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Welcome to

Charlesworth Financial Services, LLC


We strive to be the only Financial Advisor you and your family will ever need.

Thank you for your interest in Charlesworth Financial Services and having us prepare your income tax returns and/or financial services.

The $295 retainer fee will be invoiced and must be paid prior to any tax work or consulting, including extension. If your documents are not provided by March 10, 2026, you will be put on extension. An extension extends the time to file, but not the time to pay. If you believe you will owe with your extension, please let us know.

Our basic return prep fee starts at $295 and includes federal and Indiana efiling as well as identity theft protection. Additional charges will apply for states other than Indiana, forms other than basic and additional time spent on the return based on the organization of your information. Returns will be available to you in your personal secure portal. Upon completion, you will be sent via email a DocuSign request for your signature and an invoice that may be paid online or by Zelle at 219.733.2039. Use the "personal" choice and include your name in the memo.

Please complete this form and, if applicable for your spouse and dependents. After we receive this completed form, we will send you a retainer invoice for the $295 minimum and then a link to our secure portal SmartVault. When submitting info through SmartVault, by texting 219.531.9519 or in person, make sure to include all social security number(s), copy of driver's license(s) and bank account and routing number for direct deposit or electronic tax payments. Please remove all forms from envelopes and recycle the non-essential fillers.  Please do not use staples. If uploading, please scan all documents to a single pdf. Naming items individually does not help us and jpeg and png files are difficult to work with.

We do not have a dedicated receptionist, therefore we prefer clients to limit drop ins and phone calls to Tuesday thru Thursday, 9am to 4pm. We reserve lunchtime for those clients who work and have no other time to contact us.

Our practice includes not only accounting and tax preparation, but investment management, small business consulting and financial services. Clients find that an investment advisor who also prepares income taxes is beneficial for their financial future. We look forward to working with you.

Thank you.


