MCMAHON - VELTUS, S.C WASHINGTON AVE STE 103 RACINE, WI

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1 MCMAHON - VELTUS, S.C WASHINGTON AVE STE 103 RACINE, WI , Dear : This Tax Organizer is designed to help you gather the tax information needed to prepare your 2018 personal income tax return. To help you complete the organizer with minimal time and effort, when available, you will find certain information from your 2017 personal income tax return. Please review all information for accuracy, including names, addresses, occupation, and date(s) of birth. Please visit our website mcmahonveltus.com and click on Tax Reform link for a summary of the new tax legislation. If you normally drop off your income tax information, without an appointment, please do so once you feel you have received all of your documents. If you feel you need to set up an appointment to review your tax information, please follow the appointment schedule below: Racine Union Grove Burlington Greg Veltus Saturday 1pm - 5pm Saturday 7:30am-11:30am By appointment Jim Carlson By appointment Saturday 1pm-5pm Saturday 8am-11:30am Jarod Pobst By appointment Brian McMahon By appointment Donna Lane By appt. ( ) All businesses and individuals that would like our office to process their year-end W-2s and 1099s should have the appropriate information to our office as soon as possible in January. In your Tax Organizer, all social security numbers and bank account numbers have been replaced with asterisks (***-**-****) and (****1234) to protect your privacy and personal information. When you receive your completed tax return(s), please review all social security numbers and bank account information for accuracy. Report any discrepancies to this office immediately. Enter 2018 information on the Tax Organizer pages provided. If any information does not apply to you or is incorrect, please draw a line through it or make the necessary corrections. The Client Questionnaire asks about pertinent tax items necessary for preparing the most accurate tax return possible. Please answer all applicable questions and attach a statement when necessary for additional information not provided in the Client Organizer. We will also need the following information: - Forms W-2 for wages, salaries and tips. - All Forms 1099 for interest, dividends, retirement, miscellaneous income, Social Security, state or local refunds, gambling winnings, etc. - Brokerage statements showing investment transactions for stocks, bonds, etc. - Schedule K-1 from partnerships, S corporations, estates and trusts. - Statements supporting deductions for mortgage interest, taxes, and charitable contributions (including any Form 1098-C). - Copies of closing statements regarding the sale or purchase of real property.

2 - Legal papers for adoption, divorce, or separation involving custody of your dependent children. - Any tax notices sent to you by the IRS or other taxing authority. - A copy of your income tax return from last year, if not prepared by this office. Personal Finances As part of our commitment to providing our clients with the best and most comprehensive service possible, we have formed an alliance with Veltus Financial Services, LLC and have been working collaboratively with Julie Veltus to help our clients. If you have an interest in getting additional information on the items listed below please circle the item and we will forward your /or phone number onto Julie. She may help recommend solutions that truly address these financial needs and which may in turn help reduce your future tax liability. Retirement Income. I am concerned about the amount of money I'll need for retirement, and whether or not my current investments will allow for a comfortable retirement. Education Funding. I would like to be well-prepared to pay for my children's education, and to take advantage of all tax and investment strategies available. Investments. I would like to maximize the return on my current savings and investments. Family. I would like to help ensure that my family is financially secure in the event that I am unable to provide for them due to an untimely death or disability. Estate Planning. I am interested in learning more about possible tax advantages through estate planning. Insurance and Annuities Life, disability and/or long term care income insurance Review & updating my annuities I would like to meet with Julie, a registered financial services representative, for a no-obligation consultation to discuss some of these issues. I would like to have Julie contact me to set up an appointment. Preferred Contact Method Phone/ IRS regulations require paid tax preparers who expect to prepare and file 11 or more federal individual, nonresident alien, or trust tax returns to file them electronically. To comply with this requirement your return will be electronically filed this year. The benefits of e-filing include a secure way to file tax returns and it provides proof of acceptance that the IRS has accepted your return for processing. Contact this office if you prefer your return be filed on paper. The IRS does not send out unsolicited s requesting detailed personal information. Such authentic-looking s are called "phishing" s and responding may expose you to identity theft. If you receive such an from the IRS, send a copy of the to phishing@irs.gov. Please do not respond to the unless the request you send to the IRS has been verified as legitimate. You may also contact our office regarding any correspondence, written or electronic, that you receive from the IRS. Thank you for the opportunity to serve you. Sincerely,

3 MCMAHON - VELTUS, S.C. Location Telephone Fax number Racine (7033 Washington Ave) Union Grove (901 Main St.) Burlington (140 W. Chestnut St.)

4 Questions Please check the appropriate box and include all necessary details and documentation. Yes No Personal Information Did your marital status change during the year? If yes, explain: Did you get married to a same-sex spouse in a state that legally recognizes same-sex marriage? If yes, explain: Did your address change from last year? Can you be claimed as a dependent by another taxpayer? Did you change any bank accounts that have been used to direct deposit (or direct debit) funds from (or to) the IRS or other taxing authority during the tax year? Dependent Information Were there any changes in dependents from the prior year? If yes, explain: Do you have any children under age 19 or a full-time student under age 24 with unearned income in excess of $2,100? Do you have dependents who must file a tax return? Did you provide over half the support for any other person(s) other than your dependent children during the year? Did you pay for child care while you worked or looked for work? Did you pay any expenses related to the adoption of a child during the year? If you are divorced or separated with child(ren), do you have a divorce decree or other form of separation agreement which establishes custodial responsibilities? Purchases, Sales and Debt Information Did you start a new business or purchase rental property during the year? Did you acquire a new or additional interest in a partnership or S corporation? Did you sell, exchange, or purchase any real estate during the year? Did you purchase or sell a principal residence during the year? Did you foreclose or abandon a principal residence or real property during the year? Did you acquire or dispose of any stock during the year? Did you take out a home equity loan this year? Did you refinance a principal residence or second home this year? Did you sell an existing business, rental, or other property this year? Did you lend money with the understanding of repayment and this year and it became totally uncollectable? Did you have any debts canceled or forgiven this year, such as home mortgage or student loans? Did you purchase a qualified plug-in electric drive vehicle or qualified fuel cell vehicle this year? Income Information Did you have any foreign income or pay any foreign taxes during the year, directly or indirectly, such as from investment accounts, partnerships or a foreign employer? Did you receive any income from property sold prior to this year? Did you receive any unemployment benefits during the year? Did you receive any disability income during the year? Did you receive tip income not reported to your employer this year?

