Houston Tax Preparation Intake | Maxx Out Tax

This form helps us get the full picture so we can find every credit, deduction, and opportunity you qualify for. Please answer honestly and completely — it’s all to make sure you get the most out of your return.

How Did You Hear About Us? *

Returning Client

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Tax Year *

Return Type *

Select option

Individual Tax Return
Business Tax Return
Amended Tax Return
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Filing Status *

Single

Head of Household

Married Filing Jointly

Married Filing Separately

Unsure

Personal Info

Social Security Number/ ITIN *

Confirm Social Security Number/ ITIN *

First Name *

Last Name *

Date of birth *

Phone *

Email *

Occupation *

Spouse Info

Spouse First Name *

Spouse Last Name *

Spouse Date of Birth *

Spouse SSN/ITIN *

Spouse Phone *

Spouse Email *

Spouse Occupation *

Address

Street Address *

City *

State *

Country *

Country

Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
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Australia
Austria
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Bolivia
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Bouvet Island
Brazil
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Burundi
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Canada
Cape Verde
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Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Cote D"Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic Of
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea People's Democratic Republic
Republic of Korea
Kuwait
Kyrgyzstan
Land Islands
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macao
North Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Federated States of Micronesia
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Eswatini
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
UK
Ukraine
United Arab Emirates
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
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Postal Code *

Will you be claiming any dependents? *

Yes

No

Identification

Upload Driver's License/State Government ID *

Dependent(s)

Dependent #1 Full Name *

Dependent #1 SSN *

Dependent #1 Date of Birth *

Dependent #1 Relationship to You *

Son
Daughter
Step Child
Parent
Relative
Other
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Dependent #1 Months Lived With You in the Year *

All 12 Months
1
2
3
4
5
6
7
8
9
10
11
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Dependent #2

Dependent #2 Full Name

Dependent #2 SSN

Dependent #2 Date of Birth

Dependent #2 Relationship to You

Son
Daughter
Step Child
Parent
Relative
Other
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Dependent #2 Months Lived With You in the Year

All 12 Months
1
2
3
4
5
6
7
8
9
10
11
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Dependent #3

Dependent #3 Full Name

Dependent #3 SSN

Dependent #3 Date of Birth

Dependent #3 Relationship to You

Son
Daughter
Step Child
Parent
Relative
Other
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Dependent #3 Months Lived With You in the Year

All 12 Months
1
2
3
4
5
6
7
8
9
10
11
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Dependent #4

Dependent #4 Full Name

Dependent #4 SSN

Dependent #4 Date of Birth

Dependent #4 Relationship to You

Son
Daughter
Step Child
Parent
Relative
Other
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Dependent #4 Months Lived With You in the Year

All 12 Months
1
2
3
4
5
6
7
8
9
10
11
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Additional Dependents

Dependent 5
Dependent 6
Dependent 7

Income Sources

Which income forms apply to you? *

W2 Wage Statement(s)

1099 NEC

1099 MISC

1099 G - Unemployment

1099 R

1099 INT/DIV

Gig/Cash Work

Other (Business Income, etc)

None Apply to Me

Upload Income Documents

Deductions & Credits

Which apply to you in the recent year? *

Childcare/Day Care payments

Education/Tuition/Scholarships

Mortgage

Charity Donations

Medical Expenses

Retirement Contributions

None Apply to Me

Life Changes this year? *

I adopted a child this year

I experienced a natural disaster

Purchased an electric/hybrid vehicle

I made energy-efficient upgrades to my home.

Other

None Apply to Me

Upload All Supporting Documents

Business Information

Did you own a business and/or make any additional income from self-employment? *

Yes

No

Please upload any of the following that apply to your business:

Profit & Loss Statement (P&L)
1099 Forms (if issued)
Income reports from payment processors (Cash App Business, Square, Stripe, PayPal, etc.)
Large receipts or invoices for major business purchases
Handwritten income and expense log

Business Name

EIN (If Applicable)

What product/service(s) do you offer? *

Business Start Date *

Business Use of Home

Provide Monthly Totals

Square Footage of Entire Home

Square Footage of Portion Used for Business

Rent/ Mortgage Expense

Utilities

Repairs/Maintenance

Internet Expense

Homeowner's/ Renter's Insurance

Property Taxes

Mileage Deduction

Vehicle Year, Make, and Model

Date vehicle was first used for business:

Total miles driven during the year:

Total business miles driven:

Total commuting miles (home to main job location):

Total personal miles:

Do you have another vehicle available for personal use?

Yes

No

Was the vehicle leased or owned?

Leased

Owned

Do you have written mileage records or a mileage app?

Written Mileage Records

Mileage App

Both

Upload Business Income/Expense Documents

Health Insurance

Upload Health Insurance Form(s)

Prior Year Return

Upload your Prior Year Tax Return (recommended)

Identity Theft & IP Pin Verification

Have you or anyone listed on this tax return (such as a spouse or dependent) ever been issued an Identity Protection PIN (IP PIN) by the IRS? *

Yes

No

Not Sure

Please list each person on the return who has an IP PIN and enter their six-digit IP PIN. *

Example: John Smith – Self – 123456 | Jane Smith – Dependent – 654321

Payment & Refund Options

How would you like to take care of your tax preparation payment? *

Pay Upfront

Pay Out of Tax Refund

Are you expecting a refund? *

Yes

No

Unsure

How would you like to receive your refund?

Direct Deposit

Check

PrePaid Card

Would you like to apply for a Refund Advance?

Yes

No

Which Refund Advance would you like?

Interest-Free up to $1000

Up to the Maximum $7,500 (interest applies)

Direct Deposit

Bank Name *

Name On the Account *

Bank Routing # *

Confirm Bank Routing # *

Bank Account # *

Confirm Bank Account # *

Choose the type of Account *

Checking
Savings
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Additional Info

If there is any additional information you would like to tell your tax preparer?

Acknowledgment

I acknowledge that all information and documents provided to Maxx Out Tax are true, complete, and accurate to the best of my knowledge. I understand that I am responsible for maintaining supporting documentation for all income, deductions, credits, and dependents reported on my return.

I acknowledge that submitting my intake and documents is for tax preparation services, not for estimates or preview calculations. Tax preparation services officially begin once my intake and documents are submitted.

I authorize Maxx Out Tax to prepare and file my return based on the information provided and accept responsibility for all preparation fees incurred.

If I choose not to proceed after preparation has begun, I agree to pay an abandonment fee equal to 50% of the total preparation fee. I authorize Maxx Out Tax to charge the payment method on file for any preparation or abandonment fees due.

I understand that tax preparation fees remain due regardless of refund delays, mailed refunds, or federal or state offsets. Unpaid balances may result in collection action as permitted by law.

Sign Here *

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