ORGANIZER

Look for “Alerts” throughout the organizer to help you know things that IRS matches or things that only need to be filled in if you have a change from prior year with us or if you are a new client.

If you are a new client please include a copy of previous years federal and state return prepared.

Your Name / S.S #
- - / DOB
/ /

Occupation:
Spouse Name / S.S #
- - / DOB
/ /

Occupation:
Mailing Address: / Home Phone Number Work or Cell Number
( ) - ( ) -
Own/Rent Home: Real Estate Taxes Paid
Rent Paid for the Year . With or without heat? / E-mail Address: Required if you have one.

DEPENDENTS

Name / S.S. # / DOB / Relationship

Changes For This Year – Please Put Date of Change

Married / Spouse Deceased / Sold Home
Separated / Dependent Deceased / Sold Property
Divorced / Moved / Legally Blind you Spouse

Day Care

Baby Sitter Name / SS # / Address / Amount Paid / Phone
Number

EST. TAXES PAID

FROM PREVIOUS YEAR RETURN / 1ST QTR (APRIL 15) / 2ND QTR (JUNE 15TH) / 3RD QTR (SEPT 15TH) / 4TH QTR (JAN 15TH) / TOTAL AMOUNT FOR YR
Federal $ / $ / $ / $ / $ / $
State $ / $ / $ / $ / $ / $

ANY OUT OF STATE PURCHASE YOU NEED TO PAY SALES TAX ON??? $ .

QUESTIONS FOR TAX PREPARER

INCOME

Do you have any of the following?

Y / N / Y / N
Wages, salary, tips (Attached W-2) / Retirem Retirement Distribution (Attach 1099-R)
Social Security (Attach SSA-1099) / Gambling Winnings (Attach W-2G)
Unemployment? (Attach 1099-G) / Foreign Bank Accounts
Interest Income? (Attach 1099-INT) / Education Distributions (1099-Q
Dividend Income (Attach 1099-DIV) / K-1’s (Attach copy of K-1)
Did you sell any Savings Bonds? / State Tax Refund (Attached 1099-G)
Capital Gains (Attached 1099-B) / Alimony Received

RETIREMENT

You / Spouse
Employer Pension Plan? / Yes / Yes
Traditional IRA, Keogh & SEP Plans:
Contributions
Withdrawals (1099-R) (1)
Rollovers (2) or Conversions (3)
(1)  If under age 59 ½ show reason
(2)  Must be reported even if not taxable unless “transferred”
(3)  Conversions (rollovers) from a Traditional IRA or other Qualified Plan to a Roth IRA are generally taxable.

MISC ITEMS

Student Loan Interest paid $
Any adoption expense this year, if so enter amount $
Ever been denied Earned Income Credit by the IRS? Yes no / If so have you been re-certified yes no
Gifted Real Estate last year? If so call to requested documents required.
Did you pay any alimony? If yes list name, SS # and amount

RENTAL INCOME

Rental #1 Rental #2 Rental #3 Rental #4

Rent Received – Any 1099’s
Advertising
Auto & Travel
Cleaning & Maintenance
Insurance
Legal & Professional Fees
License & Permits
Mortgage Interest
Painting
Pest Control
Plumbing & Electrical
Repairs
Supplies
Cleaning Supplies
Property Taxes
Utilities
Miscellaneous
Other (list)

** If you paid anyone over $600 for goods or services, you are required to issue them a 1099-MISC

SCHEDULE A – DEDUCTIONS

MEDICAL:

Prescriptions $ / Hospitals $ / Insurance Premiums $
Doctors $ / X-Rays $ / Eye Glasses $
Dentist $ / Transportation $ / Labs $
Chiropractors $ / Lodging $ / Therapy $

TAXES:

Did you pay State Taxes Last Year $ / Property Taxes $
1st home / Vehicle Sales Tax $
Did you pay State taxes for previous year $ / Property Taxes $
2nd home
Any major purchases last year $

INTEREST:

1ST HOME: / AMOUNT / 2ND HOME: / AMOUNT
1st Mortgage / $ / 1st Mortgage / $
2nd Mortgage / $ / 2nd Mortgage / $
Mortgage Ins. / $ / Loan Fees / $
Points / $

CONTRIBUTIONS:

NOTE: Any cash donation over $250 must have a receipt stating “no goods or services were received” for donation.

Church / $ / Missions / $ / Cancer Funds / $
Heart Fund / $ / Payroll Deduct. / $ / Salvation Army / $
United Way / $ / Easter Seals / $
Other: List / $ / $
$ / $ / $

Did you donate any non-cash items such as food or used clothing? List with description with value and to whom. $

MISCELLANEOUS: Schedule A cont.

Union Dues – Taxpayer / $ / Union Dues – Spouse / $
Safety Clothing (list) / $ / Small Tools / $
$ / Uniforms – purchase / $
$ / Uniforms - cleaning / $
Tax Prep Fees / $ / Employment & Resume Fee / $
Business Dues / $ / Gambling Losses / $
Licenses & Fees / $ / Safety Deposit Box / $
Other: (list) / $ / $
$ / $

EDUCATION EXPENSE

CAUTION: These expenses qualify for tax credits, deductions and are used to justify certain exclusions and tax or penalty

Free distributions. Expenses must be segregated by student! Use a different column for each student in the family.

