YOU MUST SIGN THE ATTACHED ENGAGEMENT AGREEMENT AND RETURN IT AT THE TIME OF YOUR APPOINTMENT OR WITH YOUR TAX RETURN DOCUMENTATION.

Transcription

1 Bennett Accounting, LLC 624 W. Gurley St., Suite E Prescott, AZ (928) (928) FAX YOU MUST SIGN THE ATTACHED ENGAGEMENT AGREEMENT AND RETURN IT AT THE TIME OF YOUR APPOINTMENT OR WITH YOUR TAX RETURN DOCUMENTATION. Dear Client, Your 2014 tax organizer is attached. Please review it carefully and answer the questions on the first few pages. If you choose not to submit the entire packet, please return the Engagement Letter and questionnaire pages. Be sure to notify us of any changes (ie: address, telephone numbers, address, dependents, etc) FORMS AND DOCUMENTATION: Please be sure to give us all copies of any government forms and pertinent statements we need to complete your return. This includes Form W-2, Form 1099, Form 1098, brokerage statements and real estate closing documents. All original documents will be returned to you. APPOINTMENTS: In most cases, if we have prepared your taxes in previous years, you can drop off your information. If you would like to meet, please call early for an appointment. If your information is in our hands by March 25th, every effort will be made to complete the returns on time. EXTENSIONS: If you wish for us to file an extension, we must have your information in our hands no later than March 27th in order to estimate your tax prior to filing the extension. If your information arrives after March 27th, we will file an extension but we may not have the time to estimate any taxes owed with the extension. We call these "blind extensions." We do not consider it right or fair for us to set aside other clients' returns to handle last minute extensions for procrastinators! An extension is "an extension of time to file, not an extension of time to pay!" The IRS will charge penalties and interest on any taxes owed that are not paid by April 15th. ENGAGEMENT AGREEMENT: The attached agreement states what services are included and what is not included when we prepare your tax return. THIS AGREEMENT MUST BE SIGNED AND RETURNED TO OUR OFFICE with your tax documents.

2 HEALTH COVERAGE: Be sure to include the required information for your Health Coverage for 2014 unless you are participating in Medicare, Medicaid or Tri-Care. ELECTRONIC FILING: This office is required to file all returns electronically. The IRS E-file system is very secure. When we prepare the returns, you and your spouse must sign IRS Form 8879 before your return can be filed. This form is your authorization for us to E-file on your behalf. To prevent identity theft and for other security reasons, we recommend that all refunds and payments be handled electronically thru the E-file system. Please let me know if you have questions or concerns. ARIZONA TAX CREDITS: Be sure to include any Arizona tax credit information for public schools, private school scholarship organizations or qualified charities. PAYMENT FOR SERVICES: As stated in the attached Engagement Agreement, payment for services is due upon completion of our work. Your return will not be released or filed until payment is received. We look forward to hearing from you soon. As always, contact us if you have any questions. Cyndi Cyndi Bennett

