PACIFIC GRACE TAX & ACCOUNTING

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Robert Cross
5 years ago
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1 PACIFIC GRACE TAX & ACCOUNTING SR 20 Oak Harbor, WA (360) Fax (360) Kathy s - kathy@pacificgracetax.com Ronnie s - ronnie@pacificgracetax.com Mandy s mandy@pacificgracetax.com 2017 INCOME TAX ORGANIZER Name Spouse s Name SS# Birth date SS# Birth date Occupation Occupation Home Address Home Phone Work Phone Address Cell Phone DEPENDENTS Name Social Security # Birth date Relationship # of Months lived with you in 2017 YES NO Do you want to have your refund directly deposited to your checking or savings account? Bank Name Type: Ckg Svgs Bank routing number Account Number Do you want to pay your balance due with a direct withdrawal from your checking account? Do you want $3 of your tax money to go to the Presidential Election Campaign Fund? Does your spouse want $3 of your tax money to go to the Presidential Election Campaign Fund? May the IRS discuss this tax return with your preparer? Did you have any incidents of Identity Theft? Did the IRS issue you an Identity Protection PIN? Please bring notice. Are you legally blind? Have there been any changes to: (Check all that apply) Marital Status Dependents Employment Address Health Issues Did you make any qualified energy improvements, such as energy efficient windows, doors, etc.? Did you buy or sell Real Estate? If yes, bring in Escrow Papers - both purchase and sale. Did you have any forgiveness of debt, a property foreclosure, or a short sale? Did you have an uninsured loss from theft, fire, windstorm, or auto accident, etc. where your loss was more than 10% of Adjusted Gross Income? Do you have any bank accounts or retirement accounts in any foreign countries? MEDICAL INSURANCE QUESTIONS Did you have qualifying health care coverage for every month of 2017 for you, your spouse and all dependents? This includes employer- or government-sponsored coverage and Medicare/Medicaid. If yes, please bring all 1095-B and/or 1095-C forms received. Did anyone in your family qualify for an exemption from the health care coverage mandate? Did you enroll for lower cost coverage through your state s Marketplace or Exchange? If yes, please bring all 1095-A Forms received.

2 INCOME WAGES - Company (Bring in all copies of W-2 forms) Taxpayer Spouse RETIREMENT Pensions $ $ IRA, SEP, Keogh Distribution $ $ Annuity $ $ Other $ $ Other $ $ Social Security $ $ INTEREST INCOME - (Bring in 1099-INT forms or Year-End Bank Statements) Payer Amount Tax Exempt Amount Early Withdrawal Penalty DIVIDEND INCOME - (Bring in 1099-DIV forms) Total Ordinary Dividends Qualified Dividends Capital Gains STOCK SALES AND MUTUAL FUND WITHDRAWALS (Please furnish Brokers confirmations or Mutual Fund Statements for BOTH PURCHASE AND SALE) # Of Shares Name Of Stock Date Purchased Date Sold Total Sales Price Total Cost OTHER INCOME - (Bring in 1099 Forms) Taxpayer Spouse Alimony Received $ $ Unemployment Compensation $ $ State Income Tax Refund $ $ Relief of Debt $ $ Other (Specify) $ $ Contract / Installment Sale Receipts: Principal $ Interest $

3 ADJUSTMENTS TO INCOME IRA Contributions: Taxpayer $ Traditional Roth Spouse $ Traditional Roth Alimony Paid $ Ex-Spouse s SS# Ex-Spouse s Name Moving Expenses $ Miles from OLD HOME to OLD JOB Miles from OLD HOME to NEW JOB Qualified Student Loan Interest $ Penalty for withdrawal of Savings $ Health Saving Account Contributions (NOT Health/Medical Reimbursement) $ ITEMIZED DEDUCTIONS - SCHEDULE A EXPENSES MEDICAL AND DENTAL EXPENSES - List only what YOU paid, not amounts paid by Insurance Companies Premiums: Medical Ins $ Medicare Ins $ Auto miles traveled (medical treatment) Out of Pocket Expenses/Co-pays: Rx $ Dr&DDS $ Hospital $ Lab $ Glasses $ Other $ TAXES PAID State Income Tax $ Long Term Care Ins. Taxpayer $ Spouse $ State Real Estate Taxes on your Home $ Other Real Estate Taxes $ In 2017, if you purchased a new car, truck, SUV, RV, motorcycle, boat, airplane, prefabricated or mobile home, or home building materials, please bring purchase papers to substantiate sales tax deduction. $ INTEREST PAID If you refinanced a Real Estate Loan, please bring the Closing Papers (form HUD 1) Home loan $ 2nd Home $ Home Equity Loan $ Investment Interest $ Home Mortgage Insurance $ (Only for loans taken out after January 1, 2007) CHARITABLE CONTRIBUTIONS - (All donations require receipt, cancelled check, or bank card statement. All donations over $250 require receipt from Non-Profit Organization.) Charity Check Cash Must have receipt PROPERTY CONTRIBUTED: $500 and over require special signed forms. Include clothing, furniture, and other items donated. Use fair market value at time of gift. (Garage sale or thrift shop price.) Charity Description Amount (Fair Market Value) Miles traveled by car for charity work

4 MISCELLANEOUS EXPENSES Tax Preparation Fees $ Dues to Professional Organizations $ Safety Deposit Box $ IRA Management Fees $ Safety Equipment (Job Required) $ Job Tools and Supplies (Job Required) $ Uniforms (Job Required) $ Other Job Expenses $ ESTIMATED TAX PAYMENTS MADE (Bring in checks or copies) Carryover from $ 1st qtr (Apr 2017) Date Paid $ 3rd qtr (Sept 2017) Date Paid $ 2nd qtr (Jun 2017) Date Paid $ 4th qtr (Jan 2018) Date Paid $ TAX CREDITS CHILD CARE CREDIT - (Paid to permit you to work or look for work) Children cared for PROVIDER NAME ADDRESS SOCIAL SECURITY # AMOUNT EDUCATION CREDITS (Bring in 1098-T issued by eligible educational post-secondary institution) Amount paid for Tuition, Books, & Equipment $ Student name Has student completed the first 4 years of postsecondary education? YES Has student received educational benefits under a prepaid tuition program? (i.e. 529 or GET Plan) YES NO NO

5 RENTAL INCOME WORKSHEET Property #1 Address Property #2 Address Property #3 Address Property #4 Address PROPERTY #1 PROPERTY #2 PROPERTY #3 PROPERTY #4 TOTAL RENTS RECEIVED EXPENSES PAID Advertising Association Dues Cleaning & Maintenance Commissions/Salaries Gardening & Landscaping Insurance Janitor/Trash Legal & Accounting Licenses Lot Rent Management Fees Mortgage Interest Office Supplies Repairs Supplies Taxes Telephone Utilities Capital Improvements Auto Mileage NEW PROPERTY INFORMATION: (Bring Purchase Papers & County Tax Assessment) Purchase date (mo/day/year) Date Ready to Rent (mo/day/year) Purchase Price $ Improvements $

Personal Legal Plans Client Organizer 2018

Personal Legal Plans Client Organizer 2018 TAXPAYER NAME SOCIAL SECURITY NUMBER OCCUPATION DATE OF BIRTH EMAIL ADDRESS CELL PHONE SPOUSE Address: Home Phone: City: State: Zip: County: DEPENDENT CHILDREN & OTHER DEPENDENTS NAME SOCIAL SECURITY NUMBER