5 Did any of your life insurance policies mature, or did you surrender any policies? Did you receive any awards, prizes, hobby income, gambling or lottery winnings? Do you expect a large fluctuation in income, deductions, or withholding next year? Retirement Information Are you an active participant in a pension or retirement plan? Did you receive any Social Security benefits during the year? Did you make any withdrawals from an IRA, Roth, Keogh, SIMPLE, SEP, 401(k), or other qualified retirement plan? Did you receive any lump-sum payments from a pension, profit sharing or 401(k) plan? Did you make any contributions to an IRA, Roth, Keogh, SIMPLE, SEP, 401(k), or other qualified retirement plan? Education Information Did you, your spouse, or your dependents attend a post-secondary school during the year, or plan to attend one in the coming year? Did you have any educational expenses during the year on behalf of yourself, your spouse, or a dependent? Did anyone in your family receive a scholarship of any kind during the year? Did you make any withdrawals from an education savings or 529 Plan account? Did you pay any student loan interest this year? Did you cash any Series EE or I U.S. Savings bonds issued after 1989? Did you make any contributions to an education savings or 529 Plan account? Itemized Deduction Information Did you incur a casualty or theft loss or any condemnation awards during the year? Did you pay out-of-pocket medical expenses (Co-pays, prescription drugs, etc.)? Did you make any cash or noncash charitable contributions (clothes, furniture, etc.)? If yes, please provide evidence such as a receipt from the donee organization, a canceled check, or record of payment, to substantiate all contributions made. Did you donate a vehicle or boat during the year? If yes, attach Form 1098-C or other written acknowledgement from the donee organization. Did you have an expense account or allowance during the year? Did you use your car on the job, for other than commuting? Did you work out of town for part of the year? Did you have any expenses related to seeking a new job during the year? Did you make any major purchases during the year (cars, boats, etc.)? Did you make any out-of-state purchases (by telephone, internet, mail, or in person) for which the seller did not collect state sales or use tax? Miscellaneous Information Did you make gifts of more than $15,000 to any individual? Did you utilize an area of your home for business purposes? Did you engage in any bartering transactions? Did you retire or change jobs this year? Did you incur moving costs because of a job change? Did you pay any individual as a household employee during the year? Did you make energy efficient improvements to your main home this year? Did you receive a distribution from, or were you a grantor or transferor for a foreign trust? Did you have a financial interest in or signature authority over a financial account such as a bank account, securities account, or brokerage account, located in a foreign country? Do you have any foreign financial accounts, foreign financial assets, or hold

6 interest in a foreign entity? Did you receive correspondence from the State or the Internal Revenue Service? If yes, explain: Did you receive an Identity Protection PIN from the Internal Revenue Service or have you been a victim of identity theft? If yes, attach the IRS letter. Do you want to designate $3 to the Presidential Election Campaign Fund? If you check yes, it will not change your tax or reduce your refund. Health Care Information (If information is not provided you could be subject to a penalty) Did you have qualifying health care coverage, such as employer-sponsored coverage or government-sponsored coverage (i.e. Medicare/Medicaid) for every month of 2016 for your family? "Your family" for health care coverage refers to you, your spouse if filing jointly, and anyone you can claim as a dependent. Did anyone in your family qualify for an exemption from the health care coverage mandate? (Exemptions include: Indian tribe membership, health sharing ministry, incarceration, exempt non-citizen or economic hardship? If you received an exemption certificate, please attach or include certicate with your information) Did you enroll for lower cost Marketplace Coverage through healthcare.gov under the Affordable Care Act? If yes, please provide any Form(s) 1095-A you received. If you received a Form 1095-B (Health Coverage) or Form 1095-C (Employer Provided Health Insurance Offer and Coverage) please provide our office with the form(s). Health Savings Accounts (HSA) Did you make any contributions to a Health savings account (HSA) or Archer MSA? Did you receive any distributions from a Health savings account (HSA), Archer MSA, or Medicare Advantage MSA this year? Did you pay long-term care premiums for yourself or your family? If you are a business owner, did you pay health insurance premiums for your employees this year? Reminders If you would like a direct deposit of any tax refunds, please bring in a copy of a blank or canceled check to verify your account number with our records. If your household income is less than $24,680 or if you qualified for Wisconsin Homestead Credit in 2017, please bring in a copy of your 2018 real estate property tax bill or a renters certificate. Did you pay rent during 2018? If yes amount Who paid heat? Tenant or Landlord?

