SINGLE MEMBER LLC TAX QUESTIONNAIRE for



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SINGLE MEMBER LLC TAX QUESTIONNAIRE for To assist in the accurate and timely preparation of your personal tax return, please fill out and sign the attached questionnaire(s) and forward back to us at your convenience. The questionnaire is divided into sections. Note: Not all sections may apply to your situation. 1) General Management and Operating Questions. 2) Income and Expense Worksheet 3) Business Vehicle Questions (if applicable). 4) Office in Home Worksheet (if applicable). 5) Estimated Taxes (if applicable). 6) QuickBooks Accounting Questions (if applicable). 7) Disclaimer (if applicable). Once completed, please return the Questionnaire to one of the following: Fax: (303) 424-5013 Email: Dan: dan@jbtax.com or J.D.: jd@jbtax.com Mail: 8151 W 44 th Ave Wheat Ridge CO 80033-4459 Page 1

Single Member LLC Management Questionnaire It is important as an LLC business owner that you understand all of the following questions. If you need clarification or assistance on any question, contact us at your convenience to discuss. Are all business bank accounts under the LLC name and federal ID number? Yes No Are all business credit cards under the LLC name and federal ID number? Yes No Are all business loans under the LLC name and federal ID number? Yes No Are all registered assets (vehicles and machinery) under the LLC name? Yes No Did you issue 1099 s to all individuals, LLC s, attorneys and landlords before Jan 31st? Yes No Do you pay health insurance through the LLC? Yes No Do you use personal funds (cash/credit/checks) for LLC expenses? Yes No Do you use LLC funds for personal expenses? Yes No Did you loan any money to the LLC in the last year? Yes No Did you generate income from a State other than Colorado? Yes No Did you file and pay Use Tax for your LLC? Yes No Did you file and pay Personal Property Tax for your LLC? Yes No Are you in Good Standing with the Colorado Secretary of State? Yes No Do you have an Operating Agreement for your LLC Yes No Signed Dated Page 2

Single Member LLC Income & Expenses Worksheet Do you use QuickBooks for the LLC accounting? Yes* No *If Yes, please stop here and go to the QuickBooks Questionnaire. Business Information Business Expenses Principal Business Advertising/Website Business Address Auto (see Worksheet) Federal ID Number Commissions Contract Labor Cost of Goods Sold Business Insurance Inventory Cost (Beginning) Legal & Professional Purchases Office Expense Cost of Labor Rent (Equipment and Tools) Materials and Supplies Rent (Office or Storage) Inventory Cost (Ending) Repairs and Maintenance Operating Supplies Income Taxes & Licenses Gross Receipts or Sales Travel Returns and Allowances Meals & Entertainment Utilities Depreciable Assets (Over $500) Cell Phone Description Date Purchased Cost of Asset Note: Please list any add'l assets Internet Educational Occupational Dues Health Insurance Other (list) Page 3

Business Vehicle Questionnaire It is important as a business owner that you understand all of the following vehicle questions. If you need clarification or assistance on any question, contact us at your convenience to discuss. Do you use a business vehicle for the LLC? Yes No* *If No, please stop here and disregard the Vehicle Worksheet. Did you purchase a new business vehicle this year? Yes* No If Yes, please provide copy of sales invoice. Do you have evidence to support business use (i.e. mileage log)? Yes No Do you know the difference between commuting and business mileage? Yes No Please fill out the following information (attach separate worksheet if more than one vehicle). Vehicle Description Model of Vehicle Make of Vehicle Year of Vehicle Odometer Readings Beginning of year End of year Total miles Business miles (before 7/1) Business miles (after 6/30) Commuting miles Personal miles Page 4

Business Vehicle Worksheet There are two methods to deduct your vehicle expenses, Standard Mileage Rate (based on your business miles) and Actual Expenses (based on your annual costs). You can only claim one method on your tax return. Are you taking the Standard Mileage Rate for your vehicle expenses? Yes* No If Yes please stop here. Your mileage is reported on previous worksheet. If you are taking the Actual Expenses, please fill out the information below. Purchased Vehicles Date purchased Owned or financed? Loan balance - 12/31 Interest paid in current year Date sold Sales price Leased Vehicles Date leased Monthly lease payment Date of final payment Actual Expenses Gasoline Insurance Oil and lube Repairs Tires License and registration Auto club - AAA Emissions Parking and Tolls Signed Dated Page 5

