QED Tax Service 6520 Lonetree Blvd Rocklin, CA

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1 QED Tax Service 6520 Lonetree Blvd Rocklin, CA , Dear CLIENT: Please call to schedule an appointment OR You may want to utilize our Drop Off Service Tax Organizer, Engagement Letter & Questionnaire - Please fill out the Questionaire. Also, review and sign the engagement letter and return to me will your tax documents, and worksheets or filled in organizer. Tax perparations has become more expansive each year and so we have to try pry a little more and more. Due to the enhanced due diligence requirements, we do require that you take the time to complete and sign the questionnaire. This will help us to determine things that we may need to look into to protect your interests. Tax related documents we will need: - W2 Forms for wages - All Forms 1099 for interest, dividends, pensions, miscellaneous income, etc. - Brokerage statements for all investment accounts - If you have sold any assets in these accounts we will need the original purchase date and price (note this may already be on your statement) Forms or other year-end statements showing mortgage interest and property tax paid - Closing statement (escrow) for any Real Estate Purchase, Refinance or Sale - Schedule K1 showing income from all Partnerships, S Corporations, Estates, and Trusts - Any tax notices you have received from the IRS or Franchise Tax Board since last year - List of assets purchased or sold for a business or for a rental property - Contract or details for a purchase or sale of a business - Lease or loan contract for any new business vehicle or equipment - Receipts for large purchases that may qualify for the sales tax deduction - Mileage and expense logs - Non-Cash Donation receipts-if over $500 provide Fair Market Value, purchase price and items donated. Note: the donated items must be in good condition. Ready ahead of time? Try our Drop Off Service to get your information to us before your appointment and we will give you a 5% Discount on your 2013 Tax Preparation Fee! Just drop off, fax, mail, or ALL of your 2013 tax information at least 48 hours before your appointment. We will review and input the data. Then, during our appointment, we can do a better job focusing on important issues, questions and tax planning opportunities. This offer ends 03/31/2014.

2 Referral Program - We are expanding our referral program this year. We will offer a discount of $75 on your next tax return for each new client that you refer to us. Blank "organizers and worksheets" are available on our web site. - You may print and use these if you prefer a simpler layout, or, if you have started a new business or purchased a rental. Go to: Look under the "Resources" Tab. Thank you for the opportunity to serve you. Sincerely, QUIN BAIRD, EA QED Tax Service

3 Questions Please check the appropriate box and include all necessary details and documentation. Yes No Personal Information Did your marital status change during the year? p p If yes, explain: Did/have you celebrate(d) marriage to a same-sex spouse in a state that legally recognizes same-sex marriage? p p Did your address change from last year? p p Can you be claimed as a dependent by another taxpayer? p p Did you change any bank accounts that have been used to direct deposit? p p Dependent Information Were there any changes in dependents from the prior year? p p Do you have any children under age 19 or a full-time student under age 24 with unearned income in excess of $2,000? p p Do you have dependents who must file a tax return? p p Did you provide over half the support for any other person(s) other than your dependent children during the year? p p Did you pay for child care while you worked or looked for work? p p Did you pay any expenses related to the adoption of a child during the year? p p If you are divorced or separated with child(ren), do you have a divorce decree or other form of separation agreement which establishes custodial responsibilities? p p Purchases, Sales and Debt Information Did you start a new business or purchase rental property during the year? p p Did you acquire a new or additional interest in a partnership or S corporation? p p Did you sell, exchange, or purchase any real estate during the year? p p Did you purchase or sell a principal residence during the year? p p Did you foreclose or abandon a principal residence or real property during the year? p p Did you acquire or dispose of any stock during the year? p p Did you refinance a principal residence or second home this year? p p Did you sell an existing business, rental, or other property this year? p p Did you incur any non-business bad debts this year? p p Did you have any debts canceled or forgiven this year? p p Did you purchase a qualified plug-in electric drive vehicle or qualified fuel cell vehicle this year? p p Did you pay any student loan interest this year? p p Income Information Did you have any foreign income or pay any foreign taxes during the year, directly or indirectly, such as investment accounts or partnerships? p p Did you receive any income from property sold prior to this year? p p Did you make any withdrawals from an IRA, Roth, Keogh, SIMPLE, SEP, 401(k), or other qualified retirement plan? p p Did you make any withdrawals from an education savings or 529 Plan account? p p Did you receive any distributions from a Health savings account (HSA), Archer MSA, or Medicare Advantage MSA this year? p p Did you receive any Social Security benefits during the year? p p Did you receive any unemployment benefits during the year? p p Did you receive any disability income during the year? p p Did you receive tip income not reported to your employer this year? p p Did any of your life insurance policies mature, or did you surrender any policies? p p Did you cash any Series EE or I U.S. Savings bonds issued after 1989? p p Did you receive any awards, prizes, hobby income, gambling or lottery winnings? p p Itemized Deduction Information Did you incur a casualty or theft loss or any condemnation awards during the year? p p

