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Elite Classic City Services LLC (ECCS)Client Intake Form

Please complete this questionnaire to help us gather the essential information needed to prepare your tax return accurately and efficiently. This form covers your basic details, income, deductions, and any specific tax needs. Your answers will help us ensure a smooth filing process and maximize your eligible deductions and credits. Thank you for taking the time to provide this important information!

Are you a NEW or EXISTING Elite Classic City Services LLC Client? *

Do you still have a copy of the taxes you filed last year? *

Is your address the same as last year? *

Taxpayer Name *

Taxpayer Date of Birth *

Taxpayer Social Security Number *

Taxpayer Occupation *

Were you previously issued an Identity Protection PIN (IP PIN) by the IRS? *

Enter IPPIN Here

Phone *

Email *

Address

Street Address

City

State

Postal code

Did the taxpayer experience a natural disaster in the current filing season? *

Can another taxpayer claim you as a dependent on their tax return? *

Will you be filing a tax return with your Spouse?

Taxpayer Photo Identification *

Taxpayer Social Security Card *

Were the taxpayer or spouse employed? *

Provide your lease/mortgage or utility bill if claiming Head of Household *

Do you have any dependents who will claim in this year? *

DEPENDENT 1

Was Dependent (1) claimed on your last tax return?

Can anyone else claim dependent (1) on their taxes?

Dependent (1) Name as it appears on social security card

Dependent (1) social security number

Dependent (1) Date of Birth

Is Dependent (1) your biological child?

How many months did Dependent (1) live in your household this year?

Relationship

Is Dependent (1) disabled?

Dependent (1) social security card

Dependent (1) birth certificate

DEPENDENT 2

Was Dependent (2) claimed on your last tax return?

Can anyone else claim dependent (2) on their taxes?

Dependent (2) Name as it appears on social security card

Dependent (2) social security number

Dependent (2) Date of Birth

Is Dependent (2) your biological child?

How many months did Dependent (2) live in your household this year?

Your Relationship

Is Dependent (2) disabled?

Dependent (2) social security card

Dependent (2) birth certificate

DEPENDENT 3

Was Dependent (3) claimed on your last tax return?

Can anyone else claim dependent (3) on their taxes ?

Dependent (3) Name as it appears on social security card

Dependent (3) social security number

Dependent (3) Date of Birth

Is Dependent (3) your biological child?

How many months did Dependent (3) live in your household this year?

Relationship 3

Is Dependent (3) disabled?

Dependent (3) social security card

Dependent (3) birth certificate

FOUR OR MORE DEPENDENTS

If you have four or more dependents or qualifying children, please list their name(s) as it appears on their social security card, their social security number, date of birth and relationship to the taxpayer.

Dependent (4) Name as it appears on social security card

Dependent (4) social security number

Dependent (4) Date of Birth

Is Dependent (4) your biological child?

Is Dependent (4) disabled?

Upload Dependent (4) Social Security Card

Did you, your spouse or any dependents attend college? *

Did you, your spouse, or dependents receive health insurance through the Marketplace and get Form 1095-A? *

Did you or your spouse receive unemployment benefits this year ? *

Do you rent or own your current residence? *

Did you or your spouse make payments on your student loans this year? *

Did you or your spouse pay medical or dental expenses (not including insurance premiums)? *

Do you or your spouse own a rental property? *

Did you or your spouse have any gambling winnings ? *

Did you or your spouse sell, acquire, send, receive or exchange any virtual currency? *

Did you or your spouse receive social security benefits? *

Did you or your spouse make any charitable contributions? (Goodwill, Salvation Army, Church etc.)? *

Did you or your spouse make any charitable cash contributions of $300 or more? *

Did you or your spouse purchase an electric vehicle ? *

Did you or your spouse withdraw money from their 401k? *

Did you or your spouse receive any earnings from interest or dividends? *

Are you self-employed? *

Schedule C - Affidavit For Self-Employed Individuals Filing Taxes 1, the Taxpayer, hereby make the following sworn statement regarding the income and expenses of my self-employment business for the current tax year, in support of my Schedule C (Form 1040) submission to the Internal Revenue Service (IRS).

