US INCOME TAX ORGANIZER Tax Year
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1 US INCOME TAX ORGANIZER 2014 Tax Year PALAZZO & COMPANY EXPAT TAX PROFESSIONALS PO Box 6888, Gulfport, MS (Standard mail) Shriners Blvd. Ste B, Biloxi, MS (Express mail) or (Toll free) (Fax) Cover Copyright Palazzo and Company LLC
2 Dear Client: We appreciate the opportunity to provide you with tax services. To minimize the possibility of a misunderstanding between us, we are setting forth pertinent information about the services we will perform for you. We will prepare your federal and state (if applicable) individual income tax returns from information you provide to us. It is your responsibility to inform us if you are required to file a locality, city or school district tax return. These returns are not included with your standard tax preparation and additional fees apply. We will not audit or otherwise verify the data you submit, although we may ask you to clarify some of the information. We ask that you provide us with copies of documents only; you are responsible for the maintenance of all personal records, including original documents. It is your responsibility to maintain in your records the documentation necessary to support the data used in preparing your tax returns. This includes, but is not limited to, any business-related expenses and the required documents to support charitable contributions. If you have any questions as to the type of records required, please ask us for advice in that regard. It is also your responsibility to carefully examine and approve your completed tax returns before signing them or the e-file authorization. We are not responsible for the disallowance of doubtful deductions or inadequately supported documentation, nor for any resulting taxes, penalties and/or interest. Before we can begin your tax return, we require that you complete or update the client information portion of our tax organizer. The remainder of the organizer should be completed as well; it will help you summarize the information we need in addition to alerting us as to possible issues that need further attention. A completed organizer helps keep our fee to a minimum. We must receive all information to prepare your return, by March 15 to ensure that your return will be completed by April 15. If we have not received all of your information by March 15, and your return is not completed by April 15, you may be subject to late filing or late payment penalties. WHILE WE WILL WORK DILIGENTLY TO ENSURE THAT ALL RETURNS ARE COMPLETED BY APRIL 15, WE CANNOT GUARANTEE COMPLETION OF RETURNS BY APRIL 15 WHEN INFORMATION IS RECEIVED AFTER MARCH 15. We are not responsible for any penalties and/or interest incurred unless it is due to an error on our part. Likewise, we are not responsible for any penalty or interest incurred as a result of underpayment or late payment of tax. You are responsible for making timely estimates and payments, or assuring that proper withholdings are made through your employer. Fees for our services will be at our standard rates. In addition to our base fee, additional charges may apply when additional forms are required to be filed with your tax return. Please see questionaire tab for additional fees that may apply. Payment for service is due when rendered and prior to finalizing returns. We are responsible for preparing only the returns listed above. We provide limited support with combat zone issues as a part of our preparation. Our fee does not include responding to inquires or examination by taxing authorities, or for issues related to inaccurate or incomplete information provided to us. We are available to represent you in such matters at our standard rates, and the service would be covered under a separate engagement letter. If the above fairly sets forth your understanding, please acknowledge your acceptance in an communication by typing your name and date below. If you prefer, you may print and return a signed copy of this letter to us at the address below. WE CANNOT FINALIZE YOUR RETURN UNTIL THIS IS RECEIVED. We are looking forward to working with you. Sincerely, Palazzo & Company, LLC Approved: (Type Name) Date
