THE TAX GUY CLIENT ORGANIZER

Herb Briggs, CPA

520866th Street North

St. Petersburg, FL 33709

(727) 343-1398, (727) 418-6488

To better prepare your tax return for 2016, please provide the following documents and complete thequestionnaire so that we may assist you in reviewing your current financial planning needs. Please bring this organizer with your current driver’s license, social security cards (personal and dependents),and all your tax documents with you to your appointment.

General Information:

Name: ______

Contact Number(s):

Income Documents: Complete

  1. Copies of form W-2 from all employers you worked for during 2016.

(We can get started with the last pay stub for 2016 from these employers)

  1. Copies of form 1099INTfrom banks and credit unions where you earned interest.

(Or provide the December 2016 statement from these institutions)

  1. Copies of form 1099DIVshowing dividends from stocks, bonds, mutual funds.

(Or provide the end of year 2016 statement from these brokerages)

  1. Copies of 1099G for unemployment compensation from the state for year 2016.

(Or provide the stubs from the unemployment checks)

  1. Any distributions from retirement plans–Form 1099R (401K, IRA, Pensions) in 2016.
  2. Any other 1099 forms such as 1099MISC(self employed), 1099G(gambling winnings),

1099S(sale of a home), 1099B(sale of stocks, bonds, mutual funds).

  1. Any 1099C (Cancellation of Debt).SSA-1099 (Social Security Income)
  2. Any self-employment or rental incomeand expenses for 2016.
  3. Alimony (not child support) paid or received during 2016.
  4. Forms K-1 from S-Corporations, Trusts, Estates or Partnerships for tax year 2016. ______

Deductions: Complete

  1. Statement or Form 1098showing mortgage interest and real estate taxes paid for 2016.
  2. Gifts of cash or property during 2016 to charitable organizations.
  3. Medical and dental expenses, casualty losses, moving expenses, gambling losses.
  4. Contributions to Individual Retirement Accounts (IRA).
  5. Home repairs, vehicle purchases, and boat purchases for sales tax deduction.
  6. Energy Credits – Hybrid vehicle purchases, certain home improvements, and

certainenergy star appliances.

Other Documents: Complete

  1. Copy of driver’s license or picture ID.
  2. Copy of social security cards of primary taxpayers.
  3. Copies of dependent social security cards and date of birth.
  4. Copy of 2014& 2015tax return if you used another preparer.
  5. IRA, 401(k), and other retirement account statements______
  6. Brokerage account statements______

In an effort to help provide better future services for you, please complete the following:

Financial Planning:

  1. Have you established a living will, a trust or estate planning documents?Yes_____ No_____
  2. Do you have the correct beneficiary listed on all of your assets?Yes_____ No_____

Retirement Planning:

  1. Do you have an individual retirement plan?Yes_____ No_____
  2. Do you have a retirement plan with your current employer?Yes_____ No_____
  3. Do you have any retirement assets with a previous employer(s)? Yes_____ No_____

Insurance Planning:

  1. Do you have life insurance coverage?Yes_____ No_____
  2. Do you have disability and long term care coverage in place?Yes_____ No_____

Investment Planning:

  1. Are you satisfied with the performance of your investments?Yes_____ No_____
  2. Do you contribute to a college savings plan? Yes_____ No_____
  3. Are you currently working with a financial advisor? Yes_____ No_____
  4. Please include any additional questions, or comments you may have: ______

______

If you have any questions, please call the office (727) 343-1398, or cell (727) 418-6488.

Thank you,

The Tax Guy

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