December 2015
Maximize your Deductions and
*WIN $100 Gift Card*
To qualify, simply come properly prepared! Please bring all of the following and any other necessary items to your appointment.
· _____ Driver’s License and Social Security Cards
· _____ For all Children bring SS cards
· _____ Proof of Medical Insurance
o If you had employer coverage, you should receive a form 1095B or 1095C from your employer.
o If you are covered by Medicare your social security statement will be your proof if you are covered by Medicare
o If your coverage is from the Healthcare Exchange you MUST BRING form 1095A with you. We cannot file your tax return without it!
o If you and or your dependents were covered by Medicaid Title XIX or Hawkeye They should send you a form 1095 to show coverage if not please bring your insurance card and know the dates of coverage for each.
o If you are claiming a child as a dependent and your ex-spouse provided the insurance coverage you will need to have a copy of the 1095A or 1095B to verify proof of their coverage. If your former spouse purchased the child’s coverage on the healthcare exchange but will not share the form you can request one by filing IRS form 4506.
· What if you did not have medical insurance coverage? You may or may not be subject to penalty
o If you were offered employer insurance and did not take it you should still receive a form 1095C (if you work for a larger employer) showing the price of the offered coverage. Please bring this to your appointment. You may be exempt of penalty if the coverage offered was deemed unaffordable based on your wages.
· _____ Your W-2’s, 1099’s and all other necessary 2016 documents showing income and expenses
· _____ Your completed questionnaire found on the back of this page
· _____ If self employed or have business or rental income: Details of income and expenses
· _____ New clients: please bring your Photo ID’s, Social Security Cards, and a copy of last year’s tax return
· _____ If receiving EITC – proof that children reside with you (something with their name and YOUR address from school, medical provider, employer, daycare, etc)
· _____ If EITC and self-employed – receipts of income & expense – not just a summary
· _____ If claiming college expenses--- Form 1098T from college AND Detailed Account Summary from college showing expenses actually paid (you can usually access this from student’s online account. Please have printed and bring with you. Do not wait to attempt for the first time to log on and view it from our office- this takes up valuable time during your appointment.
o If student received scholarships – bring details of eligible expenses that can be paid for with the funds.
· _____ If claiming child that doesn’t live with you will need a signed form 8332 from the custodial parent. (you can find one to download and print on our website at www.apssiouxland.com
· _____ If Claiming dependents in Mexico bring your money wire receipts and figures showing that you supported more than half of their living expenses.
· _____ If you want direct deposit please know your bank routing and account number at the time of your appointment
· _____ Be prepared to pay at time of service. We can take your fee from your refund from an additional charge
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Appointments by calling (712)224-2942
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Income and Expenses for Deductions
Return this completed form and be entered to win a $100 gift card
Name: ___________________________ Please bring proof in medical Insurance
Address: _________________________ If insured through the Exchange, bring Form 1095A
City, State, Zip: ________________________ If private or employer Insurance bring proof of coverage
Cell Phone: ___________________________ If exempt from coverage bring Hardship Exemption Cert #
Email: _______________________________
If we did not do your taxes last year please bring your last year’s tax return.
Also bring any tax adjustments made in 2016 such as an amended tax return, letter from the IRS or Department of Revenue adjusting any taxes owed or refunded.
Please bring all necessary documents especially your W-2’s. Also consider other sources of income including but not limited to:
Wages and bonuses; investment income such as interest, dividends, sale of capital assets (and basis), K-1s; alimony; retirement income such as taxable IRA distributions, pensions, annuities, social security; gambling winnings (and documented losses) other prizes/winnings; unemployment; cancelation of debt, bankruptcy, jury duty (and any amount repaid to employer); income from cash jobs, inheritance, estate settlements, lawsuit settlements, etc.
Deductions (and other tax effecting situations): Here we only need totals but make sure you have and keep your receipts! (Iowan’s often benefit from itemizing on their state tax return even if they do not itemize on their federal return!)
1) Mortgage interest paid________, 2nd mortgage____________
2) ______, Home equity loan interest________, Points on refinance________, Real estate taxes paid________, Vehicle registration taxes paid________
3) Medical Insurance: After tax health insurance________, long term care insurance________, dental insurance________, Rx insurance________,
4) Medical Expenses: (must exceed 10% of income in order to be deductible – or 7.5% for people over 65. This percentage includes premium costs) Out of pocket medical________, vision________, and dental expense________
Co-pays___________, prescriptions_________, Miles driven for medical care_________, lodging for patient_________
(Medical expenses include, but are not limited to, glasses, contacts, orthopedic shoes, all prescriptions, x-rays, trusses, lab fees, hospitals, hearing aids/batteries, crutches, wheelchair, and all dental work.)
5) Charitable contributions: (please have receipts) monetary________ used items_______/charitable/volunteer miles driven________
6) Misc deductions: (must exceed 2% of income before becoming deductible) includes: Tax return preparation fees_____, safe deposit box_________, Investment Fees/Expense____________, Job hunting expense________, Job hunting miles__________, Out of pocket work expense including, but not limited to, mileage________, work miles not fully reimbursed__________, uniforms_________, union or professional dues________, safety equipment________, tools________, licensing and certifications________, physicals________, required cell phone________, continuing education; fees(not college)________, lodging________, number of nights out of town due to work/cont. ed________, and if you work two jobs in same day or two locations for same job enter the miles driven between job sites________
7) National Guard or Reservists that traveled more than 100 miles for drill: How many total miles__________? What were your un-reimbursed lodging costs________________? Meals__________?
8) Estimated tax payments__________, additional federal or state taxes paid________
9) Daycare/Preschool expenses while working or going to school _______________. We will need providers name, address, and federal ID#. You should have receipts or cancelled checks to claim this credit. Audits are very common.
10) Iowa residents with dependent children; tuition and/or fees paid for school, supplies, books, school sports programs (including fees and required clothing), entrance fees for school sporting events or other school functions_____________
11) Moving: Did you move more than 50 miles to a different job? Amount of non-reimbursed moving costs______
12) Other misc situations: (that may require discussion and documentation): IRA and/or College Contributions, Marriage, Divorce, Death, Birth of new child, Adoption, Bankruptcy, Cancellation of Debt, Foreclosure, Financial Insolvency, Transfer of Property, Starting or Dissolving a Business.
*For more information regarding deductible expenses for self-employment, home office, rentals, and over the road trucking please see our website at www.apssiouxland.com.
Also if you preferred our longer version of this questionnaire from prior years it can still be found on our website.
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