7 Form ID: INDX Client Organizer Topical Index This client organizer topical index is designed to help you quickly locate the items listed. To use the index just locate the topic and refer to the page number listed. The page number corresponds to the number printed in the top right corner of your organizer sheets. Topic Page Topic Page Affordable Care Act Health Coverage 69 Alaska Permanent Fund dividends 18 Alimony paid 51 Alimony received 18 Bank account information 3 Charitable contributions 59 Dependent care benefits received 12 Dependent information 1 Direct deposit information 3 11, 13 14, 17b Electronic filing 6 address 2 Federal estimate payments 8 Federal withholding 12, 25 Gambling winnings 18 Gambling losses 59 Identity authentication 7 Interest paid 58 Investment expenses 57 Investment interest expenses 58 IRA, Roth IRA contributions 26 Medical and dental expenses 57 18, 51 18a, 18b Miscellaneous itemized deductions 59, 59a Mortgage interest expense 58 Personal property taxes paid 57 Railroad retirement benefits 25 Real estate taxes 57 17, 69 17a, 17b Social security benefits received 25 State and local income tax refunds 18 State & local estimate payments 9 State & local withholding 12 Statutory employee 12 Taxes paid 57 Unemployment compensation 18 Wages and salaries 12 Please note the following conventions used throughout your client organizer: T/S/J and T/S headings should be used to indicate if an item belongs to the (T)axpayer, (S)pouse, or (J)oint. Also, if an item did not occur in your resident state, please indicate the state s postal code abbreviation in which the item occurred. Control totals and [ ] numbers are for preparer use only. Form ID: INDX

8 General: 1040 Personal Information GENERAL INFORMATION Filing (Marital) status code (1 = Single, 2 = Married filing joint, 3 = Married filing separate, 4 = Head of household, 5 = Qualifying widow(er)) Mark if you were married but living apart all year Mark if your nonresident alien spouse does not have an ITIN Taxpayer Social security number First name Last name Occupation Designate $3.00 to the presidential election campaign fund? (1 = Yes, 2 = No, 3=Blank) Mark if legally blind Mark if dependent of another taxpayer Taxpayer between 19 and 23, full-time student, with income less than 1/2 support? (Y, N) Date of birth Date of death Work/daytime telephone number/ext number Do you authorize us to discuss your return with the IRS (Y, N) Spouse General: 1040, Contact Present Mailing Address Address Apartment number City/State postal code/zip code Foreign country name Foreign phone number Home/evening telephone number Taxpayer address Spouse address General: 1040 Dependent Information Care Months expenses in paid for First Name Last Name Date of Birth Social Security No. Relationship home dependent Credits: 2441 Child and Dependent Care Expenses Provider information: Business name First and Last name Street address City, state, and zip code Social security number OR Employer identification number Tax Exempt or Living Abroad Foreign Care Provider (1 = TE, 2 = LAFCP) Amount paid to care provider in 2018 Employer-provided dependent care benefits that were forfeited Taxpayer Spouse Health Care: Coverage Health Care Coverage Your family for health care coverage refers to you, your spouse if filing jointly, and anyone you can claim as a dependent Information Prior Year Information Was your entire family covered for the full year with minimum essential health care coverage? (Y, N) Lite-1 GENERAL INFORMATION

9 Income: B1 Interest Income INTEREST/DIVIDENDS/CAPITAL GAINS/OTHER INCOME T/S/J Please provide all copies of Form 1099-INT or other statements reporting interest income. Interest Name Income Prior Year Information Income: B3 Seller Financed Mortgage Interest T, S, J s name s social security number s address, city, state, zip code Amount received in 2018 Amount received in 2017 Income: B2 Dividend Income Please provide copies of all Form 1099-DIV or other statements reporting dividend income. Ordinary Qualified Prior Year T/S/J Name Dividends Dividends Information Income: D Sales of Stocks, Securities, and Other Investment Property Please provide copies of all Forms 1099-B and 1099-S. Gross Sales Price Cost or T/S/J Description of Property Date Acquired Date Sold (Less expenses of sale) Other Basis Income: Income Other Income State and local income tax refunds Alimony received Unemployment compensation Unemployment compensation repaid Social security benefits Medicare premiums to be reported on Schedule A Railroad retirement benefits Please provide copies of all supporting documentation Information Taxpayer Spouse Prior Year Information Prior Year Information T/S/J 2018 Information Prior Year Information Other Income: Lite-3 INTEREST/DIVIDENDS/CAPITAL GAINS/OTHER INCOME

10 1040 Adj: IRA Adjustments to Income - IRA Contributions ADJUSTMENTS/EDUCATE Please provide year end statements for each account and any Form 8606 not prepared by this office. Taxpayer Traditional IRA Contributions for If you want to contribute the maximum allowable traditional IRA contribution amount, enter the applicable code: (1 = Deductible only, 2 = Both deductible and nondeductible) Enter the total traditional IRA contributions made for use in 2018 Roth IRA Contributions for Mark if you want to contribute the maximum Roth IRA contribution Enter the total Roth IRA contributions made for use in 2018 Spouse Educate: Educate2 Higher Education Deductions and/or Credits Complete this section if you paid interest on a qualified student loan in 2018 for qualified higher education expenses for you, your spouse, or a person who was your dependent when you took out the loan. T/S Qualified student loan interest paid 2018 Information Prior Year Information Complete this section if you paid qualified education expenses for higher education costs in Qualified education expenses include tuition and fees required for enrollment or attendance at an eligible educational institution. Please provide all copies of Form 1098-T. Ed Exp Prior Year T/S Code* Student s SSN Student s First Name Student s Last Name Qualified Expenses Information *Education Expense Code: 1 = American opportunity credit; 2 = Lifetime learning credit; 3 = Tuition and fees deduction The student qualifies for the American opportunity credit when enrolled at least half-time in a program leading to a degree, certificate, or recognized credential; has not completed the first 4 years of post-secondary education; has no felony drug convictions on student s record Adj: 3903 Job Related Moving Expenses Complete this section if you moved to a new home due to service in the armed forces. Description of move Taxpayer/Spouse/Joint (T, S, J) Mark if the move was due to service in the armed forces Number of miles from old home to new workplace Number of miles from old home to old workplace Mark if move is outside United States or its possessions Transportation and storage expenses Travel and lodging (not including meals) Total amount reimbursed for moving expenses 1040 Adj: OtherAdj Other Adjustments to Income Alimony Paid: T/S Recipient name Recipient SSN 2018 Information Prior Year Information Street address City, State and Zip code Educator expenses: Taxpayer Spouse Prior Year Information Other adjustments: Lite-4 ADJUSTMENTS/EDUCATE