1. Business Information

Business Name
Trade Name (if aplicable)
Principal Business or Profession

Business Start Date :

Business Address

Business City

Business State

Zip Code

EIN Number (if aplicable)

2.Income

Total Gross Income

I confirm that the reported income for the tax year has been derived solely from the business activities listed above and includes all earnings received from sales, services, and any other business-related sources. I affirm that the amount reported as income accurately reflects all amounts received.

Signature : *

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3.Expenses

Total Business Expenses

Advertising

Contract Labor

Depreciation

Insurance

Legal and Professional Fees

Supplies

Rent or Lease Payments

Utilities

Wages

Car and Truck Expenses

Other Expenses(Specify)

Taxes & Licenses

Repair & Maintenance

4.Net Profit or Loss

5.Business Use of Home (if aplicable)

Is the area used for business exclusive to business activities?

Yes

How many rooms in your home used exclusively for business purposes?

What percentage of your home's total square footage is used for business purposes?

What is the total square footage of the area used exclusively for business?

Do you have a separate entrance to your business area?

Yes

6.Record Keeping and Documentation

I affirm that I have maintained accurate and complete records of all income and expenses related to my business, including receipts, invoices, bank statements, and other supporting documents. These records are available for inspection if required by the IRS or other tax authorities.

7.Vehicle Information

Do you use your vehicle for business purposes?

Yes

What date did you put your vehicle into use?

Of the totale number of miles you drove enter the number of miles you used for:

A. Business
B. Commuting
C. Other

Was your vehicle available for personal use?

Yes

Do you or your spouse have another vehicle for personal use?

Yes

Do you have evidence to support your deduction?

Yes

If yes please upload here

8.Certification

I certify under penalty of perjury that the information provided in this affidavit is true, accurate, and complete to the best of my knowledge and belief. I understand that any false statements or misrepresentations may result in penalties, including the disallowance of claimed deductions, fines, or criminal charges.

Please Sign here *

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Do you or your spouse owe debt to any Government Agency; such as IRS, Student Loans, Child Support etc? *

Do you plan to purchase a home within the next one or two years? *

Do you currently have life insurance for you, your spouse and/or dependents? *

Please upload all applicable tax forms and supporting documents for the taxpayer, spouse, dependents, and qualifying relatives, including but not limited to: W-2, 1099, 1098, 1095-A, 1099-R, Childcare Tuition Statements, HSA records, proof of charitable donations, gambling earnings, 1099-SSA, and any other relevant tax documents

Would you like to see if you PRE-QUALIFY for a SAME DAY ADVANCE UP TO $7,000? *

Select Cash Advance Loan Amount *

Enter Your Direct Deposit Information *

Bank Name
Bank Routing Number
Bank Account Number
Name on Account

Would you like to receive a text message when your refund is funded? *

What is Mother's Maiden Name? *

How did you hear about ECCS? *

Do you and your spouse understand and agree to the fees for ECCS preparing your Federal/State income tax return? *

Accuracy, Responsibility & Authorization to File

I affirm that all information I provide to Elite Classic City Services is true, correct, and complete to the best of my knowledge. I understand that I must have supporting documentation for all information provided. I acknowledge that providing false or fraudulent information may result in civil and/or criminal penalties, including audits, restitution, fines, or imprisonment. I waive Elite Classic City Services and its preparers of any liability for errors resulting from false or incomplete information I supply.

By signing, I authorize Elite Classic City Services to prepare and electronically file my federal and state tax returns on my behalf. I understand that one copy of my tax return will be provided to me, and additional copies requested will cost $25 each.

Payment of Fees, Confidentiality & Records

I agree to pay all tax preparation fees in full at the time services are rendered. I authorize Elite Classic City Services to auto-debit my bank account, debit/credit card, or other payment method on file for any unpaid balance. I understand no refund amount, processing time, or acceptance by the IRS or state agency is guaranteed. I acknowledge that Elite Classic City Services will maintain confidentiality as required by law, and I am responsible for retaining my own tax records and documentation for at least three (3) years.