3 INSTRUCTIONS Use tab key to navigate from one block to another. Use drop down menus when arrow box appears. Complete all applicable shaded spaces. Provide requested documents. Contact us if you need assistance or have questions. 1 Your completed Personal Tax Organizer 2 All forms W-2, 1099, 1098 and final pay statement of the year, if available ITEMS YOU WILL NEED TO 3 Copies of Schedule K-1 for partnership, S corporations, estates or trusts PROVIDE TO US 4 If you acquired or refinanced a home or other property, provide closing statement 5 If you are a new client, provide copies of tax returns for last 2 years filed STEP 1 TAX RETURN QUESTIONS The following items may affect your tax return. Please answer carefully. If you answer "yes" to any of the following questions, please be sure to complete the corresponding tab of organizer. YES NO 1 Did your marital status change during the year? If yes, explain in notes. TAB 9 2 Did your resident state change during the year? If yes, explain in notes. TAB 9 3 Were you covered by health insurance throughout the year? TAB 1 4 Were there any changes in dependents? TAB 2 5 Did you pay any care expenses for a dependent who was either disabled or under age 13? TAB 2 6 Did you contribute to a state college tuition program for yourself, spouse or dependent? TAB 2 7 Did you pay any college tuition or other expenses for yourself or your dependents? TAB 2 8 Did you purchase, refinance or sell your principal home, second home, or rental property? (send closing docs) 9 Did you ever receive the First -Time Homebuyer's Credit for a home? If yes, explain in notes. TAB 9 10 Did you have a foreclosure? (send 1099-C and/or 1099-A) 11 Did you have any debt canceled? (send 1099-C) 12 Did you sell any stocks, bonds or other investment property? (send realized gain/loss statement) 13 Did you receive any miscellaneous income, such as from interest, dividends, gambling winnings, etc? TAB 4 14 Did you own a business this tax year? TAB 7 15 Did you own a rental property this tax year? TAB 8 16 Did you have a farm this tax year? If yes, please contact us for a farm schedule. 17 Are you a National Guard member or an Armed Forces Reservist and travel more than 100 miles and stay overnight to fulfill your duty? 18 Did you have any out-of-pocket expenses associated with your job? TABS 5 19 Did you have any job hunting expenses, such as agency fees, resume & portfolio costs, transportation costs for interviews, etc? TAB 6 20 Did you have any out-of-pocket medical expenses that were not covered by insurance? Include medical, dental, and vision. TAB 5 21 Did you contribute to or receive a distribution from an HSA? If yes, see notes. TAB 9 22 Did you pay sales tax on any major purchases, such as a new vehicle, boat, ATV, or building materials? TAB 5 23 Did you make any estimated payments for either your federal or state 2014 tax liabilities? TAB 6 24 Did you own a foreign bank account or foreign investment account at any time during 2013? TAB 6 25 Did you make any purchases online or out-of-state on which no sales tax was charged? TAB 9 STEP 2 CUSTOMER REWARDS - REFERRAL PROGRAM Please tell us who referred you to our company Name STEP 3 FEES Basic Expat Fee is $500 and Basic U.S. Return (no foreign income) is $350. These fees include Federal and single State tax return preparation, efiling, federal extensions (state upon request) and limited year-round planning and support. Additional Fees: Schedule C, E, or F (per form) $150 PAY ONLINE NOW Additional State or Local Tax Returns - $75 Depreciation Issues (Form 3115) $100 Second Overseas Presence Test (Form 2555) $100 Significant Stock Transactions $85/hr Separate Filing of Tax Returns for Taxpayer and Spouse $150 Transcript Fee $45 Foreign Bank Account Reporting (Form 114) $50 Fee to Mail Returns $20 Foreign Asset Reporting (Form 8938) $100 IRS/ State Issues $125/hr Foreign Corporation or Partnership (Forms 5471 or 8865) $200 Power of Attorney $45 Foreign Trust Reporting (Form 3520-A) $250 Pay online now - it's secure, fast and easy - or call Questionnaire
