File My Taxes | A Unique Experience

Who is Your Tax Professional?Single choice*

Unique Rose (Owner)

Mi-Kala Hutcherson

Jessica Foster

Maurice Carter

Do you currently have an offset with the IRS (delinquent student loans, delinquent child support, tax liens etc)? Call (800)304-3107 to confirm. You may be required to pay a deposit up front, if you answered yes to this question.*

Yes

WE DO NOT PROVIDE FREE SERVICES OR ESTIMATES. Once your intake form is received and we begin working on your tax return...TAX PREPERATION FEES ARE STILL REQUIRED whether you file with us or NOT! -In the event that your refund is INTERCEPTED due to child support, student loans, unemployment overpayment, & wage garnishments, YOUR TAX PREPARATION FEE IS STILL REQUIRED to be PAID! -By signing this disclosure, you are agreeing to pay the preparation fees even if you DO OR DONT RECEIVE YOUR REFUND. -After 48 hours from the date the refund was scheduled to arrive, if no payment or payment arrangement is made, I will be forced to put your account into collections. Please stay in communication with me, so that I can work with you if you need a arrangement. I have read the terms and conditions and privacy policy of A Unique Experience, LLC By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.*

Are You Filing a Federal or State Tax Return?*

Federal

State

Tax Year*

2023

2022

2021

Other

First Name*

Middle Name

Last Name*

Suffix

Do you have an Identity Protection Pin issued by the IRS?*

Yes

If yes, please upload this document along with any other documents that you have.

Are you, the taxpayer, over the age of 65 or legally blind?*

Yes

Social Security Number*

Date of Birth*

Occupation*

Address*

Street Address Line 2

City*

State*

Zipcode*

Did you receive Section 8, government assistance, food stamps or child support during 2023? If so, please provide the amount below.

Phone Number*

Email*

A Unique Experience LLC- 2023 Tax Intake Form

"The Best Is Yet to Come!"

Copyright © 2025. A Unique Experience. All Rights Reserved