Client's first name

Client's last name

Language spoken by client (if not English)

Space to leave notes for the preparer

Does the client meet our income limit criteria?

For which tax year(s) do they wish to file?

For which tax year are you completing this form?

Did the client already file a tax return for this tax year?

Will the client file a 1040 or a 1040-NR?

Please summarize below all years the client was present in the US (even for a short period) and what visa they had for each visit. If the specific date ranges are not also included in the I-94 travel history, please state them here.

What is the client's current immigration status?

Is the client married?

Does the client have any dependents?

Does the client have I-94 documentation (most recent entry)? 

Does the client have I-94 documentation (travel history)? 

Did the client fill out information on the second page of Form 13614-NR about the host academic institution during the tax year, including the name of an academic/specialized program director?

Does the client prefer to be contacted by text, email, or both?

Will the client provide bank information in order to receive their refund by direct deposit?

Demographic Questions

Other than English, what language do you speak at home?

What is the gender identity of the primary taxpayer?

How do you plan to use your refund?

How did you hear about us?

How did you have your taxes prepared last year?

Do you live in a Foundation Communities property?

What is your volunteer ID?

Please upload these documents to the Hub ticket: ☐ Passport ☐ Social Security card or ITIN letter for primary taxpayer (if they have one) ☐ Visa page ☐ I-20 (for F visas) or DS-2019 (for J visas) ☐ I-94 most recent entry and I-94 travel history ☐ Income documents (e.g. Form 1042-S) ☐ Prior year return, if available ☐ Bank information ☐ Form 14446 Virtual VITA Consent ☐ Any additional documents as prompted in these checklist responses ☐ This completed checklist (Download PDF after clicking Submit below) If you have any other notes to share with the FSS team, please first scroll back to the top of this checklist and add them in that initial box.