4 STEP 4 CLIENT INFORMATION Taxpayer Spouse Current Mailing Address Taxpayer Contact Information Spouse Contact Information State Info Marital Status as of 12/31/2014 First Name and initial Last Name Social security number Occupation Date of birth (MM/DD/YY) First Name and initial Last Name Social security number Occupation Date of birth (MM/DD/YY) Street Address Apartment Number City State Zip Code Home Phone Work Phone Mobile Phone Address Home Phone Work Phone Mobile Phone Address Resident State County of Residence School District or Locality STEP 5 DIRECT DEPOSIT OF REFUND / ELECTRONIC PAYMENT - CURRENT YEAR ONLY Do you want your refund directly deposited? Do you want your tax balance directly drafted? Bank Name Routing Number (9 Digits) Account Number Type of Account-Checking or Savings STEP 6 HEALTH INSURANCE INFORMATION (SEND FORM 1095-A, B, AND/OR C) Covered entire year? Insurance Policy Provider Taxpayer Spouse Dependents (List names below): Policy Number If not covered all year, place X in the boxes to the right for each month COVERED JAN FEB MAR APR MAY JUN JUL AUG If any additional explanation is needed, please use box below. 1 - Client Info
5 1 - Client Info
6 Note: Our tax professionals will determine your most correct and beneficial filing status. PRIVACY POLICY Policy can be read on last tab SEP OCT NOV DEC 1 - Client Info
7 1 - Client Info
8 STEP 7 DEPENDENTS Dependent 1 Dependent 2 Dependent 3 First name Last name Date of birth Social security number Relationship (Select) Months lived with you this year Was dependent adopted in 2014? Claimed by taxpayer or spouse Dependent 4 Dependent 5 Dependent 6 First name Last name Date of birth Social security number Relationship Months lived with you this year Was dependent adopted in 2014? Claimed by taxpayer or spouse STEP 8 DEPENDENT CARE EXPENSES - FOR DEPENDENTS UNDER AGE 13 OR DISABLED AT END OF YEAR First name Last name Date of birth Dependent Social security number Qualified dependent care expenses Disabled? First name Last name Date of birth Dependent Social security number Qualified dependent care expenses Disabled? Name of provider Street Address Provider City, state, ZIP code Identification number (SSN or EIN) Amount paid to care provider in 2014 Name of provider Street Address Provider City, state, ZIP code Identification number (SSN or EIN) Amount paid to care provider in 2014 STEP 9 HIGHER EDUCATION INFORMATION Student 1 Student 2 Student 3 First name Last name Social security number Completed 4 years of college before 2014? Amount of qualified tuition and fees paid Amount paid for course-related materials** Amount of scholarships/grants/gi Bill rec'd Student Loan Interest Paid in 2014 Contributions to state prepaid tuition program Distributions from education account **Course-related materials are those materials required to be purchased by the school. 2 - Dependents
9 STEP 10 WAGES, SALARIES, AND TIPS PLEASE PROVIDE COPIES OF ALL W-2s AND 1099s Taxpayer List All Employers For 2014 Wages (Box 1) or Spouse STEP 11 PENSION AND IRA DISTRIBUTIONS PLEASE PROVIDE COPIES OF ALL 1099-Rs Taxpayer Gross Distrbution Name of Payer Taxable Amount (Box2) or Spouse (Box 1) Distribution Code (Box 7) STEP 12 GAMBLING WINNINGS (W-2G) Name of Payer Taxpayer or Spouse Gross Winnings 1) (Box Federal Tax Withheld (Box 2) State Tax Withheld (Box 14) STEP 13 GAMBLING LOSSES & WINNINGS (NON W-2G) 2014 Amount Taxpayer or Spouse Total Gambling Losses Gambling winnings not reported on Form W-2G 3 - Income
10 STEP 14 INTEREST INCOME Name of Financial Institution Taxpayer, Spouse, or Joint PROVIDE ALL 1099-INT Tax-Exempt Interest Banks, S&Ls, FCUs (Box1) Interest Income Seller Financed Mtg (Box 1) US. Bonds, T-Bills (Box 3) Total Municipal Bonds In-state Muni-bonds (%) Early Withdrawal Penalty (Box 2) X=Foreign Bank Account STEP 15 DIVIDEND INCOME Name of Financial Institution Taxpayer, Spouse, or Joint Total Ordinary Dividends (Box 1a) PROVIDE ALL 1099-DIV Dividend Income Qualified Dividends (Box 1b) Total Capital Gain Distrib. (Box 2a) US Bonds (%) Tax Exempt Total Municipal Bonds In-state Muni-bonds (%) Foreign Tax Paid (Box 6) STEP 16 MISCELLANEOUS INCOME Social security benefits (SSA-1099, box 5) Medicare premiums paid (SSA-1099) Alimony received Jury duty pay Alaska permanent fund dividends Royalties STEP 17 STATE REFUNDS / UNEMPLOYMENT COMPENSATION Taxpayer Spouse Name of Payer (PROVIDE 1099-G) Taxpayer or Spouse Unemployment Compensation (Box 1) State or Local Refund (Box 2) 4 - Misc. Income
