PERSONAL TAX INFORMATION WORKSHEET

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Harry Owen
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1 PERSONAL TAX INFORMATION WORKSHEET Please check the appropriate box: Date Received: I need my taxes done early for my child s financial aid. Most of the information needed to complete this form can be taken from your final monthly computer bookkeeping report of the year. Taxes are prepared from figures on this worksheet and not from client s bookkeeping. March 1: If 2/3 or more of your gross income for 2016 was from farming, your taxes are due March 1. We must have this completed form back in our hands by February 1 to have adequate time to finish all farm taxes. April 15: If you had a corporation for all of 2017, are an employee receiving W2 wages or have a non-farm business, you have until April 15 to file your taxes unless you file an extension before that date. An extension extends the filing date until August 15. Even with an extension, the tax must be paid with the extension. This worksheet needs to be completed and back to Corporate Farmer by March 15, You will automatically be put on extension if not completed by April 1, Individual s Name: DOB: SSN: - - Spouse s Name: Dependent s Name: Fax: Address: City: State: Zip Code: County: School District: I have completed this form and believe it to be correct to the best of my knowledge. You may proceed with my taxes. Signature: Date:

2 RENTAL OR LEASE INFORMATION Rent From Rental Property Rental Property Rental Property Corporation #2 #3 #4 TYPE OR LOCATION: INCOME: EXPENSES: Advertising Auto & Travel Cleaning & Maintenance Commissions Legal & Other Prof. Fees Management Fees Mortgage Interest Other Interest Repairs Supplies Taxes Other Expenses CAPITAL ITEMS PURCHASED OR TRADED (Land, Tile, Equipment, Breeding Stock, Etc.) Item Purchased Date Purchased Cost or Boot Item Traded & Year Purchased

3 FARM INCOME & EXPENSES INCOME: EXPENSES: 301 Raised Cattle Sales 401 Cost of Feeder Cattle _ 302 Raised Corn Sales 402 Cost of Feeder Pigs _ 303 Dairy 403 Cost of Other Sold _ 304 Poultry 501 Breeding Fees _ 305 Fed & St. Gas Refund 502 Cash Rent Paid _ 306 Government Payments 503 Chemicals _ 307 Raised Hogs Sold 504 Dues & Publications _ 308 Custom Hire Income 505 Feed _ 309 Misc. Grain Income 506 Fertilizers & Lime _ 310 Patronage Dividends 507 Gas, Diesel, Oil _ 312 Storage 508 Drying Gas _ 313 Sheep Sales 509 Insurance on Crop _ 314 Raised Soybean Sales 510 Insurance on Property _ 315 Misc. Livestock Sales 511 Operating Interest _ 316 Landlord Reimbursement 512 Labor _ 317 Crop Ins. Reimbursement 513 Custom/Machine Hire _ 318 Hedging Income 514 Truck Expenses _ 322 CCC Taxable Income 515 Professional Fees _ 334 Misc. Taxable Income 516 Repairs _ 350 Purchase Cattle Sales 517 Seed _ 351 Purchase Hog Sales 518 Supplies _ 352 Purchased Other Sales 519 Property Taxes _ Hay & Straw 520 Trucking & Freight _ Wool 521 Utilities _ Eggs 522 Vet _ 524 Hedging Expense _ 525 Misc. Farm Expense _ 526 Rent to Shareholder _ 527 Storage Expense _ 528 Deductible Meals _ 545 Non-Farm Business Exp. _ 595 Mortgage Interest Exp. _ Gallons of gasoline used off highway 596 Employer Payroll Taxes _ Is there livestock where you live? Ο Yes Ο No 597 Advertising _ Do you own your home? Ο Yes Ο No 255 Auto Expenses _ Farm Use Truck Mileage 260 Phone Expenses _ Farm Use Auto Mileage Conservation _

4 OTHER INCOME ATTACH W-2 & 1099S Salary from W-2s: $ $ Alimony Received $ $ Social Security Benefits: $ $ Retirement Distributions: $ $ Other Taxable Income: $ $ INTEREST INCOME: Name of Company, Bank, Etc. DIVIDEND INCOME: Name of Company, Bank, Etc. STOCK & MUTUAL FUNDS SOLD: Name of Company Date Purchased Date Sold Purchase Price Sale Price CAPITAL ITEMS SOLD: (Includes Land, Equipment, Breeding Stock, Etc.) Name of Item Sold Date Purchased/Raised Date Sold Purchase Price Sale Price ITEMIZED DEDUCTIONS: Health Insurance Premiums $ Donations $ Drugs $ Union & Professional Dues $ Doctor, Dentist, Eyeglasses, Etc. $ Investment Fees & Exp. $ Casualty or Theft Losses $ Home mortgage Interest $ Real Estate Taxes $ Personal Property Taxes $ (Other than farm property)

5 INCOME & EXPENSES FROM BUSINESS Business Name: Name of Proprietor: Type of Operation: Employer ID #: INCOME: EXPENSES: Gross Receipts Returns & Allowances _ Other Income Cost of Goods Sold _ Advertising _ Bad Debts _ Car & Truck Expense _ Commissions & Fees _ Employee Benefit Programs _ Insurance _ Mortgage Interest _ Operating Interest _ Legal & Professional Fees _ Office Expense _ Rent or Lease _ Repair & Maintenance _ Supplies _ Taxes & Licenses _ Travel, meals, entertainment _ Utilities _ Wages _ Other expenses Beginning Inventory (1/1/17) Purchases Ending Inventory (12/31/17) Business Use Auto Mileage OTHER INFORMATION: Estimates: This should not include withholding from wages!

6 Contributions To: Education Credits: TAX CREDITS & DEDUCTIONS: Traditional IRA: Husband Wife Roth IRA: Husband Wife SEP: Husband_ Wife Keogh: Husband Wife 1. Student s Name: _ SSN: Qualified Expenses: Year in School: K-12 or College 2. Student s Name: _ SSN: Qualified Expenses: Year in School: K-12 or College Child Care Expenses: 1. Care Provider s Name: _ Address: Identifying Number (SSN or EIN): Amount Paid: 2. Care Provider s Name: _ Address: Identifying Number (SSN or EIN): Amount Paid: 1. Qualifying Child s Name: SSN: Qualified Expenses: 2. Qualifying Child s Name: SSN: Qualified Expenses: Student Loan Interest: Interest paid in 2017 on qualified student loans $_ Medical Savings Account: Contributions for 2017 $_ Did you have qualifying medical insurance coverage for 2017? Yes No Part of the Year, Please Specify for which Months Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Any additional information not included on these forms: *NOTE: PLEASE INCLUDE ALL W2 S AND 1099 S WHEN YOU RETURN THIS WORKSHEET.

Tax Return Questionnaire Tax Year

Tax Return Questionnaire Tax Year Print this form out, take some time to fill it out, and bring it with you when you come to the office. This will save you time and money, and help us help you more effectively. Tax Return Questionnaire