CLIENT INFORMATION SHEET ROSSMAN TAX SERVICE TAX YEAR 2018

Transcription

1 CLIENT INFORMATION SHEET ROSSMAN TAX SERVICE TAX YEAR 2018 PLEASE COMPLETE ALL PAGES OF THIS FORM RETURNS WILL T BE PREPARED WITHOUT A COMPLETED INFO SHEET PERSONAL INFORMATION- YOUR LAST NAME MUST BE THE NAME SHOWN ON YOUR SOCIAL SECURITY CARD. YOUR RETURN WILL BE DELAYED DUE TO INCORRECT LAST NAMES BEING SUBMITTED TO THE IRS. *TAXPAYER SPOUSE FIRST NAME MIDDLE INT LAST NAME AS APPEARS ON SOC. SEC. CARD FIRST NAME MIDDLE INT LAST NAME AS APPEARS ON SOC. SEC. CARD *TAXPAYER SS# *BIRTHDATE *OCCUPATION SPOUSE SS# BIRTHDATE OCCUPATION *ARE YOU BEING CLAIMED ON ATHER TAXPAYER S RETURN? ADDRESS INFORMATION- PLEASE WRITE YOUR CURRENT MAILING ADDRESS. Did you move in 2018? *STREET ADDRESS *CITY, STATE & ZIP CODE COUNTY SCHOOL DISTRICT * *HOME PHONE *CELL NUMBER *CELL PHONE CARRIER PREFERRED CONTACT METHOD: HOME PHONE CELL PHONE DID YOU BUY A HOME IN 2018 IF SO, YOU MUST PROVIDE YOUR HUD-1 CLOSING STATEMENT. DID YOU HAVE ACCESS TO A RESIDENCE IN NEW YORK CITY THIS YEAR? *DIRECT DEPOSIT- PLEASE ENTER YOUR BANK ACCOUNT INFORMATION. IF YOU DO T HAVE A BANK ACCOUNT, PLEASE CHECK THE BOX. IF BANKING INFORMATION IS ENTERED OR INFORMATION IS INCOMPLETE, YOU WILL RECEIVE YOUR REFUND CHECK(S) IN THE MAIL. **WOULD YOU LIKE TO HAVE YOUR REFUND DIRECT DEPOSITED? NAME ON ACCOUNT (MUST BE TAXPAYER AND/OR SPOUSE) BANK NAME ROUTING NUMBER ACCOUNT NUMBER CHECKING SAVINGS

2 DEPENDENT INFORMATION- LIST ANY DEPENDENTS. IF YOU CAN LONGER CLAIM SOMEONE AS A DEPENDENT, WRITE CAN T CLAIM AS THE RELATIONSHIP. ALL LAST NAMES MUST BE WRITTEN AS THEY APPEAR ON THE DEPENDENT S SOCIAL SECURITY CARD. CHILD CARE INFORMATION- A CREDIT MAY BE AVAILABLE FOR EXPENSES PAID TO A DAYCARE, PRESCHOOL, OR CAMP. YOU WILL NEED ALL OF THE FOLLOWING INFORMATION TO QUALIFY FOR THE CREDIT! CHILD CARE PROVIDER NAME *FED ID OR SS# ADDRESS AMT PAID FOR YR (S) DID YOU PARTICIPATE IN A DAYCARE BENEFIT PLAN WITH YOUR EMPLOYER? HIGHER EDUCATION INFORMATION-A CREDIT MAY BE AVAILABLE FOR QUALIFIED EXPENSES PAID TO AN INSTITUTION OF HIGHER LEARNING. THE EXPENSE MUST HAVE BEEN INCURRED AND PAID IN 2018 TO QUALIFY. YOU MUST ALSO SUPPLY A T. 1) STUDENT NAME TUITION PER YR COST INCURRED FOR BOOKS AND REQUIRED FEES: $ UNDERGRAD GRAD SCHOOL NAME *FED ID 2) STUDENT NAME TUITION PER YR COST INCURRED FOR BOOKS AND REQUIRED FEES: $ UNDERGRAD GRAD SCHOOL NAME *FED ID ENERGY CREDITS- LIST THE AMOUNT YOU SPENT ON QUALIFYING WINDOWS & DOORS, INSULATION, ROOFS, WATER HEATERS, GAS-PROPANE-OIL FURNACES, CENTRAL AIR CONDITIONERS AND BIOMASS STOVES AND SOLAR PANALS PLEASE TE, THE MAXIMUM LIFE TIME CREDIT IS GREATER THAN $ THEREFORE, IF YOU PREVIOUSLY RECEIVED A CREDIT FOR $ YOU ARE LONGER ELIGIBLE. ITEM(S) PURCHASED AMT PAID IN 2018 LONG-TERM CARE INSURANCE- ENTER THE AMOUNT YOU PAID TOWARDS LT CARE INSURANCE IN 2018 TAXPAYER SPOUSE NAME OF STATE YOU CONTRIBUTED TO A 529 PLAN: 2018 CONTRIBUTION AMOUNT TO 529 PLAN:

3 FEDERAL AND STATE ESTIMATED PAYMENTS-LIST ANY QUARTERLY ESTIMATED TAX PAYMENTS YOU MADE TO THE GOVERNMENT. FED: APRIL JUNE SEPT JAN STATE: APRIL JUNE SEPT JAN VOLUNTEER FIREFIGHTER OR EMT- YOU ARE ENTITLED TO A $200 ($400 IF BOTH HUSBAND AND SPOUSE VOLUNTEER) CREDIT ON YOUR NYS RETURN. (TAXPAYER)COMPANY/DEPT (SPOUSE)COMPANY/DEPT *FOREIGN BANK ACCOUNT- WE ARE REQUIRED TO REPORT OWNERSHIP OR SIGNATURE OVER FOREIGN ACCOUNTS. DO YOU OWN A FOREIGN BANK ACCOUNT? COUNTRY *PURCHASES WITHOUT SALES TAX DID YOU HAVE ANY PURCHASES OVER $1,000 WITHOUT PAYING SALES TAX THIS YEAR? IF SO, WHAT WAS THE AMOUNT? 2018 HEALTH INSURANCE QUESTIONS *HEALTH CARE EXCHANGE- DID YOU OBTAIN HEALTH INSURANCE THROUGH A FEDERAL OR STATE HEALTH INSURANCE EXCHANGE? IF, PLEASE MAKE SURE TO BRING FORM 1095-A THAT WAS MAILED TO YOU FROM YOUR INSURANCE COMPANY. *HEALTH INSURANCE COVERAGE- DOES EVERYONE IN YOUR FAMILY (YOURSELF AND ANY DEPENDENTS) HAVE HEALTH INSURANCE COVERAGE FOR THE ENTIRE YEAR IN 2018 IF, PLEASE FILL IN THE BOXES BELOW TAX PAYER SPOUSE MARK EACH BOX WITH AN X FOR EACH MONTH OF COVERAGE FULL YEAR COVERAGE JAN FEB MAR APR MAY JUN JUL AUG SEP OCT V DEC

4 2018 DEDUCTION PLEASE ENTER N/A FOR QUESTION THAT DO T APPLY CHARITABLE CONTRIBUTIONS- HOW MUCH DID YOU GIVE TO A QUALIFIED CHARITY IN 2018? PLEASE TE: ALL CONTRIBUTIONS MUST BE DOCUMENTED WITH RECEIPTS AND/OR LETTER FROM CHARITABLE ORGANIZATION. CASH $ N-CASH (FAIR MARKET VALUE) $ IF N-CASH, DISCRIPTION OF ITEMS DONATED NAME OF ORGANIZATION(S) YOU DONATED TO UNREIMBURSED EMPLOYEE BUSINESS EXPENSES- DID YOU HAVE ANY JOB RELATED EXPENSES THAT WERE T REIMBURSED BY YOUR (OR YOUR SPOUSE S) EMPLOYER? LOCAL TRAVEL $ UNION DUES $ UNIFORMS $ OTHER (TOOLS, SUPPLIES, ETC.) $ TOTAL MILEAGE COMMUTING MILEAGE (HOME TO WORK THEN WORK TO HOME) SPOUSE-LOCAL TRAVEL $ UNION DUES $ UNIFORMS $ OTHER (TOOLS, SUPPLIES, ETC.) $ TOTAL MILEAGE COMMUTING MILEAGE (HOME TO WORK THEN WORK TO HOME) BUSINESS MILEAGE (T COMMUTING) BUSINESS MILEAGE (T COMMUTING) (BUSINESS MILES ARE MILES TRAVELED FOR BUSINESS BUT DOES T INCLUDE MILE TRAVELED FROM AND TO HOME) MEDICAL EXPENSES- DID YOU HAVE ANY MAJOR MEDICAL EXPENSES IN 2018 EXPENSES INCURRED IN 2018 $ **PLEASE TE You must have adequate documentation to support income & deductions listed on the tax return ADDITIONAL INFORMATION- IF YOU NEED TO MENTION ANYTHING THAT COULD T FIT ON THE INFORMATION SHEET (EXTRA DEPENDENTS, OTHER CHILD CARE INFORMATION, ETC) OR HAVE ANY QUESTIONS LIST THEM HERE.