11 Itemized: A1 Medical and Dental Expenses ITEMIZED DEDUCTIONS T/S/J 2018 Information Prior Year Information Medical and dental expenses Medical insurance premiums you paid*** Long-term care premiums you paid*** Prescription medicines and drugs Miles driven for medical items ***Do not include pre-tax amounts paid by an employer-sponsored plan, amounts paid for your self-employed business, or Medicare premiums entered on Form Lite-3 Itemized: A1 Tax Expenses T/S/J 2018 Information Prior Year Information State/local income taxes paid 2017 state and local income taxes paid in 2018 Sales tax paid on actual expenses Real estate taxes paid Personal property taxes Other taxes Itemized: A2 Interest Expenses T/S/J 2018 Information Prior Year Information Home mortgage interest From Form 1098 Other home mortgage interest paid to individuals: T/S/J Payee s Name SSN or EIN 2018 Information Prior Year Information Address City State Zip Code T/S/J 2018 Information Prior Year Information Investment interest expense, other than on Sch K-1s: Refinancing Information: Refinance #1 Refinance #2 T/S/J Recipient/Lender name Total points paid at time of refinance Date of refinance Term of new loan (in months) Reported on Form 1098 in 2018 Itemized: A3 Charitable Contributions T/S/J 2018 Information Prior Year Information Contributions made by cash or check Volunteer miles driven Noncash items, such as: Goodwill, Salvation Army Itemized: A3, A-St Miscellaneous Deductions T/S/J 2018 Information Prior Year Information Other expenses, not subject to the 2% AGI limitation: T/S/J Gambling losses (enter only if you have gambling income) ***STATE USE ONLY - Complete the following fields only if you file a state return in AL, AR, CA, HI, IA, MN, NY or PA Unreimbursed expenses*** Union dues, other than amounts reported on Form W-2*** Tax preparation fees*** Other expenses, subject to 2% AGI limitation***: 2018 Information Prior Year Information Safe deposit box rental*** Investment expenses, other than on Schedule(s) K-1 or Form(s) 1099-DIV/INT*** Lite-5 ITEMIZED DEDUCTIONS

12 General: Bank Direct Deposit/Electronic Funds Withdrawal Information BANK & IDENTITY AUTHENTICATION Per IRS Security Summit requirements, verify the name of financial institution, routing transit number, account number, and type of account below. If you would like to have a refund direct deposited into or a balance due debited from your bank account(s), please enter information in the fields below. Note that electronic funds will be withdrawn only from the primary account listed below. Mark to verify all accounts listed below have been reviewed, updated as needed, and are correct. Primary account: Financial institution routing transit number Name of financial institution Your account number Type of account (1 = Savings, 2 = Checking, 3 = IRA*) Mark if married filing jointly and this is a joint account (Both taxpayer and spouse names are on the account) Mark if financial institution is foreign based (Not located in the territorial jurisdiction of the United States) Enter the maximum dollar amount, or percentage of total refund Dollar or Percent (xxx.xx) Secondary account #1: Financial institution routing transit number Name of financial institution Your account number Type of account (1 = Savings, 2 = Checking, 3 = IRA*) Mark if married filing jointly and this is a joint account (Both taxpayer and spouse names are on the account) Mark if financial institution is foreign based (Not located in the territorial jurisdiction of the United States) Enter the maximum dollar amount, or percentage of total refund Dollar or Percent (xxx.xx) Secondary account #2: Financial institution routing transit number Name of financial institution Your account number Type of account (1 = Savings, 2 = Checking, 3 = IRA*) Mark if married filing jointly and this is a joint account (Both taxpayer and spouse names are on the account) Mark if financial institution is foreign based (Not located in the territorial jurisdiction of the United States) Enter the maximum dollar amount, or percentage of total refund Dollar or Percent (xxx.xx) *Refunds may only be direct deposited to established traditional, Roth or SEP-IRA accounts. Make sure direct deposits will be accepted by the bank or financial institution. Electronic Filing: ID Auth Identity Authentication Taxpayer - Form of identification ( 1 = Driver s license, 2 = State issued identification card, 3 = No applicable identification, 4 = Identification not provided) Identification number Issue date Expiration date Location of issuance Document number (New York only) Spouse - Form of identification ( 1 = Driver s license, 2 = State issued identification card, 3 = No applicable identification, 4 = Identification not provided) Identification number Issue date Expiration date Location of issuance Document number (New York only) NOTES/QUESTIONS: Lite-6 BANK & IDENTITY AUTHENTICATION

13 Form ID: 1040 Personal Information 1 Filing (Marital) status code (1 = Single, 2 = Married filing joint, 3 = Married filing separate, 4 = Head of household, 5 = Qualifying widow(er)) Mark if you were married but living apart all year Mark if your nonresident alien spouse does not have an Individual Taxpayer Identification Number (ITIN) Taxpayer Social security number First name Last name Occupation Designate $3.00 to the presidential election campaign fund? (1 = Yes, 2 = No, 3 = Blank) Mark if dependent of another taxpayer Taxpayer with income less than 1/2 support age 18 or full-time student? (Y, N) Mark if legally blind Date of birth Date of death Work/daytime telephone number/ext number Home/evening telephone number Do you authorize us to discuss your return with the IRS? (Y, N) Present Mailing Address Dependent Information Spouse [4] [5] [6] [7] [8] [9] [10] [11] [12] [14] [15] [16] Address Apartment number City, state postal code, zip code [40] [41] [38] [39] [42] Foreign country name [44] Foreign phone number [47] In care of addressee [48] (*Please refer to Dependent Codes located at the bottom) Care Months*** Dep expenses in Codes paid for First Name[49] Last Name Date of Birth Social Security No. Relationship home * ** dependent [17] [20] [22] [24] [26] [27] [28] [29] [30] [32] [34] [1] [2] [3] [21] [31] [33] Name of child who lived with you but is not your dependent Social security number of qualifying person [50] [51] Dependent Codes *Basic 1 = Child who lived with you **Other 1 = Student (Age 19-23) 2 = Child who did not live with you due to divorce/separation 2 = Disabled dependent 3 = Other dependent 3 = Dependent who is both a student and disabled 4 = Other dependents, but do not qualify for Credit for Other Dependents (ODC) 5 = Qualifying child for Earned Income Credit only 6 = Children who lived with you, but do not qualify for Earned Income Credit 7 = Children who lived with you, but do not qualify for Child Tax Credit 8 = Children who lived with you, but do not qualify for Child Tax Credit/Credit for Other Dependents/Earned Income Credit ***Months 77 = Reported on odd year return 88 = Reported on even year return 99 = Not reported on return GENERAL Form ID: 1040

