nexus study that will enable us to determine whether any other state tax filings are required

  3. I, , hereby acknowledge that I am in agreement with the preparation service fee $ quoted to me and understand that it is my obligation to pay ALL SERVICE FEES UPFRONT (As instructed by the office), and ALL ADJUSTMENT FEES ARE OWED once my return is prepared based on the information I have provided, regardless of whether I opt not to file the return, for any reason. Should I fail to pay the full amount specified in any invoice before preparation and on the invoice’s date, a late fee of of $75.00 shall be added to the amount due, and interest of 10% percent per annum shall accrue from the 3rd business day following the invoice’s date.

    Should any tax authority, state(s) or IRS, decides or happens to audit the tax return in question as specified on this agreement, and should it NOT be any fault or error of the firm, or its representatives, an hourly rate of $150.00, at a minimum of two (2) hours, will be charged and payable to the firm to address the issue at hand. The term of this agreement would be still in place and enforce in addition to new fees.

  1. I, agree to pay or reimburse Prestige ProServe, LLC (The firm) for all agree to pay or reimburse Prestige ProServe, LLC (The firm) for all reasonable attorneys’ fees and costs in the event legal action is required to enforce any provision of this Agreement.

  2. I, , agree that regardless of where I am domiciled and regardless of where this Agreement is physically signed, it shall be deemed to have been entered into at Prestige ProServe’s office located at 161 Kings Highway East, Suite 206, Fairfield, CT 06825, and Fairfield County, CT shall be the exclusive jurisdiction for resolving disputes related to this Agreement. This Agreement shall be interpreted and governed in accordance with the Laws of CT.

  3. For Business Returns – I declare that I agree to pay the fees associated with the work performed to render any accounting and/or bookkeeping services. I understand that this service will be limited to those tasks deemed necessary for the preparation of the above mentioned tax returns (State and Federal). I am the person duly authorized and take explicit and implicit responsibility for the information provided in connection to these returns.

  4. ELECTRONIC SIGNATURE ACKNOWLEDGEMENT AND CONSENT

    I agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement. I further agree my signature on this document is as valid as if I signed the document in writing. This is to be used in conjunction with the use of electronic signatures on all forms regarding any and all future documentation with a signature requirement, should I elect to have signed electronically

    Under penalty of perjury, I herewith affirm that my electronic signature, and all future electronic signatures, were signed by myself with full knowledge and consent and am legally bound to these terms and conditions.

  5. Tax Payer / Client’s Signature     Date :