4 Did you pay out-of-pocket medical expenses (Co-pays, prescription drugs, etc.)? p p Did you make any cash or noncash charitable contributions (clothes, furniture, etc.)? p p If yes, please provide evidence such as a receipt from donee organization, a canceled check, or record of payment, to substantiate all contributions made. Did you donate a vehicle or boat during the year? If yes, attach Form 1098-C or other written acknowledgement from donee organization. p p Did you have an expense account or allowance during the year? p p Did you use your car on the job, for other than commuting? p p Did you work out of town for part of the year? p p Did you have any expenses related to seeking a new job during the year? p p Did you make any major purchases during the year (cars, boats, etc.)? p p Miscellaneous Information Did you make gifts of more than $14,000 to any individual? p p Did anyone in your family receive a scholarship of any kind during the year? p p Did you have any educational expenses during the year on behalf of yourself, your spouse, or a dependent? p p Did you make any contributions to an IRA, Roth, Keogh, SIMPLE, SEP, 401(k), or other qualified retirement plan? p p Did you make any contributions to an education savings or 529 Plan account? p p Did you enroll for lower cost Marketplace Coverage through healthcare.gov under the Affordable Care Act? p p Did you make any contributions to a Health savings account (HSA) or Archer MSA? p p Did you pay health care or long-term care premiums for yourself or your family? p p Did you pay any COBRA health care coverage continuation premiums? p p If you are a business owner, did you pay health insurance premiums for your employees this year? p p Did you utilize an area of your home for business purposes? p p Did you engage in any bartering transactions? p p Are you an active participant in a pension or retirement plan? p p Did you incur moving costs because of a job change? p p Did you, your spouse, or your dependents attend a post-secondary school during the year, or plan to attend one in the coming year? p p Did you pay any individual as a household employee during the year? p p Did you make energy efficient improvements to your main home this year? p p Did you receive a distribution from, or were you a grantor or transferor for a foreign trust? p p Did you have a financial interest in or signature authority over a financial account such as a bank account, securities account, or brokerage account, located in a foreign country? p p Do you have any foreign financial accounts, foreign financial assets, or hold interest in a foreign entity? p p Did you receive correspondence from the State or the Internal Revenue Service? p p If yes, explain: Did you receive an Identity Protection PIN from the Internal Revenue Service or have you been a victim of identity theft? If yes, attach the IRS letter. p p Do you want to designate $3 to the Presidential Election Campaign Fund/? If you check yes, it will not change your tax or reduce your refund. p p State Information CA Renters Credit! Did you live in Calif. for at least 6 months and have income less than $35,659 if you were single or $71,318 married? Provide landlord's name & address p p Would you like a portion of your State refund to go to a listed charity? p p Did you make any out-of-state purchases (by telephone, internet, mail, in person) that the seller did not collect state sales or use tax? p p CA Note: For the Dependent Care Credit, a provider's telephone number is required.

5 Taxpayer First Name & Initial Last Name QED TAX SERVICE 6520 LONETREE BLVD, ROCKLIN, CA (916) (916) FAX Tax Year Personal Information First Name & Initial Last Name Social Security # Social Security # Occupation Date of Birth Date of Death Occupation Date of Birth Date of Death Spouse Mark if legally blind Mark if legally blind Mark if dependent of another taxpayer Do you want $3 to go to the presidential campaign fund? Yes / No Mark if dependent of another taxpayer Do you want $3 to go to the presidential campaign fund? Yes / No Marital Status on 12/31 (1= Single, 2= Married Filing Joint, 3=Married filing Separately, 4= Head of Household, 5=Qualified Widower) Mark if you were married but living apart all year Address Apartment number City State Zip Code Home/Evening phone Work/Day Phone Address Present Mailing Address First Name Last Name Date of Birth Dependent Information Social Security Number Relationship Months lived in your home Care Expenses paid for dependent Name of child who lived with you but is not your dependent SS# Notes and Questions

