INNES & LOTITO, P.C. CERTIFIED PUBLIC ACCOUNTANTS
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1 INNES & LOTITO, P.C. CERTIFIED PUBLIC ACCOUNTANTS Hall Rad, Suite A Macmb, MI Telephne: (586) Fax: (586) Website: cpanerds.cm Innes.Ltit@cpanerds.cm CHECKLIST This Checklist is designed t help yu cllect and reprt the infrmatin needed t prepare yur 2014 incme tax return. Yu'll nte the Miscellaneus Questins wrksheet includes a variety f questins that are designed t assist yu in cmpleting yur tax return. If yu answer Yes t any f these questins, be sure t prvide the applicable details. PLEASE PROVIDE THE FOLLOWING INFORMATION: Cpy f yur 2013 tax return (fr 1 st year clients). Original Frm(s) W-2. Frms W-2G fr gambling winnings. Schedule(s) K-1 shwing incme r lss frm partnerships, S crpratins r estates r trusts. Frm(s) 1099 r statements reprting dividend, interest, retirement, Scial Security, state and/r lcal refunds, gambling winnings r miscellaneus incme. Brkerage statements shwing investment transactins fr stcks, bnds, etc. (Frm 1099-B). Frm(s) 1098, fr mrtgage r student lan interest r tuitin paid. (include any Frms 1099-C). Frm(s) 1095 A fr the advance payment f the premium tax credit fr lwer cst health care cverage under healthcare.gv. Ttal amunt paid fr prperty taxes, including license tabs n vehicles. Ttal amunt f medical expenses (including premiums paid) during (We dn t need t see all f the receipts.) The dllar amunt f cash and nn-cash cntributins made during the year. Cpies f clsing statements regarding the sale r purchase f real prperty. List f all incme tax estimates paid and dates. This Checklist shuld make yur task easier. It will als help us in the preparatin f yur tax return by fcusing attentin n yur special needs. Thank yu fr yur cperatin.
2 PERSONAL QUESTIONS 1. address: Please prvide yur address. It imprves ur service by eliminating phne tag when we have questins r need additinal infrmatin. 2. Will the address n yur 2014 Federal return be different frm the ne shwn n yur 2013 return? If Yes, enter the new address: Street City State Zip Phne Cell Phne: Yes N 3. Did yur marital status change during 2014? 4. Did yu pay (r receive) alimny during the tax year? If Yes, t SSN Amunt DEPENDENT QUESTIONS 5. Were there any changes in dependents frm the prir year? If Yes, please include name, scial security number & date f birth. Name S.S. # Date f Birth 6. Did yu prvide ver half the supprt fr any ther persn in 2014? 7. D yu have dependents wh must file? If s, d yu want us t prepare their returns? 8. Are yu being claimed as a dependent by anther persn? 9. D yu have any children under age 19 r a full-time student under age 24 with unearned incme greater than $2,000? 10. Are yu paying child care (nursery schl, babysitting, and husehld help) fr yur dependent children age 12 r under r a handicapped persn in rder fr yu t be gainfully emplyed, attend schl, r lk fr a jb? If Yes, hw much did yu pay in 2014? Number f children? IRS requires: Name Address Child care prvider ID # 11. Did yu pay any expenses related t the adptin f a child in 2014? Hw much?
3 12. If yu are separated r divrced with child(ren), d yu have a separatin agreement r divrce decree that establishes custdial respnsibilities? Yes N INCOME QUESTIONS 13. Did yu sell any stcks r bnds during the year? (If Yes, please attach brker's infrmatin related t the transactins.) 14. Did yu have freign incme r pay any freign taxes in 2014? 15. Did yu incur any premature withdrawal penalties frm a timed saving accunt? If Yes, amunt f penalty $ 16. Did yu surrender any U.S. Series EE r I savings bnds during 2014? 17. Did yu use the prceeds frm Series EE U.S. savings bnds purchased after 1989 t pay fr higher educatin expenses? 18. Did yu make any withdrawals frm an Educatin Savings r 529 Plan Accunt? (Include Frm 1099-Q) 19. Did yu sell and/r purchase a principal residence r ther real estate in 2014? If Yes, prvide bth the buyer s clsing statement fr when the riginal hme and the new hme were purchased as well as the seller s clsing statement fr the hme sld. 20. Did yu receive any disability r unemplyment payments this year? 21. Did yu realize a gain n prperty which was taken frm yu by destructin, theft, seizure r cndemnatin? 22. Did yu receive any incme nt included in the checklist? ITEMIZED DEDUCTIONS Deductins fr Medical and Dental Expenses When yu prvide us a listing f yur medical expenses, we dn t want all the detail. Fr yur persnal privacy, please just prvide us a summary f the medical expenses yu incurred this past year. Hwever, make sure that yu maintain the infrmatin necessary t dcument the infrmatin yu prvide t us in the event f a subsequent audit. 23. Did yu travel fr medical care? # f miles 24. Did yu pay ut-f-pcket medical expenses (C-Pays, Rx, etc.)?
