- Copy of recent monthly mortgage statement(s) for loans on all properties currently owned and form(s) 1098 mortgage interest

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1 CYNTHIA A. WILKINSON, CPA" MS TAXATION Phone (925) CERTIFIED PUBLIC ACCOUNTANT Fax: (925) CROW CANYON PLACE, SUITE 1 cpacyndi@aol.com SAN RAMON, CA Website: cpacyndi.com It is time to start gathering the information needed to prepare your 213 income tax returns. To assist you, I have enclosed a tax organizer booklet. Please read thoroughly, as this packet contains important information you need to know. If you decide to provide your own schedules instead of using the organizer, you will still need to answer the miscellaneous questions at the front of the organizer, to help ensure I do not overlook anything that might affect your tax returns. Also, please sign the Engagement Letter which authorizes me to prepare your tax returns as wen as the Record Keeping Requirements Statement if it applies to your situation. I will be offering Saturday and evening hours during the months of February, March and April 1 st through April 12th. I will be unavailable after April 12,214 through late May 214. The receptionist is available Monday through Friday 8:3 AM to 5: PM for pickup and drop off of paperwork and tax returns all throughout the year. Please provide me with the following additional information: - Copy of 212 tax returns - All of your W-2's - All 199's from banks, credit unions and brokerage statements - All K-1 's from investments in partnerships, LLC's, trusts and S-Corporations - Closing statements for all real estate transactions, including refinances - Copies of your real estate property tax statements and DMV registration paid - Any tax notices received from the IRS or other taxing authorities - Copy of recent monthly mortgage statement(s) for loans on all properties currently owned and form(s) 198 mortgage interest - Summary of medical expenses (total must exceed 1% or 7.5% if age 65 or older of adjusted gross income). Important Dates: Tuesday, April 1, Last day to have all your information to me to guarantee completion. Wednesday, April 9, Last day I can transmit E-File returns(signed efile authorization forms must be returned to me unless returns extended). Saturday, April 12, All returns are to be picked up by noon (office closed on Sunday April 13, 214. I will not be available on April 13, 14, 15, 214) Important Reminders: Federal and state governments have continued to increase the regulation and reporting requirements and it is becoming an increasingly greater burden for both the taxpayers and tax return preparers. Here are the most common regulations and requirements that might affect your returns. If you have questions about the applicability of any of these to your individual situation, please contact me.

2 Charitable Donations: The record keeping requirements for charitable donations have been toughened and here is what is in effect. For cash contributions, you must have a statement or letter from the charity showing the name of the charity, the date of the contribution, and amount given and it must state that no goods or services were received. There is no threshold for this record keeping requirement. For vehicle donations, if the value you are claiming as a deduction exceeds $5, the deduction is limited to the gross proceeds realized by the charity. If the charity intends to use the vehicle, the deduction is its fair market value. The charity will provide you with a letter or other form of documentation on the amount. If the value exceeds $5, an appraisal must be obtained. Foreign accounts: The reporting requirements for assets held overseas are increasing and the penalties for failure to report them are becoming increasingly harsh. Not all foreign holdings must be reported. If, for example you hold stock in a foreign company through a U.S. broker, those holdings do not have to be separately reported. However, if you hold any other types of foreign assets, including bank accounts (and have signature authority) and securities accounts, please let me know, and if you have any doubt as to whether any of your assets are foreign, please discuss those assets with me. Use tax: California requires payment of use tax if you purchase goods out-of-state that are used, consumed or stored in California, when no sales tax is collected on the purchase. Most such purchases are made over the internet or by mail order from out-of-state sellers. Taxpayers are required to report such purchases and pay the use tax on their California income tax returns. You have the option of totaling all such purchases and I will compute the use tax. Your second option is a "lookup table." If all of your purchases were under $1, each, I can use a "lookup table" to compute your tax. The table is based on your income. Business 199 reporting: Corporations, partnerships, LLC's, Schedule C businesses and Schedule F farms are required to state whether or not they were required to send out Form 199's and whether or not they complied with this requirement. As a reminder, a 199 should be sent to anyone you paid $6 or more in the course of your business. This includes amounts you paid for outside services, rent, and attorney fees. The IRS is stepping up enforcement of this requirement and California will disallow the deduction completely if a required 199 was not issued. I am able to help you prepare and file the 199's so if this applies to you and you are not already sending out 199's, please let me know. Extensions: I do not automatically file extensions, so if you want me to file one, you will need to specifically request this before Friday, April 11th. I will be unavailable from April 13, 214 until late May 214. Please be reminded that the extension is only for filing the return, and is not an extension to pay the tax. If you owe additional tax and it is not paid by April 15th, you may be subject to late filing or late payment penalties plus interest. There is an additional fee of $75 to prepare a return on extension. Extensions are through October 15th. When you have all, or substantially all, of your information ready, please call to arrange an appointment. If you feel an office visit is not necessary, you may send the organizer along with supporting information to my office. I will review your information and call or you with questions. Be sure to provide a current address. Please be sure to sign and date the annual letter of arrangement and record keeping requirements statement (if applicable) and complete the miscellaneous questions prior to sending the organizer. I cannot prepare your return without these items. Federal and state laws require that tax returns be filed electronically, unless you wish not to have your return e-filed. There is no difference in cost between electronically filed or paper returns. If you wish not to e-fiie, I will provide you with an "Opt Out" form to sign. Please note the April 9th deadline for me to e-file returns. If I do not receive your Signed efile authorization forms by that date, I will need to reprocess the returns as a paper return for you to file and additional fees may apply. Thank you for your help in the completion of this organizer packet, and I appreciate the opportunity to be of service to you. Check out my website at for important dates and downloads.