11 STEP 19 ITEMIZED DEDUCTIONS MEDICAL AND DENTAL EXPENSES TAXPAYER Prescription medicines Doctors, dentists and nurses Hospital and nursing homes Insurance-health/vision/dental (after tax dollars only) Insurance-long term care Medical lodging and transportation Medical miles driven DEDUCTIBLE TAXES TAXPAYER Sales tax paid on major purchases (auto, boat, RV, etc.) Real estate taxes - principal residence Real estate taxes - property held for investment Personal property taxes (car tags) Other taxes INTEREST PAID Home mortgage interest (Box 1) on form 1098 Home mortgage points (Box 2) on form 1098 Mortgage interest not reported on form 1098 Points not reported on form 1098 Mortgage insurance premiums CHARITABLE CONTRIBUTIONS Contributions by cash or check Volunteer expenses (out-of-pocket) Number of charitable miles Total noncash contributions of $500 or less If total noncash contributions are greater than $500 provide the following: Property 1 Property 2 Name of charitable organization Address Property description Date of contribution Donor's cost or basis Date acquired Fair market value Method used to determine Fair Market Value Name of charitable organization Address Property description Date of contribution Donor's cost or basis Date acquired Fair market value Method used to determine Fair Market Value MISCELLANEOUS DEDUCTIONS Union and professional dues Professional subscriptions Employment agency fees Investment expense Tax return preparation fee paid during 2014 Safe deposit box rental K-12 Educator expenses (for employees of a school) Professional/Continuing education Other deductions (list) TAXPAYER TAXPAYER TAXPAYER SPOUSE SPOUSE SPOUSE SPOUSE SPOUSE Note: It is not necessary to split out taxpayer & spouse amounts if you plan on filing a joint return. List under one or the other, but do not duplicate amounts 5 - Itemized Deductions
12 STEP 20 INDIVIDUAL RETIREMENT PLAN CONTRIBUTIONS (TRADITIONAL IRA, ROTH, SEP) Account Type Taxpayer or Spouse Amount of contribution These types of retirement plans may provide tax deductions, but are subject to eligibility requirements and contribution limits contributions are allowed through 4/15/2015. Contact us to determine your eligibility. STEP 21 ALIMONY Paid by Taxpayer Paid by Spouse Recipient's first name Recipient's last name Recipient's SSN Amount Paid STEP ESTIMATED TAX Federal Amount Paid Date Paid Overpayment applied from st quarter payment (due 4/15/14) 2nd quarter payment (due 6/16/14) 3rd quarter payment (due 9/15/14) 4th quarter payment (due 1/15/15) Additional estimated tax payments State Amount Paid Date Paid Overpayment applied from st quarter payment (due 4/15/14) 2nd quarter payment (due 6/16/14) 3rd quarter payment (due 9/15/14) 4th quarter payment (due 1/15/15) Additional estimated tax payments STEP 23 FOREIGN ASSETS List information on any foreign assets valued at $10,000 or more at any time during Include checking, savings, retirement, and investment accounts, and ownership in foreign corporations. Asset Type Individual/Joint Ownership Account Number Name of Financial Institution/Corporation Address of Financial Institution/Corporation Maximum Value During 2014 Value as of 12/31/ Misc. Items
13 STEP 24 BUSINESS INCOME GENERAL INFORMATION Principal business / profession Business name Business address City, state, zip code Employer identification number Taxpayer, Spouse or Joint ownership First schedule C filed for business Did you issue 1099s or W2s for 2014? Did you maintain an inventory of products for resale during 2014? INCOME Gross Receipts EXPENSES Accounting Advertising Answering service Bad debts from sales or service Bank charges Commissions Contract Labor Delivery and freight Dues and subscriptions Employee benefit programs Insurance (other than health) Mortgage interest (paid to banks, etc.) Other interest (not entered elsewhere) Janitorial Laundry and cleaning Legal and professional Office expense Outside services Parking and tolls Pension and profit sharing plans - contributions Pension and profit sharing plans - admin. and education costs Postage Printing Rent - vehicles, machinery, & equipment Rent - other Repairs Security Self-Employed health insurance Supplies Taxes - real estate Taxes - payroll Taxes - sales tax included in gross receipts Taxes - other (not entered elsewhere) Telephone Tools Travel Total meals and entertainment in full (50%) Department of Transportation meals in full (80%) Uniforms Utilities Wages Other expenses: (List below) For expenses greater than $500, please provide an explanation on TAB 10 Total Expenses Automobile Information (Business-Use Only) Description of vehicle (year, make, model) Car and truck expenses (not entered elsewhere) Number of business miles driven in 2014 Total number of miles driven in 2014 (business & personal) Assets Purchased: Description Date placed in service Cost $ Business
