2014 Tax Organizer. Thank you for taking the time to complete this Tax Organizer.

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1 2014 Tax Organizer This Tax Organizer is designed to help you collect and report the information needed to prepare your 2014 income tax return. The attached worksheets cover income, deductions, and credits, and will help in the preparation of your tax return by focusing attention on your special needs. Please answer all questions and enter your 2014 information in the designated areas on the worksheets. If you need to include additional information, you may use the back of a worksheet or an additional page. Note: The questions and worksheets included are designed to assist in completing your tax return. If you answer yes to any of the questions, be sure to provide the supporting documentation. It is highly recommended that you provide all your documents at the same time to make our preparation more efficient and cost effective. Please provide the following information: A copy of your 2013 tax return (if not in our possession). A copy of your childrens' 2013 and 2014 tax returns. Original 2014 W-2 Form(s). Schedule(s) K-1 showing income or loss from partnerships, SCorps, estates, or trusts. Copies of other compensation or pension documentation, such as Form 1099-MISC or Form 1099-R. Form(s) 1099 or statements reporting dividend and interest income. Brokerage statements showing transactions for stocks, bonds, etc. Form(s) 1098 reporting interest paid, copies of real estate tax bills Copies of closing statements regarding the sale or purchase of real property. All other information notices you received, or any items you have questions about. Thank you for taking the time to complete this Tax Organizer.

2 SMD CONSULTING & ACCOUNTING, LLC 8765 STOCKARD DR, SUITE 603 FRISCO, TX Telephone: (469) Fax: (469) TAX ORGANIZER Last Name First Name Last Name First Name Middle Int. Suffix Middle Int. Suffix Soc. Sec. # Soc. Sec. # Date of Birth Occupation Taxpayer Information Date of Birth Occupation Spouse Information Work Phone Work Phone Cell Phone Cell Phone Address Apartment Number City State Zip Code Home Phone Fax Number Eligible Dependent Information First Name Last Name MI Suffix Social Security Number Relationship Date of Birth Child Care Expense Childcare and Dependent Care Provider Expenses Name Address ID Number Amount Paid

3 Individual Tax Questions for the Year 2014 Please check the appropriate box and include all necessary documents. We are fishing for write-offs, so please be complete. Did any of these things happen during 2014? Personal Information Yes No Did your marital status change? If yes, explain: Are you or anyone in your family permanently disabled? If yes, explain: Did your mailing address or residence change from last year? If yes, what is the new address? Were there any changes in dependents you claimed from last year? If yes, what changes? Do you have any children with investment income greater than $2,000? Very Important: To comply with the new tax preparer requirements of the Affordable Care Act, we will need you to obtain either a Form 1095-A, B, or C from the provider of your health insurance (depending on the type of provider). If you just ask for the Form 1095, they will know what you are talking about. If you cannot obtain this form, please let us know and we will send you a worksheet that you can fill out to provide the information we need. If anyone in your household was not covered by health insurance during 2014 (and you do not qualify for one of the exemptions), you may face a penalty for not maintaining Minimum Essential Coverage. General Gain/Loss and Debt Information Did you start up or shut down a business? Did you buy, sell, or exchange any real estate? If yes, please provide all closing statements. Did you abandon or have any foreclosed real estate? If yes, please provide Form(s) 1099-A and/or 1099-C. Did you sell or write-off any stock? If yes, please provide Form(s) 1099-B with date of purchase, date of sale, cost basis, and sales price. Did you buy or sell an interest in any other investments (ex. K-1 s)? Did you take out a home equity loan or line of credit this year or refinance? If yes, please provide closing statement.