3 CYNTHIA A. WILKINSON CERTIFIED PUBLIC ACCOUNTANT 21 Crow Canyon Place, Suite 1, San Ramon, CA Phone: (925) Fax: (925) cpacyndi@aol.com website: cpacyndi.com This letter will confirm our understanding of the arrangements for preparing your income tax returns. I will prepare your Federal and California income tax returns for 213 from information you furnish. I will not audit or otherwise verify the data you submit, although I may ask you to clarify some of it or supply me with additional information. Generally, I will rely on your representation that you have maintained the documentation required by law to support the information you provide. I do not use any outside third parties for preparation of your tax returns, but I use my software supplier to transmit electronically filed returns. It is your responsibility to provide me with all the information required for the preparation of complete and accurate tax returns. You should retain all documents, canceled checks and other data that substantiates your deductions, as they may be necessary to prove the accuracy and completeness of your returns to a taxing authority. You have the final responsibility for your income tax returns and, therefore, you should review them carefully before signing and filing. I am required to determine that you have records to substantiate certain types of deductions. In that regard, you will find on the next page a Record Keeping Requirements Statement which contains the rules for SUbstantiation of travel, entertainment and certain "listed" property expenses. You will need to sign this statement if you are deducting these types of expenses. If you do not have these types of deductions, this form is not necessary. Your returns may be selected for review or audit by taxing authorities, and any proposed adjustments are subject to certain rights of appeal. In the event of an examination, I am available, upon request, to represent you. Fees for this additional service will be communicated to you in a separate letter of arrangement. I will use my professional judgment in preparing your returns. Whenever I am aware that an applicable law is unclear, or that there are conflicting interpretations of the law, I will explain the possible positions which may be taken on your return. I will adopt whatever position you request on your return so long as it is consistent with the codes and regulations and interpretations which have been promulgated. If a taxing authority should later contest the position taken, there may be assessment of additional tax plus interest and penalties, for which I assume no liability. I am responsible for preparing only the returns listed above. Although I am available to provide you with tax planning advice, I am not obligated to do so unless you specifically request it. My policy is to put all tax planning advice in writing. Therefore you should not rely on any unwritten advice as it may be tentative and not fully reviewed. You may also be required to make estimated tax payments due to unanticipated increases in income, or file employment related returns for household employees, gift tax returns or foreign bank and financial reporting (FBAR), or 199 filings, etc. and my tax preparation fee and this letter does not cover those services. I can discuss those obligations with you if you so desire. I must receive all information to prepare your returns by Tuesday, April 1 st to ensure that your returns will be completed in time to file by April 15th. If I have not received all of your information by April 1 st and your return is not completed by April 15th, you may be subject to late filing or late payment penalties plus interest. I do not file tax return extensions unless specifically requested to do so. If an extension of time to file is required, I will use the information available to me at the time to prepare an extension. An extension, however, only provides you with an extension to file the returns, not to pay the tax. I will not be available after April 12th until late May 214. The cost of preparing your tax returns is based on a fee schedule and the number of forms required to be filed. Obviously, the more complex the return requiring more forms and schedules, the higher the cost. The fee schedule was based on typical times to gather your data in meetings, correspondence, s, or telephone conversations, and fully consider the myriad of choices throughout the return preparation process, and my standard billing rate of $275 per hour. The fee for preparing your income tax returns does not include responding to inquiries or examination by taxing authorities, tax planning, tax projection calculations, or any other correspondence that I may write on your behalf. The minimum fee for preparing your returns is $35, and payment is due upon delivery of the completed returns to you, or prior to my electronically filing the return. A copy of your tax returns is provided as part of my fee; any additional copies will be provided for an additional charge. If the above sets forth your understanding, please sign and date this letter (if a joint return, only one spouse needs to sign). Approved by: Date:

4 RECORDKEEPING REQUIREMENTS STATEMENT Tax laws and IRS regulations have made the deductions for home office, travel, meals, business entertainment and gifts, and listed property more restrictive, and they need to be substantiated by adequate records or logs. Listed Property. The following are examples of listed property for the purpose of the limitation and adequate records requirements: Certain passenger vehicles; Any other means of transportation, such as airplanes, trucks, boats, etc.; Any computer or peripheral equipment not used exclusively at a regular business office. Adequate Records. The records and substantiation for travel, meals, business entertainment and gifts must establish the following: The amount of the deduction; The time and place of the business use or deduction; The purpose of the use of the property or deduction; The persons using the property for which the expense was incurred. You should keep a log, journal, diary or similar records, and each entry should be made at, or near to, the time the property was used or the expenditure was made. If you have vehicle expenses and have maintained the properly written records, please complete the vehicle information page in the tax organizer. sign and date this letter. If you have any of the above listed deductions in 213, sign and date this letter. If you cannot sign this letter, I will not be able to take any deduction relating to the above items on your tax return. Declaration I have read the above record keeping requirements and, to the best of my knowledge and belief, have kept the adequate records that are required to substantiate such deductions claimed on my tax return. By: Date:

5 ORGANI2 ER I US I Miscellaneous Questions Ifany of the following items pertain to you or your spouse for 213, please check the appropriate box and provide additional information if necessary. Yes PERSONAL INFORMATION No Did your marital status change during the year? Did your address change during the year? Cou Id you be claimed as a dependent on another person's tax return for 213? DEPENDENTS Were there any changes in dependents? Were any of your unmarried children who might be claimed as dependents 19 years of age or older at the end of 2 13? Did you have any children under age 19 or full-time students under age 24 at the end of213, with interest and dividend income in excess of$i,ooo, or total investment income in excess of $2,? INCOME Did you cash any Series EE U.S. savings bonds issued after 1989 and pay qualified higher education expenses for yourself, your spouse, or your dependents? Did you receive any disability income? Did you have any foreign income or pay any foreign taxes? PURCHASES, SALES AND DEBT Did you start a business or farm, purchase rental, or acquire an interest in a partnership, S corporation, or trust? Did you purchase or dispose of any business assets (furniture, equipment, vehicles, real estate, etc.), or convert any personal assets to business use? Did you buy or sell any stocks, bonds or other investment property in 213? Provide brokerage statements showing sales and cost basis so I can calculate your gain or loss. Miscellaneous Questions