6 GOLDEN STATE TAX & BUSINESS SERVICE 6520 LONETREE BLVD, ROCKLIN, CA (916) (916) FAX Name Income Worksheet Tax Year W-2 s, Pensions or IRA s (Enclose All Copies) Other Items to Send: Sole Proprietors: Use Schedule C worksheet or send detailed list of your income and expenses. Rental Income Use Rental Income Worksheet Partnerships / Trusts or S-Corporations Enclose all K1 s Sale of Real Estate Closing Statements (for both purchase and sale) Any other related documents you believe we may need. State Tax Refunds Unemployment Taxpayer Spouse Social Security RR Benefits Amount Taxpayer Amount Spouse Interest and Dividends Please provide statements if possible Interest Name of Payer Amount Type of Interest / Notes Dividends Name of Payer Div Amount Capital Gains Foreign Tax Paid Other Capital Gains: Sale of Stock or Property(provide closing statements) Description of Property Date Acquired Date Sold Sales Price Cost / Basis (please note we can input multiple sales directly to our software if you can provide us with an Excel spreadsheet file) Miscellaneous Income Jury Duty Alimony Received Gambling Winnings Name & Soc # Scholarship Received Bad Debt Relief Royalties Other: Please call if you need assistance.

7 QED TAX SERVICE 6520 LONETREE BLVD, ROCKLIN, CA (916) (916) FAX WWWQEDTAX.COM ADJUSTMENTS TO INCOME & TAX CREDITS TO INCOME Tax Year Estimated Taxes Paid Federal Date Paid State Date Paid Applied from Prior Year 1 st Quarter 2 nd Quarter 3 rd Quarter 4 th Quarter ADJUSTMENTS TO INCOME Taxpayer Spouse Student Loan Interest IRA Payments Circle Taxpayer Spouse Education IRA SS# of Recipient Amount Reg Reg Roth Roth SEP / KEOGH Contributions SEP Keogh Y / N Circle Maximize Taxpayer Spouse Alimony Paid SS# of Recipient Amount Interest penalty on early withdrawal from bank accounts Moving Expenses (Meals are not deductible) Description of Move over 50 miles to new job location Taxpayer Air/Bus Travel Lodging Miles Old Home to Old Job Miles Driven Shipping Household Goods Miles Old Home to New Job CREDITS Child Care Credit Name of Provider Address of Provider & Phone # Soc Sec #, Employer ID, or Tax-Exempt Spouse Amount Paid Education Credits - Bring forms sent to you by the school Name of Student Social Security Number Qualified Expenses Year in school Qualified Expenses: Tuition & Course Fees Qualified Expenses: List tuition, books and course materials separately. There are many other special credits. The Adoption Credit, Special Fuel Credits, Senior Head of Household Credit, etc. etc. etc.

8 ITEMIZED DEDUCTIONS SCHEDULE A WORKSHEET Tax Year MEDICAL EXPENSES CHARITABLE CONTRIBUTIONS Prescriptions House of Worship Health Insurance Miscellaneous Cash Glasses / Contacts Payroll Contributions Hearing Aids/Batteries/Orthopedic Eq. Volunteer Out-of-pocket expenses Labs / X-rays Volunteer Auto Mileage Dentists Other Transportation Costs Doctors List below donations over $250 given at one time Other Medical: Miles driven or transportation costs Long-Term Ins. (Special Rules Apply) Non-Cash Contributions (Under $500) Less: Insurance Reimbursements Non-Cash Contributions totaling over $500: TAXES PAID Bring receipts or list: Description, Date/Gift, Date/Purchase Real Estate Taxes (Principal Residence) Original Cost, Value of Gift, How value was determined Other Real Estate Taxes: Miscellaneous Deduction Notes: 3 types of expenses State and Local Income Taxes - Paid 1. Unreimbursed Employee Business Expenses during the year for prior year 2. Job Seeking Expenses Sales Tax Paid 3. Education to Maintain & Improve your skills Foreign Taxes Out-of-town overnight travel We need itinerary, Auto License Tax Other INTEREST PAID Institution Amount Mortgage Interest Mortgage Interest Mortgage Interest Home Equity Loan Mortgage Paid to Individual Amount Name Address Tax ID / Soc Sec# Investment Interest Margin Interest CASUALTY / THEFT LOSSES Must exceed 10% of your adjusted gross income Date of event Description of event Bring list of lost articles and value Cost of lodging, flights, local transportation, phone, gratuities Independent Contractors (1099) list business income and expenses including auto on Schedule C worksheet not below OTHER DEDUCTIONS: Tax Preparation Safety Deposit Box Employee Business Expenses List Below- Union Dues Small Tools & Supplies Job Seeking Expenses Uniforms/Safety Equipment & Upkeep Publications / Subscriptions Research Materials Business Telephone Investment expenses (subject to limits) Gambling Losses(Limited to winning total) Questions or other information AUTO used by employees: Purchase Date Make & Model Total Mileage for Year Miles Used For Business Parking and Tolls on Business Long Method Make list all expenses paid for car during the year. Also, original cost of vehicle. QED TAX SERVICE 6520 LONETREE BLVD ROCKLIN, CA (916) (916) FAX

