Brendan's Tax Service

Serving the Tax Profession Since 1990

4865 South Broad Street* Yardville, NJ 08620

Phone 609.581.8661 * Fax 609.581.1501** www.brendanstaxservice.com

Name:______Date of Birth: ______Occupation:______

Spouse: ______Date of Birth: ______Occupation:______

CURRENT ADDRESS (if different from last year) ______

PHONE DAY:______EVENING:______How late can I call? ______

Cell Phone:______Email address (for missing information needed): ______

*E-Filers: Bank or Credit Union Name: (for direct deposit only) ______

Routing #______(looking at front of check this is the 9 digit # reading left to R

Account #______(usually next to routing #)

Type of Account: Checking______Savings______

Filing Status: ______(Ex)Single, Head of Household, Married Filing Joint,

Dependent(s) (Children names)

If no changes from previous tax year, initial here ______HEALTH

INSURANCE

Name ______SS# ______DOB ______Yes No

To the best of my knowledge, this is everything necessary for the preparation of my tax returns, and I can substantiate it as required. Brendan’s Tax Service agrees to prepare federal and state tax returns as necessary based on the information provided. You will be advised of any pertinent matters.

Signed ______Date ______

Return will be delayed without signature

*Tenants: Total Rent Paid in 2011 to insure NJ State credit $______VERY IMPORTANT

Please include your last 2011 pay stub from each Employer!(optional) very useful if you include

Income Tax Checklist

I PREFER TO PICK-UP MY RETURN ______

I PREFER TO HAVE MY RETURN MAILED TO ME ______

If you think you’ll need or want an extension for your 2011 tax return, please send us your information . We’ll file the extension for you, and complete your return as soon after April 15 as possible. This worked well for many customers last year. There are no penalties for filing late if you are due a refund.If you have a balance due we can still file an Extension. IRS gives a 6 Month Automatic Extension. I do not charge a fee for Extensions. Clients Still Received their Refunds in 10-14 days. In Fact this year I will be offering a discount for those willing to File during my off-Peak Time. My schedule is obviously much more Flexible

O All W-2s for both husband and wife

O Unemployment compensation received (Form 1099-G)

O All Social Security 1099s for amounts received.

O 1099's from Pensions, IRAs, annuities,

O 1099's from bank/credit unions showing year-end interest/dividends.

O 1099's from miscellaneous income

O Self employment income even if you do not have 1099 for it.

OTHER INCOME ITEMS

O Alimony received

O Rental Income/Sale of rental property income.

O Gambling winnings and losses, best to document them. (losses cannot exceed winnings)

STOCKS & MUTUAL FUNDS All end of year 1099s from mutual funds, stock dividends. Statements from brokerage firms showing income and sales of stocks.(form 1099-B). Please give me your cost of stock sold! If unsure call your broker.

DEDUCTIONS

O Estimated tax payments made to Federal and State.

O IRA/SEP/SIMPLE/ROTH contributions made.

O Education IRA contributions

O Self employed health insurance paid.

O Medical savings accounts contributions and payouts

O Alimony paid (Also need SS# of person you paid)

O Student loan interest paid for year

O Adoption Expenses

O Moving Expenses for move of over 50 miles.

ITEMIZED DEDUCTIONS

O Mortgage statement for interest and property taxes, or separate property tax statement on any property.

O Mortgage Insurance Deduction (this will be on line 4 of your Form 1098 Mortgage Interest Statement)

O 2nd Mortgage statements and refinance .

O Charitable contributions, See Website for Detailed Checklist)

O Amount paid for: Out of pocket only! medical insurance, medical expenses after reimbursements, includes prescriptions, dental, eyes, chiropractors, physical therapy, It must exceed 7.5% of your Adjusted Gross Income.

BUY OR SELL A HOUSE OR REFINANCE

O I need your Settlement sheet only! that tells me everything! Points,Interest,taxes

RENTAL PROPERTY EXPENSES

O Rental mortgage interest, supplies, taxes, insurance, repairs, other cost associated with rental property.

ITEMIZED BUSINESS EXPENSES

O Business mileage for outside sales/other activities you use your own auto/truck for business purposes.

(sorry everyday commuting doesn’t count)

O Out of town business expenses, motels, incidentals, meals, etc.

O Other business expense-parking, pay phones, long distance, supplies, licenses, continuing education, answering services, postage, uniforms, uniform cleaning, pagers, business cell, business cards, customer gifts, insurance.

O Office in home, utilities cost, home insurance, home maintenance. Square footage of office and total for home.

O Moving expenses for business move of more than 50 miles. i.e. moving van, U-Haul, vehicle miles, motels(Must have been forced to move by employer to get this deduction)

EDUCATIONAL EXPENSES

O Educational expenses (college or vocational tech) for you/ spouse/children. Tuition, books, fees. No room/board. Identify who credit is for and year of study. (Circle) First Year Second year Third year Fourth Year

O Interest paid on student loans for the year.

O Year of study needed to determine Credits and deductions

CHILD CARE EXPENSES (must be under 13 years old) Indicate the amount you paid for each child individually. Please give me the name, address, phone # and SocSec #if day care provider Federal ID number if school provider (Furnish address and ID only if different from last year of provider) MUST INDICATE COST EACH CHILD SEPARATELY

Amount :______Child’s Name:______

Name of provider:______Address: ______

______Zip Code______

Phone # ______EIN or SS # of provider ______

Amount:: ______Child’s Name:______

Name of provider:______Address: ______

______Zip Code______

Phone # ______EIN or SS # of provider ______

An Energy credit of up to $500 is available for taxpayers who purchased certified, energy efficient windows, doors, furnaces and air conditioners during 2011.This has been extended…if you have received more than $500 in energy credits during 2009 & 2010 you are ineligible…..Please include Receipts …I will sort it out…new law is confusing…Also go to my website”ONLINE FORMS” for additional Information)

*******************New Services Offered in 2011*****************************

Be sure to visit www.Brendanstaxservice.com for latest news and Important Information

Click “ONLINE FORMS” tab for an expanded list of Checklists and Tools to help you organize your Information.