6 1 OR~ I=~ I US I Miscellaneous Questions Did you purchase, sell, or refinance your principal home or second home, or did you take a home equity loan, include a copy of your closing settlement statement and year-end mortgage statements? Did you make any residential energy-efficient improvements or purchases involving solar, wind, geothermal or fuel cell energy sources or purchase a plug-in electric vehicle? Did you have any debt canceled or forgiven including credit cards or real estate? Does anyone owe you money which has become uncollectible? (Note: the IRS considers loans between family members to be "gifts" unless your documentation of the debt and substantiation of uncollectibility is complete). Do you have any out-of-state or internet purchases for which California Sales Tax was not charged? If so, California Use Tax has to be calculated and reported. RETIREMENT PLANS Did you receive a distribution from a retirement plan (41(k), IRA, SEP, SlJYIPLE, Qualified Plan, etc.), provide I 99R?(If age 7.5 a required minimum distribution may be required.) Did you make, or plan to make, a contribution to a retirement plan (4 I (k), IRA, SEP, SIMPLE, Qualified Plan, etc.)? Did you transfer or rollover any amount from one retirement plan to another retirement plan, provide 199R? Did you convert part or all of your traditional, SEP, or SIMPLE IRA to a Roth IRA in 213? EDUCATION Did you receive a distribution from an Education Savings Account or a Qualified Tuition Program? Did you, your spouse, or a dependent incur any tuition expenses that are required to attend a college, university, or vocational school? ITEMIZED DEDUCTIONS Did you incur a loss because of damaged or stolen property that exceeds 1% of your adjusted gross income? Miscellaneous Questions (Continued'

7 nrr.anij I=R I US I Miscellaneous Questions D D Did you work out of town for part of the year and incur expenses for which you were not reimbursed? D D Did you use your car on the job (other than to and from work)?(complete recordkeeping statement) ESTIMATED TAXES D D Did you apply an overpayment of212 taxes to your 213 estimated tax (instead of being refunded)? D D If you have an overpayment of213 taxes, do you want the excess applied to your 214 estimated tax (instead of being refunded)? D D Do you expect your 214 taxable income and withholdings to be different from 213? Ifso, we need to discuss if you have to make estimated tax payments for 214. MISCELLANEOUS D D Do you want to electronically file your tax return? If I have not received your signed efile authorization by April 9th, I will not be able to file your return electronically unless the return is extended. D D Do you want to allocate $3 to the Presidential Election Campaign Fund? D D Does your spouse want to allocate $3 to the Presidential Election Campaign Fund? D D May the IRS discuss your tax return with your preparer? D D Did you have an interest in or signature authority over a financial account in a foreign country, such as a bank account, securities account, or other financial account (the FBAR)? Failure to timely file FBAR (FinCEN) is subject to harsh civil and criminal penalties. D D Did you receive a distribution from, or were you the grantor of, or transferor to, a foreign trust or did you have an interest in any foreign assets or accounts? D D Was your home rented out or used for business? D D Did you incur moving expenses due to a change of employment? D D Did you engage the services of any household employees? D D Were you notified or audited by either the Internal Revenue Service or the State taxing agency? D D Did you or your spouse make any gifts to an individual that total more than $14,, or any gifts to a trust? D D Did you (your employer) or your spouse (spouse's employer) contribute or withdraw funds from a health savings account(hsa)? Miscellaneous Questions (Continued"

8 I ORGANIZER : 213 I 14 I US I Tax Organizer Please enter all pertinent 213 information. If you have attached a government form for an item, check the box and do not enter a 213 amount. WAGES, SALARIES AND TIPS Employer name: 213 Amount 212 Amount ~ Attach Forms W-2 INTEREST INCOME Payer name : ~ Attach Forms 199-INT DIVIDEND INCOME Payer name: ~ Attach Forms 199-DIV PENSIONS, IRA AND GAMBLING INCOME Payer name: ~ Winnings not reported on W-2G , Total gambling losses , , , Attach Forms 199-R & W-2G OTHER GOVERNMENT FORMS - INCOME ~ Form Sales of stock (also include transaction hi story)..... Form 199-MISC - Miscellaneous income ,.,.. Form 199-K - Merchant card and third party network payments... Form 199-S - Sales of real estate (also include closi ng statements) I Attach Forms 199 D Form 199-G - State ta x refunds ,., I Attach Forms 199 I I Taxpayer: 8 8 Spouse: Form SSA-l 99 - Social security benefits Form 199-G - Unemployment compensation....., Form SSA-l 99 - Social security benefits......, Form 199-G - Unemployment compensation MISCELLANEOUS INCOME Taxpayer: Alimony received..... _.... _ _ Spouse: Alimony received......, ,. Other: I Attach Forms 199 I I I Attach Forms 199 I I I Ta x Organize