14 STEP 25 RENTAL PROPERTY GENERAL INFORMATION Property 1 Kind of property Location of property - address City, state, and ZIP code Percentage of ownership Purchase price Value of land included in purchase price Date first available for rent Fair market value on this date Date purchased Taxpayer, spouse or joint ownership Property 2 Kind of property Location of property - address City, state, and ZIP code Percentage of ownership Purchase price Value of land included in purchase price Date first available for rent Fair market value on this date Date purchased Taxpayer, spouse or joint ownership NOTE: Provide total rent income received, even if not on a form 1099-MISC. INCOME Property 1 Property 2 Rents Received (See form 1099-MISC, box 1) DIRECT EXPENSES Advertising Association dues Auto and travel (not entered elsewhere) Cleaning and maintenance Commissions Gardening Insurance Legal and professional fees Licenses and permits Management fees Mortgage interest (paid to banks, etc.) Qualified mortgage insurance premiums Excess mortgage interest Other interest (not entered elsewhere) Painting and decorating Pest control Plumbing and electrical Repairs Security/Alarm System Supplies Taxes - real estate Taxes - other (not entered elsewhere) Telephone Utilities Wages and salaries Other expenses: (List below) For expenses greater than $500, please provide an explanation on TAB 10 Total Expenses $ - $ - Assets Purchased: Description Date placed in service Cost 8 - Rental
15 STEP 26 COMMENTS OR QUESTIONS - TYPE IN SPACE PROVIDED PRIVACY NOTICE THIRD PARTY SERVICE PROVIDER - We DO NOT use third-party service providers. Confidentiality of your information is maintained under agreements that meet professional and government guidelines, as well as our privacy policy. PALAZZO & COMPANY, LLC PRIVACY POLICY - Like all providers of personal financial services, we are now required by law to inform our clients of our policies regarding privacy of client information. We have been and continue to be bound by professional standards of confidentiality that are even more stringent than those required by law. Therefore, we have always protected your right to privacy. TYPES OF NONPUBLIC PERSONAL INFORMATION WE COLLECT - We collect nonpublic personal information about you that is provided to us by you or obtained by us from third parties with your authorization. PARTIES TO WHOM WE DISCLOSE INFORMATION - For current and former clients, we do not disclose any nonpublic personal information obtained in the course of our practice except as required or permitted by law. Permitted disclosures include, for instance, providing information to our employees or to unrelated third parties who need to know that information to assist us in providing services to you to complete your tax return. In all such situations, we stress the confidential nature of information being shared. PROTECTING THE CONFIDENTIALITY AND SECURITY OF CURRENT AND FORMER CLIENTS' INFORMATION - We retain records relating to professional services that we provide so that we are better able to assist you with your professional needs and, in some cases, to comply with professional guidelines. In order to guard your nonpublic personal information, we maintain physical, electronic, and procedural safeguards that comply with professional standards. Please call if you have any questions because your privacy, our professional reputation, and the ability to provide you with quality professional Expatriate tax planning and preparation services are very important to us. Contact Lisa Palazzo, Owner at or [email protected] 9 - Notes
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