14 Form ID: Info Client Contact Information 2 Preparer - Enter on Screen Contact Tax matters person (Indicate which spouse handles tax return related questions) (Blank = Both, T = Taxpayer, S = Spouse) Taxpayer address Spouse address [8] [9] [10] Fax telephone number Mobile telephone number Mobile telephone #2 number Pager number Other: Telephone number Extension Preferred method of contact: Taxpayer Spouse [11] [19] [12] [13] [20] [21] [14] [22] [15] [23] [16] [24] [17] [25] , Work phone, Home phone, Fax, Mobile phone, Mobile phone #2 [18] [26] NOTES/QUESTIONS: Form ID: Info

15 Form ID: Bank Direct Deposit/Electronic Funds Withdrawal Information 3 Per IRS Security Summit requirements, verify the name of financial institution, routing transit number, account number, and type of account below. If you would like to have a refund direct deposited into or a balance due debited from your bank account(s), please enter information in the fields below. Note that electronic funds will be withdrawn only from the primary account listed below. Mark to verify all accounts listed below have been reviewed, updated as needed, and are correct. [1] Primary account: Financial institution routing transit number Name of financial institution Your account number Type of account (1 = Savings, 2 = Checking, 3 = IRA*) [3] [4] [5] [6] Mark if married filing jointly and this is a joint account (Both taxpayer and spouse names are on the account) [7] Mark if financial institution is foreign based (Not located in the territorial jurisdiction of the United States) [8] Enter the maximum dollar amount, or percentage of total refund Dollar [9] or Percent (xxx.xx) [10] Secondary account #1: Financial institution routing transit number Name of financial institution Your account number Type of account (1 = Savings, 2 = Checking, 3 = IRA*) [25] [26] [27] [28] Mark if married filing jointly and this is a joint account (Both taxpayer and spouse names are on the account) [29] Mark if financial institution is foreign based (Not located in the territorial jurisdiction of the United States) Enter the maximum dollar amount, or percentage of total refund Dollar [11] or Percent (xxx.xx) [30] [12] Secondary account #2: Financial institution routing transit number Name of financial institution Your account number Type of account (1 = Savings, 2 = Checking, 3 = IRA*) Mark if married filing jointly and this is a joint account (Both taxpayer and spouse names are on the account) Mark if financial institution is foreign based (Not located in the territorial jurisdiction of the United States) Enter the maximum dollar amount, or percentage of total refund Dollar [15] or Percent (xxx.xx) [31] [32] [33] [34] [35] [36] [16] *Refunds may only be direct deposited to established traditional, Roth or SEP-IRA accounts. Make sure direct deposits will be accepted by the bank or financial institution. Refund - U.S. Series I Savings Bond Purchases A tax refund may be used to buy up to $5,000 of U.S. Series I Savings bonds and registered for up to three different persons. If you would like to purchase U.S. Series I Savings bonds (in increments of $50) with your refund, if applicable, please complete the following information. Please note you may enter only one name per registration (with exception of married filing joint returns) and must enter the party s given name, do not use nicknames. Indicate either a maximum dollar amount (up to $5,000), or percentage of refund you would like used to purchase bonds The bonds will be registered to the name(s) on the return. For married filing joint returns this means the bonds will be registered in both names listed on the return. To register the bonds separately, leave these fields blank and use the fields provided below. Enter either a dollar amount or percent, but not both Dollar [13] or Percent (xxx.xx) [14] Bond information for someone other than taxpayer and spouse, if married filing jointly Maximum dollar amount (up to $5,000), or percentage of refund used to purchase bonds Owner s name (First Last) Co-owner or beneficiary (First Last) Mark if the name listed above is a beneficiary Dollar [17] or Percent (xxx.xx) [18] [38] [39] [40] [41] [42] Bond information for someone other than taxpayer and spouse, if married filing jointly Maximum dollar amount (up to $5,000), or percentage of refund used to purchase bonds Dollar or Percent (xxx.xx) Owner s name (First Last) Co-owner or beneficiary (First Last) [43] [45] Mark if the name listed above is a beneficiary [21] [22] [44] [46] [47] Form ID: Bank

16 Form ID: ELF Electronic Filing 6 IRS regulations require paid tax preparers who expect to prepare a certain amount of federal individual tax returns to file them electronically. To comply with this requirement your return will be electronically filed this year if it qualifies for electronic filing under IRS rules. Taxpayers may choose to file a paper return instead of filing electronically. Mark if you want to file a paper return even if you qualify for electronic filing Receive notification(s) when your electronic file is accepted by the taxing agency (Blank = None, 1 = Return, 2 = Return & Extension) If 1 or 2, please provide address on Organizer Form ID: Info Mark if you are filing a balance due return electronically and you want to pay the amount due by debiting your financial institution account [1] [2] [9] The IRS requires a Personal Identification Number (PIN) be used in signing returns that are electronically filed. Each taxpayer and spouse, if applicable, must provide a 5 digit self-selected PIN of your choice other than all zeroes. Taxpayer self-selected Personal Identification Number (PIN) Spouse self-selected Personal Identification Number (PIN) [7] [8] NOTES/QUESTIONS: ELECTRONIC FILING Form ID: ELF