9 ORGANIZER 213 I 14 US I Tax Organizer Cynthia A. Wilkinson, CPA Tax Return Appointment 21 CROW CANYON PL STE 1 SAN RAMON, CA Date: Telephone number: (925) Time: Fax number: (925) Location: address: cpacyndi@aol.com This tax organizer will assist you in ~athering information necessary for the preparation of your 213 tax return. P ease enter all pertinent 213 information. NOTE: If (OU claim the earned income credit, please provide proof that your child is a resident of the United States. This proof is trcpicall y in the form of: schoo records or statement, landlord or property mana3ement statement, health care provider statement, medical records, chi d care provider records, placement agency statement, social service recor s or statement, place of worship, Indian tribal office statement, or employer statement. NOTE: If your child is disabled, please provide one of the following forms of proof of disability: doctor statement, other health care provider statement, or social services agency or program statement. CLIENT INFORMATION First name and initial.... Last name..... Title/suffix Social security number. Occupation Date of birth (m/d/y)..... Date of death (m/d/y).,.. l=blind ,,. Home phone Work phone Work extension Cell phone......,.... address Address DEPENDENTS First name Last name..,..... Title/suffix , Date of birth (m/d/y).... Social security number... Relationship.... ".,.... Months lived at home... First name.., Last name Title/suffix ,... Date of birth (m/d/y).. Social security number. Relationship Months lived at home... In care of Street address... Apartment number.. City State. ZIP code., ,... Taxpayer Dependent No. Dependent No. Spouse Dependent No. D~endent No. Tax Organize

10 ORGANIZER 213 Tax Organizer RETIREMENT PLAN CONTRIBUTIONS Taxpayer: Traditional IRA contributions (1 =maximum) Roth IRA contributions (1 =maximum) Self-employed, SEP, SIMPLE, & qualified plan contributions (1 =maximum)... Spouse: Traditional IRA contributions (1 =maximum).... Roth IRA contributions (1 =maximum) Self employed, SEP, SIMPLE, & qualified plan contributions (1 =maximum).. OTHER GOVERNMENT FORMS - DEDUCTIONS o Form 198-E - Student loan interest D Form 198-T - Tuition and re lated expenses Amount 212 Amount Attach Forms 198 ADJUSTMENTS TO INCOME Taxpayer: Self-employed health insurance premiums... Educator expenses... Other adjustments to income: Alimony paid - Recipient name & SSN Spouse: Self-employed health insurance premiums. Educator expenses.... Other adjustments to income: Alimony paid - Recipient name & SSN MEDICAL AND DENTAL EXPENSES Prescription medicines and drugs Doctors, dentists and nurses Hospitals and nursing homes Insurance premiums.. Long-term care premiums - taxpayer Long-term care premiums - spouse Insurance reimbursement Out-of-pocket lodging and transportation expenses Number of medical miles. Other: TAXES PAID State income taxes payment on 212 state estimate State income ta xes - paid with 212 state extension..... State income taxes - paid with 212 state return State income taxes - paid for prior years and/or to other states... Tax Organize