3 BENNETT ACCOUNTING, LLC ENGAGEMENT AGREEMENT Thank you for engaging us to assist you. We are committed to offering a quality product with excellent service. Here are the terms of our professional relationship: 1. We will prepare your 2014 Federal and applicable State income tax returns based only on information which you give us. You represent that you will provide us with information which is complete, true and correct, disclosing all relevant facts. You understand we will not audit or verify your information. 2. You have reviewed our tax organizer and completed it as best you can. (We will review the tax organizer, and in some cases, we may assist in completing it by documenting things you tell us.) The IRS says it is your responsibility that all items of income and expense are properly included and presented on your tax return. You agree to review the returns carefully before signing and submitting your returns, whether filed electronically or by paper filing. 3. We will, in most situations, e-file your returns. For a variety of reasons your e-filing may be rejected, in which case we will prepare your returns for paper filing. 4. You are aware of IRS record keeping and documentation requirements and you represent that you have the necessary documentation. 5. It is possible you may receive a notice for additional tax or for clarification of items. You agree that you will contact us if you receive any communication from any taxing authority. Additional work required including responding to any inquiries from tax authorities, tax planning or amended returns will be billed at our regular hourly rates. 6. There may be elections and decisions in your return which could be challenged by tax authorities. If we see a gray area, we will discuss it with you. We are required by law to disclose any position on a return for which there is a reasonable probability of challenge. Tax law is ever-changing. It is possible that you may be assessed additional tax, interest, or penalties. While we try our best, we are human and occasionally make mistakes. It is an imperfect world. 7. We will return all original source documents provided to us. We routinely keep copies of some supporting documents, but you understand that we are not the custodian of your records and you cannot rely upon us to maintain support for your tax return. It is your responsibility to retain your records for possible examination by any government or regulatory agencies. 8. Penalties on underpayment, late filing or failure to file on time and interest on unpaid tax are your responsibility. If you receive a penalty imposed as the result of our error, we will reimburse you for the penalty or credit your account. 9. You understand what was involved in the preparation of your return and acknowledge that the return was prepared with your informed consent. You agree to the reasonableness of our bill and terms of payment. 10. You agree that our fees plus direct out-of-pocket expenses will be billed upon completion of the work. Under certain circumstances we may require a retainer prior to starting your work. Payment for services is due upon completion of our work. 11. The IRS says that any advice which you receive from us, either in writing or orally, cannot be used as a defense against the assessment of a penalty. 12. Should there be any disagreement of any sort between us, you agree to mediation. The limit of time for making a claim arising from our services is one year after the services are rendered. 13. In the case of our services covering more than one party, the undersigned enters into this agreement on behalf of all affected parties (ie: husband signing for both spouses). 14. If any provision herein is inoperative, the remainder of this agreement shall remain in full force and effect. This agreement is intended as the complete agreement and can only be modified in writing, signed by both of us. Read, understood and agreed to on / /2015. Client Name

4 ACA Requirement to Have Health Insurance In March, 2010 President Obama signed the Affordable Care Act. One provision of the Act required that in 2014 all Americans must have qualified health insurance or face a Shared Responsibility Payment more commonly known as the Health Care Penalty. A lesser known amendment to the Act allowed insurance providers and large employers a one-year delay in reporting the coverage in 2014 to both the IRS and to the Taxpayer because rules had not been established by the IRS to allow timely and correct reporting. This delay effectively rendered the Health Care penalty a voluntary oral reporting item for 2014 in many cases. In order to remind you of the rules and to protect us both from future IRS liability in the event of an audit, we require all individual taxpayers for 2014 to positively affirm the following items related to Health Care. Please initial each applicable item or enter N/A if not applicable, sign the bottom of the affirmation and return with your income tax documents. 1. We have provided you with all copies of Forms 1095-A, 1095-B, and 1095-C we received. 2. We did not receive all Forms 1095-A because we have alternate government provided qualified health care insurance from Medicare, Medicaid, or Tri-Care that covers all members of our household. 3. We have qualified employer-provided health insurance for the entire year for our entire household. 4. We have qualified other health insurance we purchased directly from an agent or insurance company for the entire year which covers our entre household. In the event you do not have qualified health insurance for the entire year for your entire household, please provide us with the following information regarding insurance coverage for all members of your household. In the absence of the completion of items 1-4 above or item 5 below, and the absence of your providing us with information regarding an exemption from the requirement to provide health insurance we will calculate the penalty and include it with your return. Name Period of Coverage Insurer Signature 1 Signature 2 BY: (Print Names) Date Date

5 US Miscellaneous Questions Please check the appropriate box and provide additional information if necessary. If you check "yes" please provide additional information or documentation. Yes No PERSONAL INFORMATION Yes No DEPENDENTS Yes No INCOME Did your marital status change during the year? Did your address change during the year? Could you be claimed as a dependent on another person's tax return for 2014 Were there any changes in dependents? Were any of your unmarried dependents 19 years of age or older at the end of 2014? Did you have any children under age 19 or full-time students under age 24 at the end of 2014, that earned interest and dividend income in excess of $950, or total investment income in excess of $1,900? HEALTH CARE COVERAGE Did you and your dependents have healthcare coverage for the full-year? Did you receive any of the following IRS Documents? Form 1095-A (Health Insurance Marketplace Statement), 1095-B (Health Coverage) or Form 1095-C (Employer Provided Health Insurance Offer and Coverage) If so, please attach. If you or your dependents did not have health care coverage during the year, do you fall into one of the following exemption categories: Indian tribe membership, health sharing ministry membership, religious sect membership, incarceration, exempt non-citizen or economic hardship? If you received an exemption certificate, please attach. Did you receive unreported tip income of $20 or more in any month? 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 with the funds? Did you receive any disability income? Did you have any foreign income or pay any foreign taxes? (Other than being reported by a Broker) Did you have any gambling income? Did you engage in any bartering? Miscellaneous Questions

