Client Tax Organizer If you have rental property or are self-employed, please request additional organizers.

Transcription

1 Client Tax Organizer If you have rental property or are self-employed, please request additional organizers. 1. Personal Information Name Soc. Sec.. Date of Birth Occupation Work Phone Taxpayer Spouse Street Address City State ZIP Home Phone Address Taxpayer Spouse Marital Status Blind Married Will file jointly Disabled Single Pres. Campaign Fund Widow(er), Date of Spouse s Death 2. Dependents (Children & s) Name (First, Last) Relationship Date Of Birth Soc. Sec.. Months Lived with you Disabled Full Time Student Dependent s Gross Income Please provide for your appointment: Previous years return (new clients only) All Statements (W-2 s, 1098 s, 1099 s, etc.) 1. Are you self-employed or do you receive hobby income? * 9. Were there any births, deaths, marriages, divorces or adoptions in your immediate family? 2. Did you receive income from raising animals or crops? * 10. Did you give a gift of more than $14,000 to one or more people? 3. Did you receive rent from real estate or other property? * 11. Did you have any debts cancelled, forgiven, or refinanced? 4. Did you receive income from gravel, timber, minerals, oil, gas, copyrights, or patents? 12. Did you go through bankruptcy * proceedings? 5. Did you withdraw or write checks from a mutual fund? * 13. (a) If you paid rent, how much did you pay? 6. Do you have a foreign bank account, trust, or business? 7. Do you provide a home for, or help support anyone not listed in Section 2 above? 8. Did you receive any correspondence from the IRS or State Department of Taxation? * (b) Was heat included in the rent? 14. Did you pay interest on a student loan for yourself, your spouse, or your dependent during the year? 15. Did you pay expenses for yourself, your spouse, or your dependent to attend classes beyond high school? * Contact us for further information

2 16. Did you have any children under the age of 19 or 19 to 23 year old students with unearned income of more than $950? 18. If you are a MA resident, did you have Fast Lane/EZ-Pass or T-Pass Expenses, or out-of state purchases subject to MA Use Tax? 17. All Taxpayers, please provide a copy of your 1099-HC. 3. Wage, Salary Income 7. Property Sold Attach W-2 s: Attach 1099-S and closing statements Employer Taxpayer Spouse Property Date Acquired Cost & Imp. Personal Residence * Vacation Home Land * Provide information on improvements, prior to sales of home, and cost of a new residence. Also see section 17 (Job Related Moving). 4. Interest Income 8. I.R.A. (Individual Retirement Account) Attach 1099-INT, Form 1097-BTC Broker Statements If 1099 attached, do not fill in amounts Contributions for tax year income Payer Amount Amount Date Check for Roth Taxpayer Spouse Tax Exempt Amounts withdrawn. Attach 1099-R & 5498 Plan Trustee Reason for Withdrawal Reinvested? 5. Dividend Income From Mutual Funds & Stocks Attach 1099-DIV If 1099 attached, do not fill in amounts. Payer Ordinary Capital Gains 6. Partnership, Trust, Estate Income n- Taxable 9. Pension, Annuity Income Attach 1099-R Payer* Reason for Withdrawal * Provide statements from employer or insurance company with information on cost of or contributions to plan. Reinvested? List payers of partnership, limited partnership, S-corporation, trust, or estate income Attach K-1 Did you receive: Taxpayer Spouse Soc. Security Benefits * * Railroad Retirement * * * Attach SSA 1099, RRB 1099

3 10. Investments Sold Stocks, Bonds, Mutual Funds, Gold, Silver, Partnership interest Attach 1099-B Investment Date Acquired Date Sold Cost Sale Price 11. Income 14. Interest Expense List All Income (including non-taxable) Mortgage Interest Paid (Attach 1098) Interest Paid to Individual for your home Alimony Received (include amortization schedule) Child Support Paid to: Scholarship (Grants) Name Unemployment Compensation (repaid) Address Prizes, Bonuses, Awards Social Security. Gambling, Lottery (expenses ) Unreported Tips Investment Interest Director / Executor s Fee Premiums paid or accrued for qualified mortgage Commissions insurance Jury Duty Worker s Compensation 15. Casualty / Theft Loss Disability Income Veteran s Pension Payments from Prior Installment Sale For property damage by storm, water, fire, accident, or stolen. State Income Tax Refund Location of Property Description of Property 12. Medical / Dental Expenses Medical Insurance Premiums (paid by you) Prescription Drugs Insulin Glasses, Contacts Hearing Aids, Batteries Braces Medical Equipment, Supplies Nursing Care Medical Therapy Hospital Doctor / Dental / Orthodontist Mileage (no. of miles) Miles after June 30 Amount of Damage Insurance Disbursement Repair Costs Federal Grants Received 16. Charitable Contributions Church, Synagogue United Way Scouts Telethons University, Public TV / Radio Heart, Lung, Cancer, etc. 13. Taxes Paid Wildlife Fund Salvation Army, Goodwill Real Property Tax (attach bills) Personal Property Tax n-cash Volunteer (no. of miles) Federally Declared Disaster Losses

4 17. Child & Dependent Care Expenses Name of Care Provider Address Soc. Sec.. or Employer ID Amount Paid Also complete this section if you receive dependent care benefits from your employer. 18. Job Related Moving Expenses 21. Business Mileage Date of move Do you have written records? Move of household goods Did you sell or trade in a car used for Lodging during move business? Travel to new home (no. of miles) If yes, attach a copy of purchase agreement 19. Employment Related Expenses That You Paid (t self-employed) Make / Year of Vehicle Date Purchased Total Miles (personal & business) Business Miles (not to and from work) Dues Union, Professional From first to second job Books, Subscriptions, Supplies Licenses Education (one way, work to school) Tools, Equipment, Safety Equipment Job Seeking Uniforms (including cleaning) Business Sales Expenses, Gifts Tuition, Books (work related) Round Trip Commuting Distance Entertainment Gas, Oil, Lubrication Office in Home : Batteries, Tires, etc. In Square Feet a) Total Home sq. ft. Repairs b) Office sq. ft. Wash c) Storage sq. ft. Insurance Rent Interest Insurance Lease Payments Utilities Garage Rent Maintenance 20. Investment-Related Expenses 22. Business Travel If you are not reimbursed for exact amount, give total expenses. Tax Preparation Fee Safe Deposit Box Rental Mutual Fund Fee Investment Counselor Airfare, Train, etc. Lodging Meals (no. of days) Taxi, Car Rental Reimbursement Received

5 23. Estimated Tax Paid 24. Deductions Due Date Date Paid Federal Amt. State Amt. Alimony Paid to Social Security. $ Student Interest Paid Health Savings Account Contributions Archer Medical Savings Acct. Contributions 25. Education Expenses 26. Questions, Comments, and Information Student s Name Type of Expense Amount Resident School District if Local Tax Applies: 27. Direct Deposit pf Refund / or Savings Bond Purchases Would you like to have your refund(s) directly deposited into your bank account? Name of Financial Institution Financial Institution Routing Transit Number Your Account Number Owner of Account Taxpayer Spouse Joint Type of Account Checking Savings To the best of my knowledge, the information enclosed in this organizer is correct and includes all income, deductions, and other information necessary for the preparation of this year s income tax returns for which I have all records. Taxpayer Date Taxpayer Date