LS Accounting & Tax Services

Credits You Want to Claim

Select all that apply. Sections will appear below based on your choices.

Earned Income Credit (EIC) Child Tax Credit / Additional CTC (CTC/ACTC) American Opportunity Tax Credit (AOTC) Child & Dependent Care Credit

Why we ask: IRS Paid Preparer Due Diligence rules (Form 8867) require us to verify eligibility and keep records.

Upload Center (Optional)

If available, attach supporting documents. (Secure upload portal available at your appointment.)

Proof of residency (school/medical records, lease, utility)
Child’s birth certificate / Social Security card
1098‑T (AOTC), transcripts, itemized tuition statements
Provider statements & EIN for dependent care
W‑2s/1099s, self‑employment records

1) Taxpayer Information

Tell us about you (and spouse if filing jointly).

Taxpayer Full Name

Date of Birth

Phone

Current Address

Filing Status

Did you live in the U.S. for more than half of the year?

2) Household & Dependents

List everyone who lived with you during the tax year and/or whom you may claim.

Full Name	SSN (last 4)	DOB	Relationship	Months Lived w/ You	Student?	Disabled?	Provided >50% Support?	Will Anyone Else Claim?

7) Income & Records

This helps us complete Form 8867 and document eligibility.

W‑2s received?

1099‑NEC/1099‑MISC (self‑employment)?

Notes about income, living arrangements, or support (optional)

8) Attestation & Signature

Please read and sign. Your responses should be complete and accurate to the best of your knowledge.

I certify the information provided is true, correct, and complete. I understand LS Accounting & Tax Services must ask these questions to comply with IRS Paid Preparer Due Diligence (Form 8867). I agree to provide documentation (if requested) supporting the credits claimed (e.g., proof of residency, school records, 1098‑T, provider EIN, etc.). I acknowledge LS Accounting & Tax Services’ privacy and data handling policies and consent to secure electronic communication.

Typed Signature

Signature Date

Preferred Contact Method

Disclaimer: This intake helps your preparer satisfy IRS Paid Preparer Due Diligence requirements (Form 8867). It is not legal or tax advice. Eligibility depends on your complete facts and current law.

1) Taxpayer Information

2) Household & Dependents

3) Earned Income Credit (EIC)

4) Child Tax Credit (CTC/ACTC)

5) American Opportunity Tax Credit (AOTC)

6) Child & Dependent Care Credit

7) Income & Records

8) Attestation & Signature