17 Form ID: IDAuth Identity Authentication 7 Taxpayer - Form of identification ( 1 = Driver s license, 2 = State issued identification card, 3 = No applicable identification, 4 = Identification not provided) Identification number Issue date Expiration date (mm/dd/yyyy) Location of issuance (State issued only) Document number (New York only) [1] [2] [3] [4] [5] [6] Spouse - Form of identification ( 1 = Driver s license, 2 = State issued identification card, 3 = No applicable identification, 4 = Identification not provided) Identification number Issue date Expiration date (mm/dd/yyyy) Location of issuance (State issued only) [9] [10] [11] [12] [13] Document number (New York only) [14] NOTES/QUESTIONS: Form ID: IDAuth

18 Form ID: Est Estimated Taxes 8 If you have an overpayment of 2018 taxes, do you want the excess: Refunded Applied to 2019 estimated tax liability Do you expect a considerable change in your 2019 income? (Y, N) If yes, please explain any differences: [52] [53] [54] [55] [56] [57] [58] Do you expect a considerable change in your deductions for 2019? (Y, N) If yes, please explain any differences: [59] [60] [61] [62] [63] Do you expect a considerable change in the amount of your 2019 withholding? (Y, N) If yes, please explain any differences: [64] [65] [66] [67] [68] Do you expect a change in the number of dependents claimed for 2019? (Y, N) If yes, please explain any differences: [69] [70] [71] [72] Mark if you use the Electronic Federal Tax Payment System (EFTPS) to pay your estimated taxes [73] [74] 2018 Federal Estimated Tax Payments 2017 overpayment applied to 2018 estimates Mark if you paid the calculated amounts on the dates due indicated below. Skip the remaining fields. [1] [5] If your estimated payments were not made on the date due or were for an amount other than the calculated amount below, please enter the actual date and amount paid. Date Due Date Paid if After Date Due Amount Paid Calculated Amount 1st quarter payment 4/18/18 [6] [7] 2nd quarter payment 6/15/18 [8] [9] 3rd quarter payment 9/17/18 [10] [11] 4th quarter payment 1/15/19 [12] [13] Additional payment [14] [15] Method* *Method of payment indicated in prior year EFW = Electronic funds withdrawal EFTPS = Electronic Federal Tax Payment System Voucher = Form 1040-ES estimated tax payment voucher NOTES/QUESTIONS: Control Totals PAYMENTS Form ID: Est

19 Form ID: St Pmt 2018 State Estimated Tax Payments 9 Taxpayer/Spouse/Joint (T, S, J) State postal code [1] [2] Amount paid with 2017 return 2017 overpayment applied to 18 estimates Treat calculated amounts as paid [3] [4] [8] Date Paid Amount Paid Calculated Amount 1st quarter payment [9] [10] 2nd quarter payment [11] [12] 3rd quarter payment [13] [14] 4th quarter payment [15] [16] Additional payment [17] [18] 2018 City Estimated Tax Payments City #1 City #2 City name City name Amount paid with 2017 return [31] Amount paid with 2017 return 2017 overpayment applied to 18 estimates [32] 2017 overpayment applied to 18 estimates Treat calculated amounts as paid Treat calculated amounts as paid [28] [50] [36] [58] [53] [54] Date Paid Amount Paid Date Paid Amount Paid 1st quarter payment [37] [38] 1st quarter payment 2nd quarter payment [39] [40] 2nd quarter payment 3rd quarter payment [41] [42] 3rd quarter payment 4th quarter payment [43] [44] 4th quarter payment [59] [60] [61] [62] [63] [64] [65] [66] Calculated Amount 1st quarter payment 2nd quarter payment 3rd quarter payment 4th quarter payment Calculated Amount 1st quarter payment 2nd quarter payment 3rd quarter payment 4th quarter payment City #3 City name Amount paid with 2017 return 2017 overpayment applied to 18 estimates Treat calculated amounts as paid City #4 [72] City name [75] Amount paid with 2017 return [76] 2017 overpayment applied to 18 estimates [80] Treat calculated amounts as paid [94] [97] [98] [102] Date Paid Amount Paid Date Paid Amount Paid 1st quarter payment [81] [82] 1st quarter payment 2nd quarter payment [83] [84] 2nd quarter payment 3rd quarter payment [85] [86] 3rd quarter payment 4th quarter payment [87] [88] 4th quarter payment [103] [104] [105] [106] [107] [108] [109] [110] Calculated Amount Calculated Amount 1st quarter payment 1st quarter payment 2nd quarter payment 2nd quarter payment 3rd quarter payment 3rd quarter payment 4th quarter payment 4th quarter payment Control Totals PAYMENTS Form ID: St Pmt