Parent or Guardian's Email Address
Email*
Confirm Email*
First Client's Name
First Name*
Last Name*
Phone*
First Client's Date of Birth*
Date of Birth
Information
Occupation Title *
Please upload a copy of your driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
County of Residence as of 1/1/2025 *
County of Employment as of 1/1/2025
Wedding Anniversary
Spouse First Name
Spouse Last Name
Spouse Date of Birth
Spouse Phone Number
Spouse Email
Please upload a copy of spouse driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
Spouse Occupation Title
Spouse County Work In
Dependent Name #1
Please select one
Dependent #1 Date of Birth
Dependent Name #2
Please Select One
Dependent #2 Date of Birth
Dependent Name #3
Please Select One
Dependent #3 Date of Birth
Comments
First Client's Signature*
Second Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Information
Occupation Title *
Please upload a copy of your driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
County of Residence as of 1/1/2025 *
County of Employment as of 1/1/2025
Wedding Anniversary
Spouse First Name
Spouse Last Name
Spouse Date of Birth
Spouse Phone Number
Spouse Email
Please upload a copy of spouse driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
Spouse Occupation Title
Spouse County Work In
Dependent Name #1
Please select one
Dependent #1 Date of Birth
Dependent Name #2
Please Select One
Dependent #2 Date of Birth
Dependent Name #3
Please Select One
Dependent #3 Date of Birth
Comments
Third Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Information
Occupation Title *
Please upload a copy of your driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
County of Residence as of 1/1/2025 *
County of Employment as of 1/1/2025
Wedding Anniversary
Spouse First Name
Spouse Last Name
Spouse Date of Birth
Spouse Phone Number
Spouse Email
Please upload a copy of spouse driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
Spouse Occupation Title
Spouse County Work In
Dependent Name #1
Please select one
Dependent #1 Date of Birth
Dependent Name #2
Please Select One
Dependent #2 Date of Birth
Dependent Name #3
Please Select One
Dependent #3 Date of Birth
Comments
Fourth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Information
Occupation Title *
Please upload a copy of your driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
County of Residence as of 1/1/2025 *
County of Employment as of 1/1/2025
Wedding Anniversary
Spouse First Name
Spouse Last Name
Spouse Date of Birth
Spouse Phone Number
Spouse Email
Please upload a copy of spouse driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
Spouse Occupation Title
Spouse County Work In
Dependent Name #1
Please select one
Dependent #1 Date of Birth
Dependent Name #2
Please Select One
Dependent #2 Date of Birth
Dependent Name #3
Please Select One
Dependent #3 Date of Birth
Comments
Fifth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Information
Occupation Title *
Please upload a copy of your driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
County of Residence as of 1/1/2025 *
County of Employment as of 1/1/2025
Wedding Anniversary
Spouse First Name
Spouse Last Name
Spouse Date of Birth
Spouse Phone Number
Spouse Email
Please upload a copy of spouse driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
Spouse Occupation Title
Spouse County Work In
Dependent Name #1
Please select one
Dependent #1 Date of Birth
Dependent Name #2
Please Select One
Dependent #2 Date of Birth
Dependent Name #3
Please Select One
Dependent #3 Date of Birth
Comments
Sixth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Information
Occupation Title *
Please upload a copy of your driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
County of Residence as of 1/1/2025 *
County of Employment as of 1/1/2025
Wedding Anniversary
Spouse First Name
Spouse Last Name
Spouse Date of Birth
Spouse Phone Number
Spouse Email
Please upload a copy of spouse driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
Spouse Occupation Title
Spouse County Work In
Dependent Name #1
Please select one
Dependent #1 Date of Birth
Dependent Name #2
Please Select One
Dependent #2 Date of Birth
Dependent Name #3
Please Select One
Dependent #3 Date of Birth
Comments
Seventh Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Information
Occupation Title *
Please upload a copy of your driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
County of Residence as of 1/1/2025 *
County of Employment as of 1/1/2025
Wedding Anniversary
Spouse First Name
Spouse Last Name
Spouse Date of Birth
Spouse Phone Number
Spouse Email
Please upload a copy of spouse driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
Spouse Occupation Title
Spouse County Work In
Dependent Name #1
Please select one
Dependent #1 Date of Birth
Dependent Name #2
Please Select One
Dependent #2 Date of Birth
Dependent Name #3
Please Select One
Dependent #3 Date of Birth
Comments
Eighth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Information
Occupation Title *
Please upload a copy of your driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
County of Residence as of 1/1/2025 *
County of Employment as of 1/1/2025
Wedding Anniversary
Spouse First Name
Spouse Last Name
Spouse Date of Birth
Spouse Phone Number
Spouse Email
Please upload a copy of spouse driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
Spouse Occupation Title
Spouse County Work In
Dependent Name #1
Please select one
Dependent #1 Date of Birth
Dependent Name #2
Please Select One
Dependent #2 Date of Birth
Dependent Name #3
Please Select One
Dependent #3 Date of Birth
Comments
Ninth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Information
Occupation Title *
Please upload a copy of your driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
County of Residence as of 1/1/2025 *
County of Employment as of 1/1/2025
Wedding Anniversary
Spouse First Name
Spouse Last Name
Spouse Date of Birth
Spouse Phone Number
Spouse Email
Please upload a copy of spouse driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
Spouse Occupation Title
Spouse County Work In
Dependent Name #1
Please select one
Dependent #1 Date of Birth
Dependent Name #2
Please Select One
Dependent #2 Date of Birth
Dependent Name #3
Please Select One
Dependent #3 Date of Birth
Comments
Tenth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Information
Occupation Title *
Please upload a copy of your driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
County of Residence as of 1/1/2025 *
County of Employment as of 1/1/2025
Wedding Anniversary
Spouse First Name
Spouse Last Name
Spouse Date of Birth
Spouse Phone Number
Spouse Email
Please upload a copy of spouse driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
Spouse Occupation Title
Spouse County Work In
Dependent Name #1
Please select one
Dependent #1 Date of Birth
Dependent Name #2
Please Select One
Dependent #2 Date of Birth
Dependent Name #3
Please Select One
Dependent #3 Date of Birth
Comments
Click to customize section title
How did you hear about Charlesworth Financial Services?*
Investment client
Attended event at Pennsy Depot Banquet Room and saw sign
Referred by family, friend or colleague (let us know who)
Internet search
Facebook
Chamber listing
Referred by:
I (We) agree to an up front retainer fee of $295 and that at completion we will promptly pay any additional charges *
I (We) agree
I (We) agree to open all tax form envelopes, remove non-essential fillers and organize our tax papers *
We agree to discard empty envelopes before submitting information
Have you (and spouse) texted "YOUR NAME" to 219.531.9519 to exchange encrypted information with us?*
No, we will do so upon completion of this engagement letter
Yes
No, we do not text

Thank you and welcome to Charlesworth Financial Services.

Julianne M. Charlesworth, CPA/PFS

Justene R. Charlesworth, CPA, MBA

219-531-9519 ~ Charlesworth.CPA

College & Retirement Planning, Income Tax Planning & Preparation

Small Business Consulting, Financial Services

Fixed and Variable Annuities*, Life, Disability and Long Term Care Insurance

Securities offered through Avantax Investment ServicesSM, Member FINRA, SIPC. Investment advisory services offered through Avantax Advisory ServicesSM. Insurance services offered through an Avantax affiliated insurance agency.

 

Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Information
Occupation Title *
Please upload a copy of your driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
County of Residence as of 1/1/2025 *
County of Employment as of 1/1/2025
Wedding Anniversary
Spouse First Name
Spouse Last Name
Spouse Date of Birth
Spouse Phone Number
Spouse Email
Please upload a copy of spouse driver's license here.
  
Valid file types: JPG, GIF, PNG, and PDF
Spouse Occupation Title
Spouse County Work In
Dependent Name #1
Please select one
Dependent #1 Date of Birth
Dependent Name #2
Please Select One
Dependent #2 Date of Birth
Dependent Name #3
Please Select One
Dependent #3 Date of Birth
Comments
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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