6 US Miscellaneous Questions Yes No Did you have any illegal or unreported income? Yes No PURCHASES, SALES AND DEBT Did you start a business or farm, purchase rental or royalty property, or acquire an interest in a partnership, S corporation, trust, or REMIC? Did you purchase or dispose of any business assets, or convert any personal assets to business use? Did you buy or sell any stocks, bonds or other investment property in 2014? Did you sell or refinance your principal home or second home, or did you take a home equity loan? Did you purchase any residential energy-efficient or solar energy improvements? Did you purchase a new motor vehicle in 2014? Did you have any debts cancelled or forgiven? Does anyone owe you money which had become uncollectible? Yes No RETIREMENT PLANS Yes No EDUCATION Did you receive a distribution from a retirement plan (401(k), IRA, SEP, SIMPLE, Pension Plan, etc.)? Did you make a contribution to a retirement plan thru your employer (401(k), SIMPLE, Qualified Plan, etc.)? Did you make a contribution to a Self Employed retirement plan (Solo 401(k), SEP, etc.)? Did you make a contribution to a Tradition IRA or Roth IRA? Did you transfer or rollover any amount from one retirement plan to another retirement plan? Did you convert part or all of your traditional IRA, SEP IRA, or SIMPLE IRA to a Roth IRA? 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? Yes No ITEMIZED DEDUCTIONS Did you incur a loss because of damaged or stolen property? Did you work out of town for part of the year? Miscellaneous Questions (Continued)

7 US Miscellaneous Questions Did you use your car on the job (other than to and from work)? Yes No ESTIMATED TAXES Did you apply an overpayment of 2013 taxes to your 2014 estimated tax (instead of being refunded)? If you have an overpayment of 2014 taxes, do you want the excess applied to your 2015 estimated tax (instead of being refunded)? Do you expect your 2015 taxable income and withholdings to be different from 2014? Yes No MISCELLANEOUS Do you want to allocate $3 to the Presidential Election Campaign Fund? Does your spouse want to allocate $3 to the Presidential Election Campaign Fund? May the IRS discuss your tax return with your preparer? Did you own any foreign bank accounts or have authority over a financial account in a foreign country? Did you receive a distribution from a foreign trust, or were you the grantor of, or transferor to, a foreign trust? Was your home rented out or used for business? Did you incur moving expenses due to a change of employment? Did you incur any expenses working as a K - 12 classroom teacher? Did you receive a distribution from a Medical Savings Account (MSA)? Did you receive a distribution from a Long Term Care Policy (LTC)? Did you engage the services of any household employees? Were you notified or audited by either the Internal Revenue Service or the State taxing agency? Did you or your spouse make any gifts to an individual that total more than $14,000, or any gifts to a trust? Did your bank account information change within the last twelve months? Yes No ARIZONA TAX CREDITS--Please include receipts Did you make a contribution to an Arizona public school for the Arizona Tax Credit? Did you pay any "Pay-to-Play" or "Pay-to-Attend" fees to an Arizona public school? Did you make a contribution to an Arizona Private School Tuition Organization for the Arizona Tax Credit? Did you make a cash/check contribution to an organization that qualifies for the Arizona Working Poor Tax Credit? Miscellaneous Questions (Continued)

8 US Tax Organizer Bennett Accounting, LLC 624 W. Gurley St., Suite E Prescott, AZ Telephone number: (928) Fax number: (928) address: info@bennettaccounting.com Tax Return Appointment Date: Time: Location: This tax organizer will assist you in gathering information necessary for the preparation of your 2014 tax return. Please enter all pertinent 2014 information. NOTE: If you claim the earned income credit, please provide proof that your child is a resident of the United States. This proof is typically in the form of: school records or statement, landlord or property management statement, health care provider statement, medical records, child care provider records, placement agency statement, social service records 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).... 1=blind Home phone Work phone Work extension Cell phone address In care of Street address Apartment number.. Address City State ZIP code DEPENDENTS First name Last name Title/suffix Date of birth (m/d/y)..... Date of death (m/d/y).... Social security number... Relationship Months lived at home.... First name Last name Title/suffix Date of birth (m/d/y)..... Date of death (m/d/y).... Social security number... Relationship Months lived at home.... Taxpayer Dependent No. Dependent No. Spouse Dependent No. Dependent No. Tax Organizer

