WAGNER ACCOUNTING & TAX SERVICE, INC.



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WAGNER ACCOUNTING & TAX SERVICE, INC. 999 Century Drive, Suite 5 Dubuque, Iowa 52002 (563) 556-4508 Fax (563) 556-0407 www.wagneracct.com 2014 Income Tax Information Organizer To Our Valued Tax Clients: 607 Myatt Drive, Suite 1 Maquoketa, Iowa 52060 (563) 652-5152 Fax (563) 652-5152 We wish you a Happy New Year and hope your 2015 is off to a great start! Thank you for allowing us the opportunity to serve you in this, our 42nd Tax Season. We encourage you to begin gathering your tax materials as soon as possible. Our Income Tax Information Organizer has been revised to enable us to accurately prepare your tax return with all income and allowable deductions. Business, Rental or Farm income should be detailed on separate organizer worksheets. If these worksheets are not included, please let us know. Additionally, all of our organizer worksheets are available under the Forms tab on our website at www.wagneracct.com. In its final session of the year, Congress passed the Tax Increase Prevention Act of 2014. The Act extended a long list of expired tax breaks, retroactive to the beginning of 2014. The extensions granted by this act only apply to 2014. For these tax breaks to survive into 2015, they must again be renewed by Congress. Chief among the extended provisions are: a maximum of $500,000 Section 179 depreciation deduction; State Sales Tax deduction; Educator Expense deduction; Tuition & Fees deduction, Private Mortgage Insurance (PMI) deduction; and the ability to distribute IRA funds to charity. Affordable Care Act provisions effective for 2014 returns include reporting of health insurance information on the tax return. If you purchased insurance through the Health Insurance Marketplace, you must have form 1095-A to file your return. Additionally, business, farm, and rental property owners will see changes to repair and capitalization regulations. All eligible returns will be electronically filed for no additional fee. Returns will be accepted by the IRS starting January 20 th for most taxpayers. Generally, refunds are deposited within 21 days of e-file acceptance. The IRS will not guarantee a date for direct deposit of refunds. Returns need to be reviewed, signed and paid for prior to transmission. In order to provide the most affordable service to all of our clients, we do not accept credit or debit cards. In addition to our income tax services, we provide custom accounting, consulting, and payroll solutions for any business. We also offer IRA and annuity sales, estate planning, financial reviews, and retirement planning. More information concerning these services is available upon your request. Dave, Tom, Marissa, and our tax personnel will all be available for Income Tax Consultation and Preparation. If you wish to schedule an appointment, please call as soon as you have accumulated your data. Our staff will be happy to schedule time with any of us. Should you need assistance, or have a tax question, please contact us at your convenience. As always, we appreciate your past business and look forward to working with you in the future. David A. Wagner Thomas A. Wagner

Page 2 2014 INCOME TAX INFORMATION ORGANIZER YES NO Interview Questions If any of the following items pertain to you or your spouse for 2014, please check the appropriate box and provide additional information as necessary. 1. Did your address change during the year? 2. Did your marital status change during the year? 3. Were there any births, adoptions, marriages, divorces, or deaths in your tax household? 4. Do you provide a home for or help support anyone not listed on last year s return? 5. Did you and your tax household members have healthcare coverage for the full year? 6. Did you purchase health coverage from the Health Insurance Marketplace? 7. Did you receive Premium Tax Credit from the Marketplace or health insurance? 8. Did you apply for a health coverage exemption from the Marketplace? 9. Did you receive unreported tip income of $20 or more in any month? 10. Did you receive any Unemployment compensation income? 11. Do you have any reportable gambling income? 12. Did you receive any disability income? 13. Did you have any debts cancelled, debts forgiven, or bankruptcy proceedings? 14. Did you withdraw, transfer, or rollover any amount from a retirement plan? 15. Did you receive an inheritance? 16. Did you receive interest from or pay interest on a Land Contract (Seller Financing)? 17. Did you pay or receive alimony? 18. Did you pay interest on a Student Loan during the year? 19. Do you have a foreign bank or financial account, business or trust? 20. Do you have foreign assets, foreign income, pay foreign taxes, or file foreign returns? Please provide your preferred contact information: Best Contact#: Email:

