Happy New Year! We would like to wish you and your family health, happiness and increased prosperity throughout It s also tax time again!!!

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1 Dear Valued Client: Happy New Year! We would like to wish you and your family health, happiness and increased prosperity throughout It s also tax time again!!! As you may know we are undergoing internal and external renovations. Exciting!!! In this process we kindly appreciate your patience and will continue to offer our prestige services as we have since Please disregard any financial institutions such as H&R Block, Jackson Hewitt, Tax Services R US, etc... With efforts to gain your business while we gear up for 2017 we will continue to earn your business same as always! Including same phone number, same fax, same , same website, same improving GF!!! Many of you may have received your W 2 s by now, but if not... NO PROBLEM. If you do not receive your W 2 s by January 31, 2017, please retain your last paycheck stub issued in 2016 to expedite the filing process. Please review checklist and fill out the forms included to assist you in gathering tax sensitive information. Otherwise, I look forward to hearing from you sometime this tax season. As you know, helping those with prior/present tax issues is our specialty, so please pass along our business information so that friends, family and associates may benefit from our reliable services. We will continue to show our appreciation by compensating you for your referral business. Many blessings in the coming year!! Sincerely, GF Team Midway Rd., Suite120,Addison, TX (866) toll free phone fax contactus@griggsfinancial.com

2 Phone: Alt Phone: Toll Free: Midway Rd., Suite 120 Addison, TX Personal Information Fax: Alt. Fax: Are you currently active duty military? YES NO Are you currently serving as military reservist? YES NO Please circle one: Can Be Claimed Single Head of Houshold Married Married Filing Separetly Qualifiying Widow/Widower Name Soc. Sec. No. or ITIN No. Date of Birth Cell Phone TAXPAYER Occupation DL. Num. State DL. Issue Date DL. Exp Date MAILING ADDRESS (NO P.O. Box) City, State, Zip Code, County If married filing separately, spouse's information must be provided Name Soc. Sec. No. or ITIN No. Date of Birth Cell Phone SPOUSE Occupation 2. Dependents (Children & Others) DL. Num. State DL. Issue Date DL. Exp Date Name (First, Last) Relationship (son, step child,parent,etc) Social Security No. or ITIN No. Date of Birth Full Time College Student Health Insurance YES/NO 3. Health Insurance Do you have health Insurance in 2016? YES NO If NO, please initial here (spouse) At any time during the tax year did you have health insurance through the MARKETPLACE, even for 1 month: YES If you had insurance but were NOT covered the entire year, please circle the month of coverage NO JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC Referred By: (Applies only if you are a NEW CLIENT) Please answer the following questions to determine maximum deductions 1 Did you have any side jobs, odd jobs, hobbies and/or additional income during the No year, regardless if you were compensated or not? Did you receive any MISC's forms? Please elaborate: 2 Did you go through bankruptcy proceedings? No If so, year and type (2A.) Are you planning on or in the process of filing bankruptcy? No 3 Did you have any unreimbursed employee expenses? No

3 Phone: Alt Phone: Toll Free: Midway Rd., Suite 120 Addison, TX Fax: Alt. Fax: Did you have major expenses (medical, home, property damage)? No 5 Have you made any withdrawwals from your 401K, IRA or any retirement plan? No If YES, please indicate reason for early withdrawl) 6 Are you a Home Owner? No 7 Are you in the process or do you plan on buying or refinancing a home within the No next 1-3 years? 8 Are you in the process or plan on applying for any type of Financial Loan? No Purpose of loan 9 Do you OWE the IRS, levies, student loans, child support, other financial No institution,etc.? If so, please indicate amount owed & to whom; 9b. Do owe another tax companyand or any refinanced loans, etc.? No 10 Did you receive Disability Payments or unemployment Compensation? 11 What was your 2015 AGI (Adjusted Gross income) or PIN# ( Applies only if you are a NEW CLIENT) Taxpayer AGI Spouse AGI or PIN# or PIN#. Disclaimer By the signature(s) below, I acknowledge the information enclosed in this client information sheet is correct and includes all income, deductions, other information necessary for my express consent to have. Services (Preparer) assist in submitting my 2016 federal and state income tax return. I understand that Preparer "cannot guarantee" the amount, date or receipt of my refund once in the hands of the appropriate taxing authority. I understand that Preparer does not audit my return. I further understand that any refund due to me may be reduced or consumed by any claimed or existing indebtedness I may have to the Internal Revenue Services (IRS) or other collecting authorities. I authorize Preparer to assist and submit my return based solely upon the information that I provide and I certify that all the information provided to Preparer is accurate to the best of my belief. In addition to fees rendered to Preparer consulting, assisting, providing audit assistance, plan options; I the acknowledge and consent to various use of online software, tax forms, publications, and any other outsource that I and Preparer find necessary. Taxpayer Date Spouse Please list below other individuals that we can assist with their tax preparation and YOU can earn extra cash this Summer!!, anyone YOU refer and has their tax preparation done with. will earn YOU extra cash. Don't miss out!!!!! Date Name: Name: Name: Phone/ Phone/ Phone/

