New Client Data Request

Date

Tax Payer Information

Your Name (required)

Address (required)

City (required)

State (required)

Zip Code (required)

Home Phone (required)

Work Phone

Mobile Phone

Fax Number

Your E-mail Address (required)

Your Birth Date

Spouse Information

Spouse Name

Spouse Home Phone

Spouse Work Phone

Spouse Mobile Phone

Spouse Fax Number

Spouse E-mail Address

Spouse Birth Date

School District

County

Referred By

Dependents

Dependent 1 Name

Dependent 1 Birth Date

Dependent 2 Name

Dependent 2 Birth Date

Dependent 3 Name

Dependent 3 Birth Date

Dependent 4 Name

Dependent 4 Birth Date

Dependent 5 Name

Dependent 5 Birth Date

1. Do you owe any outstanding fees to your prior tax professional?
YesNo

2. Did you have any disagreements with your prior tax professional regarding reporting of income or allowable tax deductions?
YesNo

If yes, please describe those disagreements

3. Why did you leave your prior tax professional?

4. Are you interested in or would you like to discuss any of the following services?
Asset preservation planningBusiness succession planningOutsourcing your payrollMonthly external CFO servicesOutsourcing your recordkeepingConsulting Services (ex. internal controls over your financial activities, business growth strategies, cost analysis)

Attachment:

Individual Tax Preparation Engagement Letter

Dear Client,

We appreciate the opportunity to work with you and advise you regarding your income taxes. The Internal Revenue Service imposes penalties upon taxpayers, and upon us as return preparers, for failure to observe due care in reporting for tax purposes. In order to ensure an understanding of our mutual responsibilities, we ask all clients for whom we prepare tax returns to confirm the following arrangements.

We will prepare your 2020 federal and state(s) income tax returns, as well as any local income tax returns based upon information and representations you provide to us. We will not audit or otherwise verify the data you submit to us, although we may ask you to clarify some of the information. We will prepare the tax returns solely for filing with the Internal Revenue Service and state and local tax authorities. They are not intended to benefit or influence any third party, either to obtain credit or for any other purpose. You are responsible for determining your state and local tax filing obligations with any state or local authorities, including, but not limited to income, franchise, sales, use or property taxes. You agree that we have no responsibility to research these obligations or to inform you of them. If upon reading your completed tax organizer, it comes to our attention that you may have an obligation to file additional income tax returns, we will notify you of this and prepare the additional returns you request.

We must receive all information to prepare your returns by April 1, 2021, to ensure that your returns will be completed by April 15, 2021. If we have not received all of your information and your returns are not completed by April 15, 2021, you may be subject to late filing and/or late payment penalties.

You are responsible for maintaining adequate documentation to substantiate the accuracy and completeness of your tax returns. You should retain all documents that provide evidence and support your reported income, credits and deductions on your returns as required under tax law. You are responsible for the adequacy of all such documents. You represent that you have such documentation and can produce it, if needed, to respond to any audit or inquiry by taxing authorities. You agree to hold us harmless with respect to any additional taxes, penalties, or interest imposed on you by taxing authorities resulting from the disallowance of tax deductions due to inadequate documentation. You have the final responsibility for the income tax returns and, therefore, you should review them carefully before you sign them.

Our engagement does not include any procedures designed to detect errors, fraud, or theft. Therefore, our engagement cannot be relied upon to disclose such matters. In addition, we are not responsible for identifying or communicating deficiencies in your internal controls. You are responsible for developing and implementing internal controls applicable to your operations.

We will use our judgement in resolving questions where the tax law is unclear, or where there may be conflicts between the taxing authorities' interpretations of the law and other supportable positions. Unless otherwise instructed by you, we will resolve such questions in your favor whenever possible. The law provides various penalties that may be imposed when taxpayers understate their tax liability. If you would like information on the amount or circumstances of these penalties, please contact us.

Unless otherwise noted, we will perform our services in accordance with the Statements on Standards for Tax Services (“SSTSs”) issued by the American Institute of Certified Public Accountants (“AICPA”) and U.S. Treasury Department Circular 230 (“Circular 230”). It is our duty to perform services with the same standard of care that a reasonable income tax preparer would exercise in this type of engagement. It is your responsibility to safeguard your assets and maintain accurate records pertaining to transactions. We will not hold your property in trust for you, or otherwise accept fiduciary duties in the performance of the engagement.

You have final responsibility for your tax returns. We will provide you with a copy of your electronic tax returns and accompanying schedules and statements for review prior to filing with the IRS and state and local tax authorities (as applicable). You agree to review and examine them carefully for accuracy and completeness. You will be required to verify and sign a completed Form 8879, IRS e-file Signature Authorization for 1040, and any similar state and local equivalent authorization form before your return can be filed electronically. In the event that you do not wish to have your tax returns filed electronically, please contact our firm. Additional procedures will apply. You will be responsible for reviewing the paper returns for accuracy, signing them, and filing them timely with the tax authorities. The original filing due dates for your Federal tax return is April 15, 2021. Due dates vary for state and local jurisdictions. It may become necessary to apply for an extension of the filing deadline if there are unresolved tax issues or delays in processing. Or if we do not receive all of the necessary information from you on a timely basis. All tax owed are due by the original filing due date. Federal, state and local authorities impose various penalties and interest charges for non-compliance with tax laws and regulations, including failure to file or late filing of returns, and underpayment of taxes. You, as the taxpayer, remain responsible for the payment of all tax, penalties, and interest charges imposed by tax authorities. We rely on the accuracy and completeness of the information you provide to us in connection with the preparation of your tax returns. Failure to disclose or inadequate disclosure of income or tax positions may result in the imposition of penalties and interest charges.

Our fees for these services will be based upon the amount of time required at our standard billing rates. Payment for our services is due at the time your returns are received by you. Invoices not paid on a timely basis will be subject to a 1.5% monthly finance charge.

This engagement does not include responding to inquiries by any governmental agency or tax authority. If your tax return is selected for examination or audit, you may request we assist you in responding to such inquiry. If you ask us to represent you, we will confirm this in a separate engagement letter and delineate how additional charges for this service will be calculated.

We will not respond to any request from banks, mortgage brokers or others for verification of any information reported on these returns. We do not communicate with third parties or provide them with copies of tax returns, except as provided by written authorization from you.

This engagement letter, including any attachment, encompasses the entire agreement of the parties and supersedes all previous understandings and agreements between the parties, whether oral or written. Any modification to the terms of this engagement letter must be made in writing and signed by both parties. At the completion of our engagement, the original source documents will be returned to you. Work papers and other documents created by us are our property. Such original work papers will remain in our control, and copies are not to be distributed without our prior written consent. If any portion of this engagement letter is deemed invalid or unenforceable, said finding shall not invalidate the remainder of the terms set forth in this engagement letter.

If the foregoing fairly sets forth your understanding, please download the individual tax preparation engagement letter and sign in the space indicated and attach to the client information submission below or return to our office. Please also read A Word About Our Fees before submission.

Sincerely,
Westbrook & Co., P.C.

Your Signature