Tax Resolution Underwriting Worksheet

Transcription

1 Tax Resolution Underwriting Worksheet Office: Tax Consultant: Date: Personal Information Spouse info Taxpayer's name DOB SSN Filing Status (SINGLE, JOINTLY, SEPARATELY) Address Home Phone Number Cell Phone Number Work Phone Number Best time to call Mailing Address (if different) Taxpayer's name DOB SSN Filing Status Address Home Phone Number Cell Phone Number Work Phone Number Best time to call Mailing Address (if different) Page 1

2 Employment Type Tax Situation W-2 or 1099 or both Are you employed? What do you do for a living? If self employed : Business Name Business Type (entity e.g. LLC, INC, S-corp, Partnership) EIN Taxes from witholding or profits IRS TAX DEBT AMOUNT? IRS TAX YEAR(S) OWED? When were they filed? STATE TAX DEBT AMOUNT? STATE TAX YEAR(S) OWED? When were they filed? Business Tax owed Have you received any letters from IRS? Mention Lien? Date Received By regular mail or Certified Mail? What did letter state? Tax and Employment Status General Assets (properties) Did you file all tax returns up-to-date? If not, what year(s) are you missing? Is there an active GARNISHMENT OR LEVY? Are you currently on a payment plan with the IRS? Payment Amount? Start Date? Are you currently on a payment plan with the State? Payment Amount? Start Date? Is there an IRS Revenue Officer assigned? Revenue Officer's contact information Name IRS or State address Phone number Married/Single? Financial Questionnaire Number of people in house hold below age 65 Number of people in house hold above age 65 Legal Dependents Asset (Personal) Cash Bank account balances Investments (stocks, bonds CD's, Mutual Funds) Life Insurance Whole Life or Term Life? If it's Whole Life, how much CASH VALUE you have in the policy? (not face amount) Page 2

3 Assets (other) Income (husband) Income (wife) Expenses Retirement Account Values - 401(k), IRA, etc. Real Estate R/E Mortgage Balance Vehicle 1 (year/model/mileage) Vehicle 1 Value Vehicle 1 Loan Balance Vehicle 2 (year/model/mileage) Vehicle 2 Value Vehicle 2 Loan Balance Personal Effects Do you have any other assets attached to your SSN? If yes, what type? What is the value? Income (Personal) W2, 1099 or Self Employed? If W2, what is your Gross Monthly Income before taxes? If S/E, what is your Adjusted Gross Income (Net Income) for the last 3 years average (Yearly Income)? If S/E, how much do you pay for estimated tax payment (Quarterly)? Pension Distributions (K-1) Alimony Child Suppport (Royalty, Rent subsidy) W2, 1099 or Self Employed? If W2, what is your Gross Monthly Income before taxes? If S/E, what is your Adjusted Gross Income (Net Income) for the last 3 years average (Yearly Income)? If S/E, how much do you pay for estimated tax payment (Quarterly)? Pension Distributions (K-1) Alimony Child Suppport (Royalty, Rent subsidy) Expenses (Personal) Food Housekeeping Supplies Apparel & Services Personal Care Misc Mortgage/Rent Home Owners Insurance Property Taxes Electric Page 3

4 Expenses (healthcare) Expenses (court order) Expenses (childcare) Expenses (life insurance) Expenses (student loans) Expenses (medical bills) Expenses (Quarterly taxes) Assets (properties) Income Income (other) Expenses Business Gas Water Sewer/Trash Cable Phone Auto payment/lease Auto Insurance Public Transportation How much is your monthly health insurance? (medical, dental, vision & disability) What are your monthly out of pocket healthcare expenses (outside of medical insurance payment)? Do you have any court ordered payments? (child support, alimony, judgments) How much is the monthly payment? How many payments are left? If you have child support, how old are they & how much you pay for each child? Do you have childcare expenses? Do you pay life insurance per month? Do you pay student loans? What's the balance? Do you have any outstanding medical bills? What's the balance? Quarterly Tax amount Assets (Business) Cash Account balances Receivables Tools & Books Assets Income (Business) Gross receipts Income Expenses (Business) Materials Inventory Gross wages & salary Rental Expense Supplies Page 4

5 Utilities/Telephone Vehicle gas/oil Repair maintenance Insurance Taxes Notes: detail letters, liens, tax situation - how did they end up owing IRS/State? Page 5