5 ROSSMAN TAX SERVICE 2018 ENGAGEMENT LETTER Dear Client, Due to IRS and our Insurance Company s regulations we are requesting that you read the following, sign and date. If you are filing a joint tax return or married filing separate return, the client who is signing this Engagement Letter attests that they have reviewed this engagement letter with their spouse and both agree to the Terms of the Engagement for Preparation of the 2018 Tax Return. We (I) hereby attest to the following: 1) All information provided in this client information sheet is correct. 2) We (I) have provided current Banking Information for E-Filing. 3) We (I) have provided all documents that are required to prepare the 2018 tax return. 4) We (I) have adequate documentation to support income & deductions listed on the tax return 5) We (I) acknowledge that all income (including cash) has been reported on the return. 6) We (I) understand that Rossman Tax Service will not be held responsible for any errors on the tax return due to client omissions or incorrect information on the client information sheet and that an additional fee will be incurred in order to make corrections. 7) We (I) understand that both the taxpayer and spouse are responsible for any tax liability on a joint tax return. 8) We (I) are responsible for the tax return and payment of my (our) balance due to the IRS or New York State by April 15 th. 9) We (I) are responsible to send any amount owed to either IRS or New York State with my extension. 10) In the event of a potential divorce of a married couple, Rossman Tax Service is the representative of both the taxpayer and the spouse. If there is potential information that may be harmful to one party or the other, Rossman Tax Service will be obliged to divulge such information to the other party. Rossman Tax Service reserves the right, where there is a conflict of interest between the two parties and Rossman Tax Service, to request that one or both of the parties seeks accounting advice elsewhere. 11) We(I) understand that it is our(my) responsibility to have reviewed the Tax Return, Transmittals and bank account information prior to signing our e filing forms with the preparer and are aware of the content of the tax return and whether I (We) are receiving a refund or if I (We) have a balance due. 12) We (I) are also aware that my mistakes will delay my refund. 13) All services must be paid in full before E-Filing or receipt of a taxpayer copy. POST DATED CHECKS WILL BE PERMITED. There is a $50 Bounced Check Fee. 14) One taxpayer copy will be given each year upon payment. Any additional copies of Tax Returns will require a$25 fee. 15) All work papers and prepared tax returns are the property of Rossman Tax Service. If the return is not prepared by us we will return to the client all of their documents. Not our work papers or tax returns. 16) We (I) understand that if requested by IRS or State, we (I) will produce receipts and documentation to substantiate income and deduction. I further understand that I should keep records of income and receipts for a minimum of 7 years. THIS ENGAGEMENT IS LIMITED TO THE PREPARTION OF INCOME TAX RETURNS. ADDITIONAL SERVICES SUCH AS PROJECTIONS OR GOVERNMENT EXAMINATIONS WILL INCUR AN ADDITIONAL CHARGE. WE (I) ALSO ACKWLEDGE THAT PAYMENT IS DUE UPON COMPLETION OF THE TAX RETURN AND THAT ONCE PAYMENT IS MADE, THE FEE FOR SERVICES RENDERED IS NREFUNDABLE. * CLIENT NAME DATE SIGNATURE