20 Form ID: W2 Wages and Salaries #1 12 Please provide all copies of Form W Information Prior Year Information Taxpayer/Spouse (T, S) Employer name Were these wages earned for service as: (1 = Minister, 2 = Military, 3 = Farming / Fishing, 4 = National Guard) Mark if this is your current employer Federal wages and salaries (Box 1) Federal tax withheld (Box 2) Social security wages (Box 3) (If different than federal wages) Social security tax withheld (Box 4) Medicare wages (Box 5) (If different than federal wages) Medicare tax withheld (Box 6) SS tips (Box 7) Allocated tips (Box 8) Dependent care benefits (Box 10) Box 13 - Statutory employee Retirement plan Third-party sick pay State postal code (Box 15) State wages (Box 16) (If different than federal wages) State tax withheld (Box 17) Local wages (Box 18) Local tax withheld (Box 19) Name of locality (Box 20) [1] [3] [5] [6] [10] [12] [14] [16] [18] [21] [23] [25] [27] [29] [30] [31] [32] [34] [36] [38] [40] [43] Control Totals Wages and Salaries #2 Please provide all copies of Form W Information Prior Year Information Taxpayer/Spouse (T, S) Employer name Were these wages earned for service as: (1 = Minister, 2 = Military, 3 = Farming / Fishing, 4 = National Guard) Mark if this your current employer Federal wages and salaries (Box 1) Federal tax withheld (Box 2) Social security wages (Box 3) (If different than federal wages) Social security tax withheld (Box 4) Medicare wages (Box 5) (If different than federal wages) Medicare tax withheld (Box 6) SS tips (Box 7) Allocated tips (Box 8) Dependent care benefits (Box 10) Box 13 - Statutory employee Retirement plan Third-party sick pay State postal code (Box 15) State wages (Box 16) (If different than federal wages) State tax withheld (Box 17) Local wages (Box 18) Local tax withheld (Box 19) Name of locality (Box 20) [1] [3] [5] [6] [10] [12] [14] [16] [18] [21] [23] [25] [27] [29] [30] [31] [32] [34] [36] [38] [40] [43] Control Totals Form ID: W2

21 Form ID: B-1 Interest Income 13 Please provide copies of all Form 1099-INT or other statements reporting interest income. *Whole numbers will be treated as $ amounts. Enter percentages in the XXX.XX format. For example, enter 100% as or 75.5% as Type Interest [1] Tax Exempt Penalty on U.S. Obligations* Tax Exempt* Foreign Taxes T/S/J Code (**See codes below) Income Income Early Withdrawal $ or % $ or % Paid Prior Year Information Blank = Regular Interest 3 = Nominee Distribution **Interest Codes 4 = Accrued Interest 5 = OID Adjustment 6 = ABP Adjustment 7 = Series EE & I Bond Control Totals Form ID: B-1

22 Form ID: B-2 Dividend Income 14 Please provide copies of all Form 1099-DIV or other statements reporting dividend income. *Whole numbers will be treated as $ amounts. Enter percentages in the XXX.XX format. For example, enter 100% as or 75.5% as T Total U.S. Foreign S Type Ordinary [2] Qualified Cap Gain 28% Tax Exempt Obligations* Tax Exempt* Taxes Prior Year J Code (**See codes below) Dividends Dividends Distributions Section 1250 Sec Capital Gain Dividends $ or % $ or % Paid Information **Dividend Codes Blank = Other 3 = Nominee Control Totals Form ID: B-2

23 Form ID: D Sales of Stocks, Securities, and Other Investment Property 17 Please provide copies of all Forms 1099-B and 1099-S Did you have any securities become worthless during 2018? (Y, N) Did you have any debts become uncollectible during 2018? (Y, N) Did you have any commodity sales, short sales, or straddles? (Y, N) Did you exchange any securities or investments for something other than cash? (Y, N) T/S/J Description of Property [1] Date Acquired Date Sold Gross Sales Price (Less expenses of sale) Cost or Other Basis [8] [9] [10] [12] Control Totals Form ID: D

24 Form ID: Income Other Income Information Prior Year Information State and local income tax refunds [1] Taxpayer Spouse Alimony received [3] [4] Unemployment compensation [8] [9] Unemployment compensation federal withholding [8] [9] Unemployment compensation state withholding [8] [9] Unemployment compensation repaid [11] [12] Alaska Permanent Fund dividends [17] [18] Self- Employment Income? T/S/J (Y, N) 2018 Information Prior Year Information Other income, such as: Commissions, Jury pay, Director fees, Taxable scholarships [14] NOTES/QUESTIONS: Control Totals Form ID: Income

25 Form ID: SSA-1099 Social Security, Tier 1 Railroad Benefits Please provide a copy of Form(s) SSA-1099 or RRB Taxpayer/Spouse (T, S) State postal code [1] [2] Social Security Benefits If you received a Form SSA , please complete the following information: Net Benefits for 2018 (Box 3 minus Box 4) (Box 5) Voluntary Federal Income Tax Withheld (Box 6) From the DESCRIPTION OF AMOUNT IN BOX 3 area of Form SSA-1099: Medicare premiums Prescription drug (Part D) premiums 2018 Information [8] [10] [12] [14] Prior Year Information Tier 1 Railroad Benefits If you received a Form RRB , please complete the following information: Net Social Security Equivalent Benefit: Portion of Tier 1 Paid in 2018 (Box 5) Federal Income Tax Withheld (Box 10) Medicare Premium Total (Box 11) 2018 Information [22] [25] [27] Prior Year Information Additional Information About Benefits Received Additional information about the benefits received not reported above. For example did you repay any benefits in 2018 or receive any prior year benefits in This information will be reported in the SSA-1099 DESCRIPTION OF AMOUNT IN BOX 3 area or in the RRB-1099 Boxes 7 through 9. [40] [41] [42] [43] [44] NOTES/QUESTIONS: Control Totals Form ID: SSA-1099