9 US Tax Organizer Please enter all pertinent 2014 information. If you have attached a government form for an item, check the box and do not enter a 2014 amount. WAGES, SALARIES AND TIPS Employer name: 2014 Amount 2013 Amount Attach Forms W-2 INTEREST INCOME Payer name: Attach Forms 1099-INT DIVIDEND INCOME Payer name: Attach Forms 1099-DIV PENSIONS, IRA AND GAMBLING INCOME Payer name: Attach Forms 1099-R & W-2G Winnings not reported on W-2G Total gambling losses OTHER GOVERNMENT FORMS - INCOME Form 1099-B - Sales of stock (also include transaction history) Form 1099-MISC - Miscellaneous income Form 1099-K - Merchant card and third party network payments Attach Forms 1099 Form 1099-S - Sales of real estate (also include closing statements).. Taxpayer: Form 1099-G - State tax refunds Attach Forms 1099 Form SSA Social security benefits Form 1099-G - Unemployment compensation Spouse: Form SSA Social security benefits Form 1099-G - Unemployment compensation Attach Forms 1099 Attach Forms 1099 MISCELLANEOUS INCOME Taxpayer: Alimony received Other: Spouse: Alimony received Tax Organizer

10 US Tax Organizer RETIREMENT PLAN CONTRIBUTIONS Taxpayer: Traditional IRA contributions (1=maximum) Amount 2013 Amount 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 Form 1098-E - Student loan interest Form 1098-T - Tuition and related expenses Attach Forms 1098 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 - 1/14 payment on 2013 state estimate State income taxes - paid with 2013 state extension State income taxes - paid with 2013 state return State income taxes - paid for prior years and/or to other states Tax Organizer

11 US Tax Organizer TAXES PAID (continued) City/local income taxes - 1/14 payment on 2013 city/local estimate City/local income taxes - paid with 2013 city/local extension City/local income taxes - paid with 2013 city/local return State and local sales taxes (except autos and special items) Use taxes paid on 2014 purchases Use taxes paid on 2013 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 Personal property taxes (including automobile fees in some states).... INTEREST PAID Home mortgage interest and points paid: 2014 Amount 2013 Amount Attach Tax Notice Attach Forms 1098 Home mortgage interest not on Form 1098 (include name, SSN, & address of payee): Points not reported on Form 1098: Mortgage insurance premiums on post 12/31/06 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 Organizer

12 US Health Coverage Form 39.1 Please do not complete this information if coverage is indicated on Form 1095-A, 1095-B or 1095-C. GENERAL INFORMATION 1=entire household covered for all months, 2=no months COVERED INDIVIDUAL (#1) (a) First name.. (a) Last name.. (b) ID number (SSN or TIN).... (c) Date of birth (m/d/y) (d) 1=covered all 12 months.... (e) Months of coverage: 1=January =February =March =April =May =June =July =August =September =October =November =December COVERED INDIVIDUAL (#2) (a) First name.. (a) Last name.. (b) ID number (SSN or TIN)..... (c) Date of birth (m/d/y) (d) 1=covered all 12 months..... (e) Months of coverage: 1=January =February =March =April =May =June =July =August =September =October =November =December COVERED INDIVIDUAL (#3) COVERED INDIVIDUAL (#4) (a) First name.. (a) Last name.. (b) ID number (SSN or TIN).... (c) Date of birth (m/d/y) (d) 1=covered all 12 months.... (e) Months of coverage: 1=January =February =March =April =May =June =July =August =September =October =November =December (a) First name.. (a) Last name.. (b) ID number (SSN or TIN)..... (c) Date of birth (m/d/y) (d) 1=covered all 12 months..... (e) Months of coverage: 1=January =February =March =April =May =June =July =August =September =October =November =December Series: 4100 Health Coverage Form