WHO IS THE STUDENT: / This column is designated for:
Taxpayer / / /
Spouse / / /
Dependent: / / /
Dependent: / / /
FOR TUITION CREDIT ONLY – Qualified Education
Check if at least half-time student
Post-Secondary – First 4 years
After first 4 years
Fees- Enrollment/Attendance Only
CONTUING EDUCATION EXPENSES – TAXPAYER OR SPOUSE ONLY
Tuition & Fees
Seminar Fees, Etc.
Books/Supplies
Travel

Attach Tuition Statements from Schools

BUSINESS VEHICLE INSTRUCTIONS

Miles driven section MUST be completed for every vehicle that is used for business. Actual expenses are NOT required if you use “standard mileage rate” However, they are required if you are using the actual expense method the first year vehicle was placed in service. If this is the first year of business use for the vehicle, provide a copy of purchase or lease contract.
DO NOT complete this section or the Business Vehicle Expense section if your vehicle
Is used for commuting to and from work and for personal travel. / Vehicle 1 T S / Vehicle2
T S
Check if vehicle provided (owned) by employer / /
Enter reimbursement provided by employer / $ / $
Is reimbursement included on W-2 / /
Date Originally acquired
Parking (do not include parking at your place of employment / $ / $
Business miles driven / Total miles auto drive. Personal & Business (required) / mi / mi
For Work / mi / mi
Between 1st & 2nd job / mi / mi
Job seeking/temporary job sites / mi / mi
Rental / mi / mi
Self-employed business / mi / mi
Other: / mi / mi
Avg round trip distance to work (required) / mi / mi
Total commuting for the year (required) / mi / mi
Business Vehicle Expenses: Complete only if vehicle used for business
Gasoline, Oil, Lubrication
Repairs & Maintenance
Tires, Batteries, etc
Insurance (do not duplicate elsewhere)
Wash & Wax
Lease Payments
Other:
Away-From Home Expenses: / You / Spouse
Airfare
Auto Rental, Taxi, etc
Meals & tips (100% of expense)
Lodging & Tips (do not include meals)
Laundry
Other:

.

BUSINESS EXPENSE NOTE:

Business expense deductions must be based on LOGS and/or receipts and records. The combination of records should document:

•The business purpose, date, time, place & amount. For business meals and entertainment, you must also document that:

·  You discussed business during the meal OR

·  You had a substantial bona fide business discussion or activity before or after the meal/entertainment OR

·  You ate alone while out of town. You must also record the name and business relationship of each person entertained.

Gifts are limited to $25 per person per year. You may not deduct these expenses unless documented.

OFFICE IN HOME EXPENSES

To qualify, an “office in the home” must be used exclusively and on a regular basis (a) as your principal place of business or (b) by patients, clients or customers in meeting and dealing with you in a normal course of business. A home office will qualify as your principal place of business if: (1) You use it exclusively and regularly for the administrative or management activities of your trade or business, and 2) You have no other fixed location where you conduct substantial administrative or management activities of your trade or business. If you are an employee, the home office use must also be for the convenience of the employer. If you qualify, you have the option of deducting $5 per square foot (300 square feet maximum) or itemizing your office expenses. If you choose not to itemize your expenses, only complete the square footage areas.

Total Sq Feet of: / Home / Office / Storage
Expenses: / Rent* / $ / Utilities / $ / Insurance / $
Maintenance & Repairs: Office / Home in General **

*if you own your home, provide purchase settlement statement and list of improvements to office.

**Roof, outside painting OK; not lawn care

SELF EMPLOYMENT

YOU SPOUSE

Gross Income / $ / $
Returns & Refunds / ( ) / ( )
Beginning Inventory Jan 1st
Purchases
Inventory used for Personal Use
Ending Inventory Dec 31st – Attached inventory sheets
EXPENSE ** / YOU / SPOUSE / EXPENSE / YOU / SPOUSE
Advertising / $ / $ / Rent – Other / $ / $
Bank Charges / $ / $ / Repairs / $ / $
Dues & Pubs / $ / $ / Seminars / $ / $
Entertainment 100% / Supplies / $ / $
Gifts / $ / $ / Taxes – Payroll / $ / $
Insurance / $ / $ / Taxes – Sales / $ / $
Interest (mortgage) / $ / $ / Taxes – Property / $ / $
Interest (other) / $ / $ / Telephone / $ / $
Legal & Professional Fees / $ / $ / Utilities / $ / $
Office Expense / $ / $ / Wages (W-2) / $ / $
Equipment Rental / $ / $ / Other: List / $ / $
Other: List

Equipment purchased: Provide list including description, purchase date & cost.

** If you paid anyone over $600 for goods or services, you are required to issue them a 1099-MISC

ELECTRONIC FILING INFORMATION

We will be using electronic filing of your return if it qualifies.

NOTE: if you wish to use direct deposit, please provide the information below:

Name of your financial institution

If filing a joint return, the account must be a joint account

Routing Transit Number (RTN) Must contain 9 digits

Account Number checking or savings

DECLARATION;

I have provided the information on this form to the best of my knowledge and hereby declare it is complete and ready for the preparation of my/our income tax returns. Where business deductions shown, I acknowledge having spent these amounts and have a log or diary of such activities, pursuant to section 274(a) and can fully substantiate such deductions.

SIGNATURE (must be signed) DATE

9

9