26 Form ID: IRA Traditional IRA Taxpayer Are you or your spouse (if MFJ or MFS) covered by an employer s retirement plan? (Y, N) Do you want to contribute the maximum allowable traditional IRA contribution amount? If yes, enter the applicable code: (1 = Deductible only, 2 = Both deductible and nondeductible) Enter the total traditional IRA contributions made for use in 2018 Spouse 26 [1] [2] [3] [4] [5] [6] Taxpayer Enter the nondeductible contribution amount made for use in 2018 Enter the nondeductible contribution amount made in 2019 for use in 2018 Traditional IRA basis Value of all your traditional IRA s on December 31, 2018: Spouse [11] [12] [13] [14] [15] [16] [17] [18] Roth IRA Please provide copies of any 1998 through 2017 Form 8606 not prepared by this office Taxpayer Mark if you want to contribute the maximum Roth IRA contribution [27] Enter the total Roth IRA contributions made for use in 2018 Enter the total amount of Roth IRA conversion recharacterizations for 2018 Enter the total contribution Roth IRA basis on December 31, 2017 Enter the total Roth IRA contribution recharacterizations for 2018 Enter the Roth conversion IRA basis on December 31, 2017 Value of all your Roth IRA s on December 31, 2018: [47] Spouse [28] [29] [30] [37] [38] [41] [42] [43] [44] [45] [46] [48] NOTES/QUESTIONS: Control Totals Form ID: IRA

27 Form ID: OtherAdj Other Adjustments 51 Alimony Paid: T/S/J Recipient name Recipient SSN 2018 Information Prior Year Information [1] Address Address Address Educator expenses: Other adjustments: 2018 Information Prior Year Information Taxpayer Spouse [3] [6] [4] [7] NOTES/QUESTIONS: Control Totals Form ID: OtherAdj

28 Form ID: A-1 Schedule A - Medical and Dental Expenses 57 T/S/J 2018 Information Prior Year Information Medical and dental expenses, such as: Doctors, Dentists, Hospital/nursing home fees, Lab/x-ray fees, Medical supplies, Hearing aids, Eyeglasses/contact lenses, and Insurance reimbursements received [1] [2] Medical insurance premiums you paid: [4] [5] Long-term care premiums you paid: [7] [8] Prescription medicines and drugs: [10] [11] [13] Do not include pre-tax amounts paid by an employer-sponsored plan or amounts entered elsewhere, such as amounts paid for your self-employed business (Sch C, Sch F, Sch K-1, etc.) or Medicare premiums entered on Form SSA Do not include pre-tax amounts paid by an employer-sponsored plan or amounts entered elsewhere, such as amounts paid for your self-employed business (Sch C, Sch F, Sch K-1, etc.) Miles driven for medical items [14] Schedule A - Tax Expenses T/S/J [18] State/local income taxes paid: 2017 state and local income taxes paid in 2018: [21] [22] Real estate taxes paid: [24] [25] Personal property taxes: [27] [28] Other taxes, such as: foreign taxes and State disability taxes [30] [31] Sales tax paid on major purchases: [36] [37] Sales tax paid on actual expenses: [39] [40] 2018 Information [19] Prior Year Information Control Totals Form ID: A-1

29 Form ID: A-2 Interest Expenses 58 T/S/J [1] Home mortgage interest: From Form Interest Paid [2] 2018 Points Paid 2018 Type* Mortgage Ins. Premiums Paid Prior Year Information Blank = Used to buy, build or improve main/qualified second home *Mortgage Types 1 = Not used to buy, build, improve home or investment T/S/J Payee s Name Other, such as: Home mortgage interest paid to individuals SSN or EIN 2018 Information Prior Year Information [4] Address City, state and zip code Address City, state and zip code [5] T/S/J Name and address of other person who received Form 1098 for jointly liable mortgage interest you paid - s/borrower s name Street Address City/State/Zip code Refinancing Points paid in Taxpayer/Spouse/Joint (T, S, J) Recipient/Lender name Total points paid at time of refinance Points deemed as paid in 2018 (Preparer use only) Date of refinance Term of new loan (in months) Reported on Form 1098 in 2018 [7] [11] [12] Taxpayer/Spouse/Joint (T, S, J) Recipient/Lender name Total points paid at time of refinance Points deemed as paid in 2018 (Preparer use only) Date of refinance Term of new loan (in months) Reported on Form 1098 in 2018 T/S/J [15] Investment interest expense, other than on Schedule(s) K-1: 2018 Information [16] Control Totals Form ID: A-2

30 Form ID: A-3 T/S/J Contributions made by cash or check (including out-of-pocket expenses) [2] [3] Volunteer miles driven Noncash items, such as: Goodwill/Salvation Army/clothing/household goods Charitable Contributions 59 [5] [6] [8] **Mark if qualifying disaster relief contribution made in 2018 for relief efforts in the California wildfire disaster area Qual Disaster Relief** 2018 Information Prior Year Information Any contribution of cash, a check or other monetary gift requires a written record of the contribution in order to claim the contribution on your return. Individual contributions of $250 or more must be accompanied by a written acknowledgment from the charity to claim the contribution on your return. [9] Miscellaneous Deductions T/S/J 2018 Information Prior Year Information Other expenses, not subject to the 2% AGI limit: [12] [13] Gambling losses: (Enter only if you have gambling income) [15] [16] NOTES/QUESTIONS: Control Totals Form ID: A-3

31 Form ID: A-St Miscellaneous Itemized Deductions (State Use Only) 59a Complete the information below only if you file a state return in AL, AR, CA, HI, IA, MN, NY or PA. entered here will be used to calculate your state return, but will be ignored for federal return purposes, as the deductions are not allowed. T/S/J 2018 Information Prior Year Information Unreimbursed expenses, such as: Uniforms, Professional dues, Business publications, Job seeking expenses, Educational expenses [1] [2] Union dues, other than amounts reported on Form W-2: [4] [5] [7] Tax preparation fees [8] Other expenses, subject to 2% AGI limit, such as: Legal/accounting/custodial fees [10] [11] [13] Safe deposit box rental [14] Investment expenses, other than on Schedule(s) K-1 or Form(s) 1099-DIV/INT: [16] [17] NOTES/QUESTIONS: Control Totals Form ID: A-St