11 ORGANIZER 213 Tax Organizer TAXES PAID (continued)' 213 Amount 212 Amount City/local income taxes - 1/13 payment on 212 cityllocal estimate. Cityllocal income taxes paid with 212 city/local extension.... City/local income taxes paid with 212 city/local return. State and local sales taxes (except autos and special items). Use taxes paid on 213 purchases.... Use taxes paid on 212 state return. Sales tax on autos not included above Sales taxes paid on boats, aircraft, and other special items.... Real estate taxes principal residence... Real estate taxes property held for investment.. Foreign income taxes o Personal property taxes (including automobile fees in some states). INTEREST PAID Attach Tax Notice Home mortgage interest not on Form 198 (include name, SSN, & address of payee): Attach Forms 198 Points not reported on Form 198: Mortgage insurance premiums on post 12/31/6 contracts Investment interest (interest on margin accounts): Passive interest CASH CONTRIBUTIONS NOTE: No deduction is allowed for cash or check contributions unless the donor maintains a bank record, or a written communication from the donee, showing the name of the organization, contribution date(s), and contribution amount(s). Volunteer expenses (out of pocket).. Number of charitable miles... NONCASH CONTRIBUTIONS NOTE: No deduction is allowed for contributions of clothing and household items that are not in good used condition or better, in addition, a deduction for any item with minimal monetary value may be denied. MISCELLANEOUS DEDUCTIONS Union and professional dues... Tax return preparation fee. Safe deposit box rental Investment expenses Estate tax, section 691 (c) Unreimbursed employee expenses: Other: Tax Organize

12 ORGANIZER 213 Noncash Contributions (Form 8283) 26 If your total noncash contributions are in excess of $5 in 213, please complete the information below for each donee using the following guidelines: * If you contributed a motor vehicle, boat, or airplane with a claimed value of more than $5, attach Form 198-C or other written acknowledgement received from the donee organization. * A deduction for contributions of clothing or other household items that are not in good used condition or better is not allowed. In addition, a deduction for any item with minimal monetary value may be denied. However, these rules do not apply to any contribution of a single item for which a deduction of more than $5 is claimed, if a qualified appraisal for the donated property is provided. DONATED PROPERTY INFORMATION No. LI_-l Name of charitable organization (donee)... Street address City State.... ZIP code _..... l=spouse, 2=joint..... f-:8::.::o:..:::o _ f-:8::.::~ _... ~8~3:.:..1+_ Property description (other than vehicle) Identification number (VIN) Vehicle Year (yyyy}.... _ ~14= Make and model f-:8~2:..:::9_+_ I J Mileage at time of donation f-:8~3~+..,i; , -----l Date of contribution (m/d/y).. 5 I Date acquired by donor (m/y) I How acquired by donor (Table 1 or describe) Donor's cost or basis Fair market value I I Method used to determine FMV (Table 2 or describe). 85 I Name of charitable organization (donee) _.... ~8::::::.:: Street address ~8~~1' City _.... _..... ~8::::::!: State f.c8~3:.:..1+_ ZIP code l=spouse, 2=joint.. Property description (other than vehicle). 83 Identification number (VIN) No_ LI_--, Vehicle Year (yyyy) Make and model Mileage at time of donation ~83~ , Date of contribution (m/d/y) I Date acquired by donor (m/y) _... 6 I How acquired by donor (Table 1 or describe). 84 Donor's cost or basis _. 7 I Fair market value I Method used to determine FMV (Table 2 or describe) I 1 How Property was Acquired 2 Method Used to Determine FMV 1 = Purchase 3 = Inheritance 1 = Appraisal 3 = Catalog 4 = Exchange 4 = Comparable sales 2 = Gift 2 = Thrift shop value For other methods, see IRS Pub Series: 21 Noncash Contributions (Form

13 ORGANIZER I US 1 Capital Gains & Losses (Schedule ) I 17 If you sold any stocks, bonds, or other investment property in 213, please list the pertinent information for each sale below or ~rovide a spreadsheet file with this information. 8e sure to attach all 19-8 forms and brokerage statements. Quantity Description of Property LJate Date Sold Sales Price Cost or Basis Blank=basis rep. E~en ses of Sale Federal Income (Box 8) Acquired (Box 1a) (gross or net) to IRS, 1 =nonrec. if gross sales No. (Box 3) Tax Withheld (Box 1 b) (Box 2) security (Box 6) price eniered) (Box 4) Series: 52 I 17 Capital Gains & Losses (Schedule D