4 Income Summary TaxPayer: Social Security: Please fill out and initial every form you are providing us with to file your 2016 Tax Return. All W-2 Information Company Name Employer ID Year Box 1 Box 2 Box 18 Box 19 Initial All 1099 Information Company Name Employer ID Year Box 3 Box 4 Box 18 Box 19 Initial All Additional Income Company Name Employer ID Year Annual Income Initial 1 2 Verified By: Date: Prepared by Griggs Financial [Date] Page 1

5 Tax Preparation Checklist Tax Preparation for Personal Information The IRS needs to know who is filing the tax return, as well as how many people are covered on it. To make this easy, they require: Your Social Security number Your spouse s Social Security number (if married) Social Security numbers for any dependents Tax Preparation for Income Information The following documents will help you prepare all the income information that you need to file a federal tax return: W 2 Forms from all employers you (and your spouse, if filing a joint return) worked for during the past tax year Forms if you (or your spouse) completed contract work and earned more than $600. Investment income information (including: interest income, dividend income, proceeds from the sale of bonds or stocks, and income from foreign investments). Income from local and state tax refunds from the prior year. Business income (accounting records for any business that you own) Unemployment income Rental property income Social Security benefits Miscellaneous income (including: jury duty, lottery and gambling winnings, Form 1099 MISC for prizes and awards, and Form 1099 MSA for distributions from medical savings accounts) Tax Preparation for Income Adjustments The following adjustments can help reduce how much you owe in taxes, and in turn, increase your chance of receiving a tax refund: Homebuyer tax credit Green energy credits IRA contributions Mortgage interest Student loan interest Medical Savings Account (MSA) contributions Self employed health insurance Moving expenses Midway Road Phone: Fax: Suite 120 Alt. Phone: Alt. Fax: Addison, Texas Toll Free: Alt Fax: Website: contactus@griggsfinancial.com

6 Tax Preparation for Credits and Deductions There are many tax credits and tax deductions for various expenses, which are designed to help lower the amount of tax that an individual has to pay: Education costs Childcare costs Adoption costs Charitable contributions/donations Casualty and theft losses Qualified business expenses Medical expenses Job and moving expenses Tax Preparation for Direct Deposit Are you interested in having your tax refund directly deposited into your bank account? If so, you will need to provide two things: Your bank account number The bank s routing number Midway Road Phone: Fax: Suite 120 Alt. Phone: Alt. Fax: Addison, Texas Toll Free: Alt Fax: Website: contactus@griggsfinancial.com

7 Personal Living Expenses Use this worksheet to calculate your monthly or annual expenses Tax Year Average Monthly or Annual Personal Livingxd3 Expenses Item: Cost or Aannual Household Rent (Not Mortgage) Utilities Water & Sewer Gas/Electric Waste Disposal Phone Cable Internet Home Maintenance Security System Lawn Maintenance Home Improvements Pool Maintenance Pest Control Automobile Gas and Oil Repairs License Fee Parking and Tolls Cleaning Car Rental Car Payment Clothing Uniforms Specific Work Attire Dry Cleaning Safety Equipment Repair Child Expenses Daycare/Babysitter Tuition/School Books Entertainment Travel Meals Hobbies

8 Personal Living Expenses Food Groceries Lunch Contributions Church Tithes Donation other than cash Donation other than cash valued over $500 Please provide receipt(s) Household Items Please provide receipt(s) Medical/Dental Expenses Out of Pocket Deductibles Insurance Premiums Prescribed Medicines Doctor's Visit Mileage Insurance Premiums Life Medical Auto Disability Home Owners Mortgage (MIP) Taxes Property (Residence(s)) Real Estate Other Interest Mortgage Interest Student Loan Miscellaneous Job dues Periodicals Job Related Education Job Related Relocation Reservist Travel Expenses Alimony Payment Other: TOTAL $ - $ -

9 14665 Midway Road Suite 120 Addison, TX Self-Employed Business Expenses Tax Year Use this worksheet to calculate your monthly or annual expenses Average Monthly or Annual Overhead Expenses Item: Rent or Mortgage Payment Utilities Phone Lines (Landline, Cell, FAX, Internet) Phone Charges (Tollfree, Long dx, Voice Mail, Cell, Pager) Repair and Maintenance Payroll (Taxes, Payroll Services, etc.) Benefits (Health Insurance, Retirement, etc.) Independent Contractors Equipment (Lease/Purchase, Maint., Repairs, Depreciation) Office Supplies Postage and Delivery Janitorial Licenses and Permits Legal Fees Accounting and Other Professional Fees Insurance (Workers Compensation, Liability, etc.) Parking Fees and Tolls Business Insurance Bank Charges Credit Card Processing Fees Loan Repayment (Principal and Interest) Bad Debt/Collection Fees Business Travel, Meals and Entertainment Vehicle Expense Dues and Subscriptions Marketing and Advertisement Business Related Education Expense Cost Automobile Expenses (If you deduct expenses you cannot deduct mileage.) Please include so we may determine the best deduction. Gasoline and Oil Repair and Maintenance Car Wash Auto Insurance Registration Loan Interest (If you deduct miles you cannot deduct actual expense.) Please include so we may determine the best deduction. Odometer Reading as of January 1st Odometer Reading as of December 31st Total Miles Driven Business Miles During this Period Vehicle Year Make Model Is the Vehicle a Purchase or a Lease (Check One Please) Miscellaneous TOTAL $ -

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