4 Income Information Yes No Did you receive any contractor income? If yes, please provide Form(s) 1099-MISC and please complete the attached schedule of income & expenses. Did you receive (or rollover) any retirement account distributions? If yes, please provide Form(s) 1099-R (and Form 5498 if rolled over). Did you receive any unemployment income? If yes, please provide Form(s) 1099-G Did you receive a distribution from your own life insurance policy? If yes, please provide documents. Did you cash in any U.S. Savings bonds? If yes, please provide documents. Did you contribute to or distribute from a 529 Plan or other education savings plan? If yes, in what state? ; amount contributed $ ; amount distributed $ Did you receive an award from a lawsuit? If yes, please provide details and amounts received. Did you receive executor fees or jury duty fees? If yes, amount $ Did you receive or pay alimony or spousal support (not child support)? If yes, amount $ and were you the payer or payee? Did you qualify for Medicare or for any Social Security benefits such as retirement, death, or disability? If yes, please provide Form(s) SSA-1099 or similar statement. Did you own an interest in a partnership, S corporation, or trust? If yes, please provide Schedule K-1(s). Were you a grantor or transferor for a foreign trust, have an interest in or a signature or other authority over a bank account, securities account, or other financial account in a foreign country? If yes, please attach explanation & provide documentation. Did you pay any foreign taxes? If yes, please provide documentation. Did you receive any income during the year from property sold in a prior year? If yes, please provide documents.

5 Did you file bankruptcy or have debts forgiven or cancelled this year? If yes, please provide Form(s) 1099-C Did you have any gambling income? If yes, please provide Form(s) W-2G. If yes, did you have any losses? Send proof of losses for review. Yes No Did you work out of state or receive income from outside Texas during the year? If yes, you may be required to file a state return; please provide details with your supporting documents. Did you receive any other form of income that is not included on this organizer? If yes, please provide documents with explanation. Deduction Information Did you incur substantial out-of-pocket medical expenses? If yes, provide amount for doctor fees $, prescriptions $ eye care $, health insurance $, other $ If you are self-employed, did you pay health insurance premiums? If yes, amount $ Did you pay long-term care (nursing home) premiums for yourself or your family? If yes, amount $ Did you have a Health Savings Account (HSA) with a High-Deductible Health Plan? If yes, provide the contributions $, qualified withdrawals $ and whether single or family coverage. Did you purchase a motor vehicle or boat during 2014? If yes, please provide supporting documents which show sales tax paid. Did you pay real estate taxes for any property in 2014? If yes, please provide supporting documents. Note: You must have paid the taxes in 2014 to qualify for the deduction. Did you pay mortgage interest for your primary residence or a second residence? If yes, please provide Form(s) If more than one residence, please specify which form relates to which residence. Did you pay any student loan interest this year? If yes, please provide Form(s) 1098-E. Did you have a donee receipt for all cash or check charitable contributions of $250 or more and proof of all charitable contributions (cash and noncash)? Did you have unreimbursed employee business expenses or an allowance? If yes, please provide details of amounts paid and type of expense.

6 Yes No Did you utilize an area of your home regularly and exclusively for business purposes? If yes, provide the square footage of home office, total area of the home, and expenses incurred for the whole home. Did you use your car on the job, other than for commuting? If yes, please complete the attached Auto Expense Worksheet. Did you have any moving expenses related to a new job or job location? If yes, miles from old home to old job miles from new home to old job amount paid $. Note: If the difference is less than 50 miles you will not qualify for deduction. Did you have any job-seeking expenses including mileage and supplies? If yes, please provide details of expenses in your paperwork. Did you incur any casualty or theft losses during 2014? If yes, please provide an explanation of the type of loss, amount received from insurance, and value before and after loss. Did you have a safe deposit box? If yes, how much did it cost? Did you have any investment/financial advisory fees (including seminars or books)? If yes, how much did it cost? Did you make any retirement contributions? Did you make or would you consider a Roth conversion? College & Credit Information Did you pay for any higher education costs including, tuition, books and supplies for either you or any of your dependents? If yes, please provide Form(s) 1098-T. Did you make energy efficient improvements to your home in 2014? If yes, please attach details. Have you started a process of adoption? If yes, please attach details. Did you start a new retirement plan in your business this year? Did you make any quarterly estimated tax payments? If yes, please provide amounts and dates.