WAGNER ACCOUNTING & TAX SERVICE, INC. Page 3 Page 3 Taxpayer Information (if not already on file) Name: SS # Birth Date: Spouse: SS # Birth Date: Address: County of Residence: School District of Residence: Direct Deposit of Refunds Yes (Please attach a deposit ticket marked for savings or checking.) Dependents (if not already on file) Name (First, Initial): Social Security Number: Relationship: Date of Birth: Income Please Provide all Applicable Forms Wages & Salaries: (W-2 Forms) Unemployment: (Form 1099-G) Interest & Dividends: (1099-INT & 1099-DIV Forms, including Tax-Exempt & Municipal Interest) Gambling or Lottery Winnings: (All Forms W-2G) IRA s, Pensions, Annuities: (Form 1099-R) Social Security Income: (Form SSA-1099 for Taxpayer & Spouse) IRA s, Pensions Other Income: Adjustments & Credits IRA Deduction: Taxpayer: Spouse: Payment to Keogh Plan, SEP or SIMPLE: Moving Expenses (Work Related over 35 Miles): Student Loan Interest (Please provide Form 1098-E) Alimony paid: Health Savings Account (HSA) Contributions: Educator Expenses: Child Care Name of Provider: ID# Address: Amount Paid: (If more than one provider, please list on separate sheet.) Estimated Income Tax Data Federal Amount Date State Amount Date 1st Quarter Payments $ $ 2nd Quarter Payments $ $ 3rd Quarter Payments $ $ 4th Quarter Payments $ $ We will again make out your Estimated Income Tax Payments for 2015 based on your 2014 tax. If you expect a significant change in your income for 2015, please discuss this with us.

Page 4 2014 INCOME TAX INFORMATION ORGANIZER Deductions Medical & Dental DO NOT include amounts paid for or reimbursed by Health Insurance or premiums paid with pre-tax income. Medical Insurance: Medicare Premium: Long Term Care Insurance: Doctor, Dentist, Nurse: Hospitals, Lab Fees: Prescription Drugs: Eye Glasses, Hearing Aids: Braces, Dentures: Equipment (Prescribed): Medical Travel (miles): Medical Lodging: Nursing or Long Term Care : HSA Expenses: Other: Taxes Real Estate (Home): Real Estate (Non-Home): Car License (IA Only): Sales Tax on Major Purchases: Interest Paid Home Mortgage Paid to Financial Institutions- (Please bring 1098 Forms): Home Mortgage Paid to Individuals: (List Name, Address, SS #): Points: Investment Interest: Vacation or Second Home, Camper, Houseboat Mortgage: Home Equity Loans: Contributions *Written documentation is required for all gifts of $250 or more* Church: United Way: Red Cross, MDA, Cancer: Misc. Door-to-Door: Non-Cash* (clothing, food, misc.): *Itemized receipts are required if over $250* Other Miscellaneous: Expenses for Charitable Work: Volunteer Mileage (miles): Miscellaneous Deductions Tax Preparation: Safe Deposit Box: IRA Custodial Fees: Investment Fees: Second Job Mileage: Union Dues: Prof. Dues & Journals: Job Hunting Expense: Education Expense: Job Supplies: Small Tools: Safety Equipment: Uniforms & Laundry: Gambling/Lottery Losses (Limited to Gambling/ Lottery Winnings): Other: Employee Business Expense -Travel Away from Home- -Days Away from Home: -Lodging Expense: -Total Business Miles: -Meal Expense: -Auto Expense- -Total Miles Driven: -Parking Fees: -Other: Tuition -Grades K-12- Iowa Residents: Tuition, Fees, Textbooks, Materials Required for Extra Curricular Activities: Illinois Residents: Tuition, Fees, Textbooks: (IL Residents please provide Education Credit Form) -Post-Secondary Education - (Form 1098-T is required) Residential Energy Improvements (Less Rebates) -Solar: -Wind/Fuel Cell: -Geothermal:

WAGNER ACCOUNTING & TAX SERVICE, INC. Page 5 Income Tax Preparation Engagement Thank you for choosing Wagner Accounting & Tax Service, Inc. to assist you with your tax affairs. This section confirms the terms of our engagement with you and the nature and extent of services we will provide. We will prepare your federal and state income tax returns using information you provide to us. We may ask for clarification of some items, but we will not audit or otherwise verify the data you submit. We will perform accounting services only as needed to prepare your income tax returns. Our work will not include procedures to discover defalcations or other irregularities. Accordingly, our engagement should not be relied on to disclose errors, fraud or other illegal acts. The scope of work in connection with the preparation of your federal and state income tax returns is intended to be in compliance with the requirements issued by the various taxing authorities. Because tax laws are not always clear, honest differences of opinions may arise between our interpretation of laws and that of the taxing authorities. We will assist you in resolving these differences in your favor whenever possible. You and/or your duly appointed representative agree not to hold Wagner Accounting & Tax Service, Inc. liable for interpretations made with regard to any of the information supplied by you and used in the preparation of your tax returns. Unless compelled to do so by law, Wagner Accounting & Tax Service, Inc. does not disclose any irregularities or provide statements with regard to the validity of the information supplied by you to any taxing authority. It is your responsibility to provide information required for preparation of complete and accurate returns. Please review any completed tax returns carefully. As income tax return preparers, we have a responsibility both to the various taxing authorities with whom we file tax returns as well as to our clients. Any client will remain liable for the contents of tax returns prepared by Wagner Accounting & Tax Service, Inc. with data provided by said client. We will return your original records to you at the end of this engagement. You should keep all documents, cancelled checks and other data that support your reported income and deductions. This information may be necessary to verify accuracy of the returns to a taxing authority. All tax returns are subject to review and acceptance by the various taxing authorities. You may appeal any adjustments proposed by a taxing authority. In the event of an examination or other taxing authority contact, Wagner Accounting & Tax Service, Inc. can respond or represent your position to the taxing authority; however, there may be a fee for this service. All tax return preparation fees must be paid before the tax return can be electronically processed. Once payment is received and the proper forms are signed to electronically file the return, we will file the tax return. Please acknowledge this statement correctly summarizes your understanding of the arrangements for this work by signing below and return it to us, along with your Organizer. If we do not receive this statement from you in fully executed form, but receive from you a completed copy of your Organizer and/or supporting documentation, such receipt will be deemed to evidence your acceptance of all the terms set forth above. Wagner Accounting & Tax Service, Inc. Accepted by: (Taxpayer) (Spouse) Date: Privacy Notice We do not disclose any nonpublic personal information about our clients or former clients to anyone, except as instructed to do so by such clients. We restrict access to nonpublic personal information to those professionals necessary to provide our services, and we maintain physical, electronic, and procedural safeguards to guard your nonpublic personal information.

Wagner Accounting & Tax Service, Inc. 999 Century Drive, Suite 5 Dubuque, IA 52002-3776 607 Myatt Drive, Suite 1 Maquoketa, IA 52060 Visit us online: www.wagneracct.com 2014 Income Tax Information Organizer Things to Bring (if applicable): You re made entirely from recycled materials, so you qualify for a green energy tax credit. Your 2013 Tax Return (If not prepared by our office) W-2 Forms for Wages 1099-R s for Retirement Income 1099 s for Interest, Dividends and Other Income W-2G s for Gambling Income K-1 s for Partnerships, Corporations or Estates Social Security Benefits Statement 1099-K for Business Credit Cards Received 1098 s Showing Mortgage Interest Paid 1098-T s for College Tuition Paid Brokerage Statements for Stock Sales Closing Statements for Real Estate Sales or Purchases Health Insurance Coverage Information We would like to thank you, our valued customers, for your support over the past 42 years. We look forward to serving your needs in the future. In addition to our broad range of Accounting and Income Tax Services, we also offer the following: Payroll Services Life Insurance Reviews Annuities Gift Planning Estate Planning Retirement Planning WAGNER ACCOUNTING & TAX SERVICE, INC.