9 SELF-EMPLOYED BUSINESS INCOME AND EXPENSES SCHEDULE C Tax Year Prepare a separate worksheet for each business. Please, do not duplicate these expenses on any other worksheet Principal Business or Profession Business Name Employer ID# Business Address (if different from return) Income Regular Income Other Income: BUSINESS EXPENSES ADVERTISING BAD DEBTS CAR/TRUCK EXPENSES See Worksheet Cost of Goods Sold BEGINNING INVENTORY PURCHASES COST OF LABOR MATERIALS & SUPPLIES OTHER COSTS ENDING INVENTORY DUES & PUBLICATIONS PROF. SKILLS EDUCATION (SEMINARS, ETC.) GIFTS FOR BUSINESS COMMISSIONS / FEES PAID SMALL TOOLS & EQUIPMENT (Under $200) EMPLOYEE BENEFITS INSURANCE (Liability/Office/Equipment) INTEREST (FINANCIAL INST) INTEREST (OTHER) LEGAL FEES/TAX PREP OFFICE SUPPLIES & POSTAGE RENT (Machinery, Equipment) RENT (Other) REPAIRS / MAINTENANCE TAXES & LICENSES TRAVEL: Out-of-town Overnight Transportation Lodging Meals (Bring List of Location & # days) BUSINESS ENTERTAINMENT UTILITIES WAGES PAID (Bring Form 940) Business Equipment Purchased During Year SHIPPING SUB CONTRACTOR FEES TELEPHONE FOR BUSINESS CELLULAR PHONE INTERNET SERVICES / WEBPAGE OTHER: Make List Self-Employed Health Insurance Business Automobile (Short Method) Description Date Purchased Cost (Call for Long, Itemized Method worksheet) Purchase Date Make & Model Total Mileage for Year Miles Used For Business Parking and Tolls on Business Long Method Make list all expenses paid for car during the year. Office in Home (Must be principle place of business) Also, original cost of vehicle. Total square footage of home/apt. Mortgage interest Utilities Square footage of office / storage Real Estate Tax Insurance Purchase Price of Home * Rent Repairs/Maintenance QED TAX SERVICE 6520 LONETREE BLVD ROCKLIN, CA (916) (916) FAX

10 RENTAL INCOME WORKSHEET Use separate worksheet for each rental property. Do not duplicate expenses elsewhere. Description of Property Address / Location Did you use it for personal use? yes no If yes # of days personal use # of days rented INCOME: RENT OTHER Advertising Auto List miles driven or fill-in auto worksheet on main organizer Schedule A Other Travel Cleaning & Maintenance Commission Insurance Legal/Professional Fees Management Fees Mortgage Interest Paid to Banks Mortgage Interest Paid to Individuals Name: SS# : Other Interest Repairs Supplies Taxes (Real Estate / Property) Utilities Other (List) EXPENSES: DEPRECIATION List Purchase of property/equipment or capital repairs made during the year Prior year information will be carried from prior returns. Description Purchase Date Cost QED TAX SERVICE 6520 LONETREE BLVD ROCKLIN, CA (916) (916) FAX

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