By signing below, I confirm I have read, understood, and agree to all the terms above.

Client Printed Name: *

Signature: *

Clear

Date: *

Client Engagement Acknowledgement

Dear Client,

Thank you for choosing Elite Classic City Services. Please review these important points about our work together:

Our Services – We prepare your tax return based only on the information you provide. You are responsible for keeping your records (receipts, bank statements, etc.) for at least 5 years.

Accuracy & Judgment – We use our professional judgment but cannot guarantee the IRS (or state) will always accept every tax position. You are responsible for providing complete and accurate information.

Scope of Work – Our services cover annual income tax preparation only, unless agreed otherwise. Payroll, sales tax, property tax, audits, and legal compliance are not included unless arranged separately.

Fees – Fees are based on forms and time. Payment is due before we release your completed returns. Non-payment may result in legal collection of fees.

Delivery – Once paid, we provide your tax return, e-file authorization forms, and payment vouchers if applicable. Returns cannot be filed without your signed authorization.

Additional Work – We include up to 120 minutes of correspondence with tax authorities per year. Extra time is billed at $99/hour. Audit representation requires a separate agreement or Audit Protection plan.

Privacy – Your information is confidential. We may use it internally for client communications (like newsletters or greetings), but never sell or share it.

Identity Verification – For security, we may request documents (ID, Social Security card, etc.) to verify your identity.

CONSENT TO USE OF TAX RETURN INFORMATION Federal law requires this consent form be provided to you. 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. However, federal law also prohibits us from revealing any personal or financial information to any third party. Therefore as a matter of fact, we will never reveal your financial or personal information in any way, to anyone, unless you specifically request we do so, and provide in writing to us the specific person or persons to whom you wish that disclose to be made, which is done on a wholly separate consent form from this. For the purposes of this consent form please note we are seeking consent only to satisfy requirements set forth by federal law so we may speak with you on the phone, send you email correspondences of any kind, send you mailings, newsletters, email reminders, holiday and occasional cards and greetings, and reminders of upcoming deadlines, etc. You are not required to complete this form. If we obtain your signature on this form by conditioning our service on your consent, your consent will not be valid. 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 a period of three years from the date you have signed the consent. The undersigned hereby consents to the use; by Elite Classic City Services its owner, employees, and staff; of any and all tax return information pertaining to: Direct questions, inquiries or requests you make regarding your tax returns, situation, or issues. Requests you make for copies of your documents, figures, numbers, or information. Upon your direct request in order to connect you with another professional in another field or profession so you may gain further information on a certain topic not available or in the realm of expertise of this firm. Notification of important tax law changes. Notification of changes or information that will impact our engagement, such as a change of firm website address, email address, physical location, or other such contact, biographical or geographical information. Other reasonable business purposes including but not limited to: appointment reminders, holiday mailings, birthday greetings and other informational mailings. The tax information may not be disclosed or used by Elite Classic City Services, its owner, employees, or staff, for any purpose other than that which is permitted by this consent document. 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 by email at complaints@tigta.treas.gov.

CONSENT FOR PAYMENT We here at Elite Classic City Services value the relationship we have with all of our clients. We are in the business to provide you with the absolute best service you can have. With saying that, we would like to remind you that we are providing you a service NOT a refund. You as a taxpayer have the choice to pay your tax preparation fees by one of the following: cash, check, money order, credit card, or directly from your refund*. *If you choose to have the tax preparation fees taken from your refund and for whatever reason your taxes are intercepted, YOU ARE STILL RESPONSIBLE FOR THE TAX PREPARATION FEES! Please contact us immediately at our office for payment or payment arrangements. By signing your return you are agreeing to pay the preparation fees regardless if your refund was received or not. After 90 days from the date the refund was scheduled to arrive if no payment or payment arrangement is made, we will be forced to put your account into collections and/or debit your bank account. We hope we never have to go this route, so please keep open communication with us so we can work with you!

By signing, you agree to these terms and authorize us to prepare your tax

return. Thank you for trusting us—we look forward to serving you.

Client Signature: *

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Select Date *

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Bank-level Encryption + Data privacy note

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