14 1 ORGANIZER 213 Direct Deposit &Estimates (Form 14 ES) 3,6 Please enter all pertinent 213 information. DIRECT DEPOSIT I ELECTRONIC PAYMENT (3) ~:::::~:o~~~~:~~fe~d:;~atl:~;:f~:~into bank ac. c. o..u.n.t,',... ::. :. :. :.:,,' '.,... :..:. ~-=331c...:!6-t l 1=electronic payment of estimated tax.. L...--=-=----'--. -'- ---J BANK INFORMATION Name of Bank Percent to Deposit (xx,xx) Routing Number Account Number Type of Account (Table 1) ESTIMATED TAX 114 ES (6) 213 Federal Amount Paid Date Paid TS Voucher Amount Overpayment applied from st quarter payment nd quarter payment......,.,,...,,,, rd quarter payment... " th quarter payment Additional Estimated 4 41 Tax Payments Paid with extension.....,, State Amount Paid Date Paid TS 213 Voucher Amount Overpayment applied from st quarter payment nd quarter payment....,,,,,,..,.., "4 3rd quarter payment th quarter payment Additional Estimated Tax Payments Paid with extension....,,...,,. 11 "1 84 Type of Invest. (Table 2) 1 Type of Account 1 ~ Savin!)s 2 ~ Checking 2 Type of Investment 1 Checking or savings (default) 6 Coverdell savings accounl (ESA) 2 Taxpayer's IRA (next year limits) 7 Other 3 Spouse's IRA (next year limits) 8 Taxpayer's IRA (current year limits) 4 Health savings account (HSA) 9 Spouse's IRA (current year limits) 5 Archer MSA Series: 51, 54 (t=taxpayer, S=spouse, blank=joint) Direct Deposit & Estimates (Form 14 ES

15 ORGANIZER 213 Direct Deposit &Estimates (Form 14 ES) (cont.) 7.1 Please enter all pertinent 213 information. APPLICATION OF 213 OVERPAYMENT (7.1) If you have an overpayment of 213 taxes, do you want the excess refunded? D Other (please explain): or applied to 214 estimate?... D 214 ESTIMATED TAX INFORMATION Do you expect your 214 taxable income to be different from If "yes" explain any differences in income, deductions, dependents, etc.: Yes D No D Do you expect your 214 withholding to be different from 213? If "yes" explain any differences: Yes D No D Series: 54 (t=taxpayer, s=spouse, blank=joint) Direct Deposit & Estimates (Form 14 ES) (cont.

16 ORGANIZER 213 Child and Dependent Care Expenses (Form 2441) 33.1,33.2 Please enter all pertinent 213 information. Last year's amounts are provided for your reference. You must have paid for the care of one or more dependents enabling you to work or attend school to qualify for this credit. 213 Amount 212 Amount DEPENDENT CARE EXPENSES (33.1) Taxpayer Spouse Taxpayer Spouse Dependent care expenses incurred but not paid in ~--=36'------t =55=-=36-~------I1 Employer-provided benefits forfeited in ' _... 1' --'-'=~~...,.---=.l=~-----, PERSONS AND EXPENSES QUALIFYING FOR DEPENDENT CARE CREDIT First name ,., Last name ,.. Date of birth (m/d/y) _.., No 1 I Social security number......, Qualified d1endent care expenses incurred an paid in =disabled =spouse, 2=joint..,....., amt: NO.C::=:J First name Last name ,.,.. _ Date of birth (m/d/y)..., Social security number , Qualified d1endent care expenses incurred an paid in =disabled ,, =spouse, 2-=joint ,.. 21 ~12 amt: First name., 17 Last name Da1e of birth (m/d/y) NO.C::=:J Social security number Qualified d1endent care expenses incurred an paid in l=disabled =spouse, 2~ioint _ amt: PERSONS OR ORGANIZATIONS PROVIDING CARE (33.2) NO.C::=:J Name of provider Street address..., City, state, ZIP code Identification number (SSN or EIN) Amount paid to care provider in spouse, 2~joint ~12 amt: 15 I I Name of provider _... _ Street address _ No_c:=J City, state. ZIP code Identification number (SSN or EIN) Amount paid to care provider in ~12 amt: 1-spouse, 2~ioint I 33.1,33.2 Series: Child and Dependent Care Expenses (Form 2441