Tax Organizer For

2016 Income Tax Return

This Tax Organizer can be used to help identify the information needed to prepare your 2016 income tax return. While this organizer addresses the more common tax issues, it is not intended to cover all aspects of the tax code.

Please enter your 2016 information and return this organizer along with all Form W-2’s, 1099’s, and any other documentation you feel will assist with the preparation of your 2016 income tax return.

If you are a first-time client, please also provide a copy of your previous year’s tax return. For existing clients, please be sure to notate any new events or transactions for 2016 in the comments section.

If you have any questions, please feel free to contact me.

PERSONAL INFORMATION
Taxpayer's name / SSN
Spouse's name
/ SSN
Home Address / Apt Number
City / State / Zip
Home # / Work # / Cell #
E-Mail Address(es):
Date of Birth / Occupation / Blind? / Disabled?
Taxpayer / Y/N / Y/N
Spouse / Y/N / Y/N
FILING STATUS
Indicate your filing status to be used on your 2016 income tax return:
___ / Single / ___ Check if parent (or someone else) can claim you as a dependent
___ / Married Filing Joint
___ / Married Filing Separate ___ Check if you lived apart from your spouse for all of 2016
___ / Head of Household (May be used if unmarried and you paid over half the cost of keeping
up a home for your dependent or qualifying child)
___ / Qualifying Widow(er) with Dependent Child (May be used if your spouse died in 2014 or
2015 and you had a child living with you whom you can claim as a
dependent) Date of Death:______
OTHER INFORMATION
Do you wish to electronically file your return? Yes_____ No_____
Have you been a victim of identity theft and contacted by the IRS? Yes_____ No_____
If yes, please furnish the 6-digit pin issued to you by the IRS ______
Do you wish to contribute $3 to the Presidential Election campaign? (will not affect refund or balance due)
Taxpayer / Yes / No / Spouse / Yes / No
Do you want to allow the paid preparer to discuss your return with the IRS? / Yes / No
For Direct Deposit
Name of Financial Institution
Routing Number
Account Number
Account Type (check one): Checking ____ Savings ____
DEPENDENTS
The term ‘dependent’ means a “qualifying child” or “qualifying relative”.
____ Check here if you are unsure if your child or relative listed below meets the required tests to
qualify as a dependent.
First Name / Last Name / SSN / Relationship / Date of birth / # of
months lived with you in 2016 / Child care expenses paid in 2016
CHECKLIST
Check
If yes / In 2016, did you… / # of Forms / Form
receive wages and salaries? / W-2
receive any dividend income? / 1099-DIV
receive any interest income? / 1099-INT or OID
receive any IRA or retirement distributions? / 1099-R
sell stock, mutual funds, bonds or exercise stock options?
(will need original cost and purchase dates) / 1099-B
receive unemployment benefits or social security benefits? / 1099-G, 1099-SSA
have partnership, S corporation, trust or estate income? / Schedule K-1
have rental and/or royalty income and expenses? / If yes, please provide detail
have business income & expenses? (Check applicable sources: _____self-employment _____operation of farm) / If yes, please provide detail
receive any miscellaneous income reported on 1099-MISC? / 1099-MISC
pay student loan interest or higher education expenses? / 1098-E,
1098-T
contribute to an IRA, SEP, or Keogh Plan? / If yes, please provide detail
contribute to and/or receive distributions from a health savings account (HSA) or medical savings account (MSA)? (These are different than a flexible spending account). / 1099-SA, 5498-SA
use a home office exclusively and 100% for business? / If yes, please provide detail
Check
If yes / In 2016, did you… / # of Forms / Form
you and your dependents have healthcare coverage for the full-year? Check below where you received insurance from:
EMPLOYER ____ GOVT MARKETPLACE___ INDIVIDUAL POLICY ___ / If no, will need further detail
you receive any of the following IRS documents regarding your healthcare coverage: Form 1095-A, Form 1095-B, Form 1095-C or receive an exemption certificate? / If yes, please provide form(s)
retain all receipts for sales tax paid on purchases? / If yes, provide total taxes paid; otherwise IRS tables will be used
purchase a new motor vehicle such as a car/truck/van/SUV, motorcycle, boat, RV/motor home, etc.? / Copy of receipt showing sales tax paid
pay high out-of-pocket medical & dental expenses (more than 10% of your adjusted gross income)? / If yes, please provide detail
pay real estate property taxes on your home? / 1098 or tax statement
pay home mortgage interest? / 1098
sell your home? / If yes, please provide detail
refinance your home? / If yes, please provide detail
own a qualifying second home (e.g. vacation home)? / If yes, please provide detail
make cash or non-cash contributions to charity? / If yes, please provide detail
have high unreimbursed job expenses? / If yes, please provide detail
earn any foreign income or have any foreign taxes paid? / If yes, please provide detail
have day care/after-school care expenses for children/dependents? / Need provider name, address, EIN, and amount paid for each child
pay expenses related to the adoption of an eligible child? / If yes, please provide detail
pay a household employee cash wages of $2,000 or more? / If yes, please provide detail
have any children 18 or under (or student under age 24) with unearned income of more than $2,100? / If yes, please provide detail
make any energy efficiency improvements such as exterior windows/doors, insulation, water heaters, etc.? / If yes, please provide detail
repay or are repaying the First-Time Homebuyer Credit? / If yes, please provide detail
receive any notices/correspondence from the IRS or a state agency? / If yes, please provide detail
make any federal estimated tax payments for 2016 taxes? / If yes, please
provide detail

Please note additional comments or questions in the space below. Also note here any new events that occurred for 2016. ***If you are a new client and were referred to me, please notate below the name of the person who referred you.***

Mary Bamburg, CPA

1946 Savannah Drive, Round Rock, TX 78681

E-mail: Cell: 512-589-5100 Fax: 512-367-5950