Were you referred to us for 2024? *

Yes

No

Full name of the person who referred you

Have you been assigned a OBA Tax and Consulting Services Tax Professional? *

Yes

No

Select OBA Tax and Consulting Services Team Member *

Full Legal Name *

Your Date of Birth

Your SSN *

Email *

Current Mobile Phone *

Current Home Phone Number

Current Occupation *

What SCHOOL DISTRICT did you live in as of December, 31 2024 *

What COUNTY did you live in as of December, 31 2024? *

Will you be filing more than one STATE return? *

Yes

No

Can someone else claim you as a Dependent? 2024 *

Yes

No

Did you file your 2023 tax return? *

Yes

No

Did you receive your expected refund? *

Yes

No

Have you ever had EARNED INCOME CREDIT DISALLOWED by the IRS? *

Yes

No

Have you been a victim of identity theft and been given an identity theft protection PIN by the IRS? *

Yes

No

Enter identity your 2024 IRS Identity Protection PIN *

Were you enrolled at least part time in an accredited college, trade school or university? *

Yes

No

How many years of school have you completed prior to December 31, 2024? *

Enter Name of the College, Trade School University *

What type of degree were/are you seeking? *

Did you receive a tuition statement, 1098T or 1098E form from the school? *

Did you work while in school? *

Yes

Amount Earned While in School

Do you have any drug related felonies? *

Yes

No

Are you Married or Single? *

Married

Single

Do you and your Spouse file Jointly? *

Yes

No

Did you live apart from your spouse during the last 6 Months of 2024? *

Yes

No

Spouse Full Legal Name *

Spouse Social Security Number *

Spouse Date of Birth *

Spouse Mobile Phone *

Spouse Email *

Spouse Current Occupation *

Has your Spouse been a victim of identity theft and been issued a Identity Theft Protection PIN by the IRS? *

Yes

No

Enter your Spouse's Identity Protection PIN? *

Was your Spouse enrolled at least part time in an accredited college, Trade School or University *

Yes

No

How many years of school did your Spouse completed prior to December 31, 2024? *

Name of accredited College, Trade School or University your Spouse Attended *

What type of degree was your Spouse seeking? *

Did your Spouse work while they attended school? *

Yes

No

How much did your Spouse earn while in school *

$

Did your Spouse have any drug related felonies? *

Yes

No

Are you claiming any Dependent(s) that you provided MORE THAN HALF the support for 2024? *

Yes

No

Are you claiming a Dependent that is a child UNDER THE AGE of 13? *

Yes

No

Will you claim the CHILD CARE DEDUCTION for 2024? *

Yes

No

Were any of your Dependants enrolled at least part time in an accredited College, Trade School or University in 2024? *

Yes

No

Did any listed Dependents receive a tuition statement 1098-T or 1098-E for 2024?

Yes

No

If the Dependent worked while in school, enter the amount earned during the school year in 2024

$

Dependent 1: Amount of Time Spent in Your Home During in 2024 *

Dependent 2: Amount of Time Spent in Your home During in 2024 *

Dependent 3: Amount of Time Spent in Your Home During in 2024 *

Dependent 4: Amount of Time Spent in Your Home During in 2024 *

Dependent 5: Amount of Time Spent in Your Home During in 2024 *

Do You Have Joint Custody of the Dependents Listed Above? *

Yes

No

Did you receive ANY Supplemental Non-Taxable Income such as Child Support, Food Stamps, Medicaid / Medicare, TANF, Social Security or Disability? *

Yes

No

Did you receive any GAMBLING WINNINGS in 2024? *

Yes

No

Did you withdraw from your 401k in 2024? *

Yes

No

Have you received your 1099-R? *

Yes

No

Did you receive unemployment in 2024? *

Yes

No

Did you receive your 1099-G 2024? *

Yes

No

Did you buy or sell any stocks or crypto currency in 2024? *

Yes

No

Have you received your tax forms eg. 1099-B etc.? *

Yes

No

Did you drive for Uber, or any other rideshare service in 2024? *

Yes

No

Have you received a1099-K, 1099-NEC or both in 2024 *

Yes

No

Were you an independent contractor for any companies like DOORDASH, INSTACART in 2024? *

Yes

No

Have you received a 1099-K, 1099 NEC for DOORDASH, INSTACART etc. for 2024? *

Yes

No

Do you own a home? *

Yes

No

Did you purchase your home in 2024? *

Yes

No

Have you received tax documents for your home in 2024? *

Yes

No

If applicable, enter the amounts paid regarding your Main home in 2024 *

Enter Amount Paid for Property Taxes
Enter Amount Paid for Mortgage Interest
Enter Amount Paid for Real Estate Taxes

Did you pay for Property Insurance in 2024? *

yes

No

Enter amount total amount paid for property insurance in 2024 *

Did you make any energy improvements to your MAIN HOME in 2024? *

Yes

No

Did you pay UPKEEP or REPAIR expenses in 2024? *

Yes

No

Did you rent in 2024? *

Yes

No

Did you pay for RENTERS INSURANCE in 2024?  *

yes

No

Was your home used as a DAY CARE FACILITY in 2024? *

Yes

No

Did you purchase an ELELECTRIC VEHICLE in 2024? *

Yes

No

Enter Make, Model and Amount Paid *

Did you have any large MEDICAL of DENTAL expenses in 2024?

Yes

No

Did you donate PERSONAL PROPERTY (NOT MONEY) to any charity's in 2024? *

yes

No

Which Person is Disabled *

You

Your Spouse

Dependent (Under 13)

Dependent (Not listed on Intake Form)

Has the selected individual been declared Disabled by a Physician? *

Yes

No

Can documentation of the Disability be provided? *

Yes

No

Is this the individual selected expected to recover in the next calendar year? *

Yes

No

Is the Disabled Dependent, your BIOLOGICAL CHILD ? *

Yes

No

If Dependent was selected, did you pay out of pocket for any uncovered Medical Expenses *

Yes

No

Are you or your spouse listed as the Social Security Representative Payee for this Dependent? *

Yes

No

Do you want your refund Deposited Directly to your bank account? *

Yes

No

Name of Bank for Direct Deposit *

Account Number: *

Routing Number: *

I certify that I am the account owner or have authority to access this account. I further acknowledge that I am responsible for incorrect information, mistyping or any other issues resulting from my error and to hold OBA Tax and Consulting Services harmless if any issues shall arise due to the same

Clear

I CONSENT TO DISCLOSING MY INFORMATION

YES

Taxpayer Signature *

Clear

Taxpayer's Spouse Signature 2024

Clear

Referral#1 Full Name 2024

Referral#1 Mobile Number 2024

Referral#2 Mobile Number 2024

Referral#3 Full Name 2024

Referral#3 Mobile Number 2024

Enter the total area (sq ft.) of your home
Enter the square feet used for Daycare
Enter the hours used for the Daycare PER DAY
Enter the days available for the Daycare PER YEAR
Enter days of the week used available for Daycare