7 Planning Information Yes No Are you covered by a pension plan? Do you need help with your retirement planning? Do you need help with life, disability, long-term care, or health insurance planning? Do you need help with your education planning? Do you need help with your estate planning? Do you need help with your investment planning? Do you need help with your recordkeeping? Do you need coaching for your small business? Miscellaneous Information Did you receive correspondence from federal, state, or local tax authorities? If yes, please provide copies of all correspondence received. Do you have employer-provided stock options that you can exercise or sell? Did you make gifts of more than $14,000 to any one individual? Did you engage in any bartering transactions? Did you pay any household employee over age 18 wages of $1,900 or more? If yes, provide copies of forms W-2, W-3, and state unemployment tax returns. Would you like to have your refund direct deposited into your bank account? If yes, please provide a voided check for the account information. Do you have a current will and power of attorney for health care and financial decisions? Approximate date of last revision: Do you expect significant changes in income, expenses, or dependents for 2015? If yes, explain: Did your mortgage balance exceed $1m or your home equity debt exceed $100k? Attention Business Owners and Contractors: Please complete the attached schedule of income & expenses to help with the preparation of your return, or send an Accountant s Copy of your QuickBooks file.

8 2014 Business Income & Expenses Business Name Business Address Federal EIN # Texas Taxpayer # (Note: You may provide a copy of your QuickBooks file in lieu of completing this form.) Income: Gross Receipts Cost of Goods Sold: Direct Materials Direct Labor Merchant Fees Other Expenses: Advertising Commissions Contract Labor Insurance - Health (Employees) Insurance - Health (Self & Family) Insurance - Other (Do not include Auto) Interest Expense Internet & Web Legal & Professional Fees Meals & Entertainment Office Supplies Rent - Building/Office Rent - Equipment Repairs & Maintenance Salaries & Wages Taxes - Other Taxes - Payroll Telephone/Cell Phone Travel Other (please specify): Please provide a brief description of the type of business:

9 2014 Auto Expenses Please provide the following information for each vehicle used for business purposes: Make Vehicle 1 Vehicle 2 Vehicle 3 Model Year Date Service Began Beginning Mileage AND Ending Mileage -OR- Total Mileage Business Miles Commuting Miles Tolls/Parking Please write which business or W2 job each vehicle applies to below: Vehicle 1 Vehicle 2 Vehicle 3

10 Third-party Disclosure Form Your Name: Address: City, State, ZIP: SSN: Consent for Disclosure of Information Federal law requires this consent form be provided to you. Unless authorized by law, we cannot disclose, without your consent, your tax return information to third parties for purposes other than the preparation and filing of your tax return. If you consent to the disclosure of your tax return information, Federal law may not protect your tax return information from further use or distribution. You are not required to complete this form. If we obtain your signature on this form by conditioning our services on your consent, your consent will not be valid. If you agree to the disclosure of your tax return information, your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year. Authorization I/We, authorize your firm to release our tax returns, tax information and tax-related documents as detailed below to the following person and/or institution: Bank/Lender Name: Contact Person: Address: City, State, Zip: FAX Phone

11 Page 2 of 2 Duration of this consent for the information checked below (one year if blank): Any information which is requested Only a copy of my tax return for the following year(s): Only the following specific information: Your name Signature Date Spouse's name Signature Date If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at , or by at

12 CREDIT/DEBIT CARD AUTHORIZATION FORM 9555 Lebanon Road Suite 104 Frisco, TX YOUR COMPLETION OF THE AUTHORIZATION FORM HELPS US TO PROTECT YOU, OUR VALUED CUSTOMER, FROM CREDIT CARD FRAUD. ALL INFORMATION ENTERED IS KEPT STRICTLY CONFIDENTIAL. Directions: 1) Print this form and complete this form in dark ink 2) Be sure to complete ALL information 3) Cardholder and/or business owner must sign on designated line 4) We reserve the right to verify the information provided with your issuing credit card company 5) Include a copy of the front and back of the signed credit card 6) Fax (469) , or scan and the completed form and photocopies of the credit card to CREDIT/DEBIT CARD TYPE O VISA O MASTERCARD O DISCOVER CREDIT/DEBIT CARD NUMBER EXPIRATION DATE CVC CODE COMPANY NAME (if applicable) CARD HOLDER NAME BILLING ADDRESS CITY STATE ZIP Phone # Fax # With my signature below, I, the Cardholder or Corporate Officer, am acknowledging that I authorize SMD Consulting & Accounting, LLC to charge my credit card for full payment of open invoice(s) and/or retainers due to SMD Consulting & Accounting, LLC. Signature as on Credit Card: Printed Name: Date:

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