Office In Home Questionnaire and Worksheet Do you use an office in the home for your LLC business? Yes No* *If No, please stop here and disregard the Office in Home Worksheet. Is your Office in Home used regularly and exclusively as your business office? Yes No Is your business a daycare? Yes* No If Yes, see Daycare only below. Did you claim Office in Home expenses last year? Yes No* If No, see Cost of Home information below. Business Use of Home Home Expenses Total square feet of home. Mortgage Interest (Form 1098) Total square feet of office. Did you live in home all year? Cost of Home Purchase price of home* FMV on date of home office Cost of prior improvements Date placed in service Date taken out of service *Please provide settlement statement (1st year only) Real Estate Taxes Homeowners Insurance Rent (if you don't own) Repairs and Maintenance Utilities: See below* *Includes Gas/electric/water/trash/HOA dues Daycare Only Total hours used for daycare Did you live in home all year? Page 6

Estimated Taxes Paid Did you pay any estimated tax payments for your LLC? Yes No* *If No, please stop here and disregard this Estimated Tax Worksheet. Federal Payments State Payments 1st Quarter April 15th 1st Quarter April 15th 2nd Quarter June 15th 2nd Quarter June 15th 3rd Quarter Sept 15th 3rd Quarter Sept 15th 4th Quarter Jan 15th 4th Quarter Jan 15th Federal Extension State Extension Current Year April 15th Current Year April 15th Page 7

Single Member LLC QuickBooks Questionnaire It is important as an LLC business owner that you understand all of the following accounting questions. If you need clarification or assistance on any question, contact us at your convenience to discuss. Do you use QuickBooks for the LLC accounting? Yes No* *If No, please stop here and disregard this QuickBooks Questionnaire. Please provide the following information in regards to your accountant/bookkeeper: Name: Phone: Email: User Name and Password for QuickBooks: Answer the following questions in regards to the QuickBooks data: Are all the LLC bank accounts reconciled for 12/31? Yes No Are all the LLC liabilities and loans reconciled for 12/31? Yes No Are all the LLC credit cards reconciled for 12/31? (if applicable) Yes No Did you account for any new assets purchased by the LLC? Yes No Did you account for any assets sold by the LLC? Yes No BEGINNING TAX YEAR 2011 Due to new IRS regulations, J&B Tax Accountants can no longer make adjustments to your tax return information based on your QuickBooks data without all of the supporting documentation. This means that J&B Tax Accountants will not be reviewing or offering opinion on your QuickBooks data. Your on-site accountant or bookkeeper will be responsible for ALL entries and reconciliations into your QuickBooks file, and, therefore, also responsible for the accounting on the tax return. As such: Do you want J&B to reconcile the books before preparing the tax return? Yes No* *If No, please sign the attached disclaimer on next page. Signed Dated Page 8

Accounting Disclaimer for This signed statement is to acknowledge that the client has prepared and reviewed the accounting that will be used for the preparation of the business tax return. It is the understanding of the client that J&B Tax Accountants, Inc. has not reviewed or audited the information to verify its accuracy and as such can render no opinion on it. If, upon review by a government agency, the accounting information is found to be inaccurate for reporting purposes, the client will be responsible to substantiate any position taken. If the client would like representation on any accounting work not overseen by J&B Tax Accountants, Inc., the client will deposit a retainer fee equal to 15% of the estimated fee. The hourly rate for client representation shall not exceed $125/hour. If the client would like J&B Tax Accountants, Inc. to prepare, review and/or audit the business books, the client understands that there will be an additional fee included with the preparation of the tax return. The hourly rate for accounting preparation, review and/or auditing shall not exceed $75/hour. Client Signature Dated Page 9