4 Deductins fr Taxes Paid Incme Taxes Paid We shuld be able t btain all the infrmatin we need with respect t Federal & State incme taxes paid frm yur W-2 & 1099 Frms. If yu paid Federal r State estimates, we will need t knw the amunt paid, wh it was paid t and the date it was paid. Real Estate Taxes Please prvide us with cpies f the paid real estate prperty tax bills. Aut License Plates Peple ften frget t include infrmatin abut aut license plate fees paid. In Michigan, aut license plate fees are allwed as a deductin. Deductins fr Interest Paid Include any Frm 1098 yu received. If yu paid land cntract interest in 2014, we need the name, address, amunt & taxpayer ID f the recipient. Yes N 25. Did yu take ut a hme equity lan this year? 26. Did yu refinance yur principal residence r 2 nd hme this year? Prvide us with Frm 1098 fr mrtgage. Deductins fr Charitable Dnatins Peple ften frget t list all f their charitable dnatins. 27. D yu have evidence frm the charity t substantiate cash dnatins f $250 r mre? 28. Did yu make any nncash (clthes, furniture, cars, etc.) dnatins? D yu have evidence frm the charity t substantiate nncash dnatins f $500 r mre? 29. Did yu travel fr any chartable purpse? # f miles Charitable miles 30. D yu have any wrthless securities r uncllectible bad debts? (Bad debts with relatives usually are nt deductible.) Educatinal Deductins and Credits 31. Did yu pay any student lan interest r have any educatinal expenses in 2014? Please prvide the statement r the amunt.
5 32. Did yu pay any cllege tuitin in 2014? (Include Frm 1098-T) Name f student Amunt Undergraduate Name f schl r Graduate Yes (circle ne) N Miscellaneus Deductins 33. If either yu r yur spuse are self-emplyed, are either f yu cvered under an emplyer's health plan at anther jb? 34. Did yu have any business related educatinal expenses? 35. Did yu use an area f yur hme fr business purpses? If s, we need square ftage f the space used & ttal ftage f the huse. Please als include csts fr hme wners insurance, utilities, repairs & maintenance. 36. D yu have recrds fr business related travel and expenses? Infrmatin must include: amunt, time and place, date and descriptin f business gift(s), business purpse, and business relatinship f recipient. 37. Did yu have any expenses related t seeking a new jb during the year? 38. Did yu mve because f a jb change? 39. Did yu travel fr any f the fllwing reasns? # f miles Business Mving RETIREMENT QUESTIONS 40. Did yu r yur spuse receive Scial Security Benefits in 2014? 41. Did yu r yur spuse reach age 70 ½ in 2014? 42. Have yu, r d yu plan n cntributing t a Regular IRA, Rth IRA, SEP, Kegh r SIMPLE plan fr tax year 2014? If Yes, self $ Reg IRA-Rth IRA-SEP-Kegh-SIMPLE (circle ne) spuse $ Reg IRA-Rth IRA-SEP-Kegh-SIMPLE (circle ne) 43. Are yu r yur spuse an active participant in an emplyer prvided retirement plan such as pensin, prfit sharing, 401(k) r stck purchase plan?
6 Yes N 44. If yu are subject t the IRA deductin limitatins based n adjusted grss incme, d yu want t cntribute the maximum allwed as a deductin? If Yes, are yu planning t make any nndeductible IRA cntributins? 45. Did yu receive payments frm a pensin r prfit sharing plan? If Yes, did yu use the prceeds t fund cllege tuitin and csts, r were yu a first time hme buyer? 46. Did yu receive a ttal distributin frm an IRA r ther qualified plan that was partially r ttally rlled ver int anther IRA r qualified plan within 60 days f the distributin? 47. Did yu cnvert any regular IRA's int Rth IRA's? HEALTH CARE INFORMATION 48. Did yu have qualifying health care cverage, such as emplyer-spnsred cverage r gvernment-spnsred cverage (i.e. Medicare/Medicaid) fr every mnth f 2014 fr yur family? Yur family fr health care cverage refers t yu, yur spuse if filing jintly, and anyne yu can claim as a dependent. 49. Did anyne in yur family qualify fr an exemptin frm the heath care cverage mandate? 50. Did yu enrll fr lwer cst Marketplace Cverage thrugh healthcare.gv under the Affrdable Care Act? If yes, please prvide any Frm(s) 1095-A yu received. 51. Did yu make any cntributins t a Health savings accunt (HSA) r Archer MSA? 52. Did yu receive any distributins frm a Health savings accunt (HSA), Archer MSA, r Medicare Advantage MSA this year? 53. Did yu pay lng-term care premiums fr yurself r yur family? 54. If yu are a business wner, did yu pay health insurance premiums fr yur emplyees this year? GENERAL QUESTIONS 55. Were yu ntified by the Internal Revenue Service f changes t a prir year's return? (If Yes, enclse agent's reprt)
7 56. Were yu n Active Duty in the U.S. Armed Frces r utside the U.S. after the sale f yur residence? If Yes, enter the dates f active duty (mnth, day, year) Frm: T: Yes N 57. Did yu pay any individual as a husehld emplyee during 2014? 58. Did yu purchase a qualified plug-in electric drive vehicle r qualified fuel cell vehicle in 2014? If s please enclse a cpy f the invice. 59. Did yu start a business, purchase a rental prperty r farm, r acquire interests in partnerships r S crpratins? 60. Did yu make gifts f ver $14,000 t an individual r trust r cntribute t a prepaid tuitin plan? 61. Were there changes t a prir year's incme, deductins, credits, etc. which wuld require filing an amended return? 62. Wuld yu like t designate $3 t the Presidential Electin Campaign Fund? Checking Yes will nt change yur tax r reduce yur refund. 63. Did yu make any ut-f-state purchases (by telephne, internet, mail, r in persn) n which the seller did nt cllect sales r use tax? If s, what was the ttal amunt f the purchases? 64. If yu are due a Federal r State refund, wuld yu like them directly depsited int yur checking r savings accunt? If Yes, prvide the fllwing: Type Checking Savings Ruting # Accunt # 65. Did yu receive an Identity Prtectin PIN frm the IRS? If yes, include the IRS Letter. 66. Did yu change any bank accunts that have been used t direct depsit yur refunds?
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