"Foreign" or "abroad" means only any country outside the USA, and does not include the USA.

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Chester Rice
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1 TAX CLIENT QUESTIONNAIRE: FORM 1040 INDIVIDUAL TAX RETURN - (i.e. NOT for Partnerships, S Corps, C Corps, Estates nor Trusts) For Tax Year(s): Instructions: Keep in mind that questions below a section heading pertain to that heading, so answer accordingly. Please answer the questions as best you can and make notes of anything you feel needs further discussion or add a question you need answered. Terms: "You" can refer to anyone being included on your tax return: yourself, your spouse, or a dependent. "Foreign" or "abroad" means only any country outside the USA, and does not include the USA. Currencies: Please leave amounts in their original currency, noting which currency it is (MXN, USD, EUR, etc.). I will use either the x-rates.com rate or the IRS safe harbor rate (whichever is to your benefit) for the tax return. However, if you insist on using your own rate, please provide the rate and the source for it. Special Circumstances: If you have a small business (including abroad), a home office, were employed outside the USA, had a rental property, capital gains/losses, foreign financial income, or foreign mutual funds, then you will have additional information I will need. You will find worksheets on the website (taxesabroad.com) to help you organize the information needed. You will also find ideas for these special circumstances at the end of this questionnaire. Providing complete information speeds up the preparation of your return. New Clients: After completing this questionnaire and gathering relevants documents for your "yes" answers, please contact my assistant Paul: paul@taxesabroad.com or Bring the following items to your appointment: 1) completed questionnaire and all documents pertaining to your "yes" answers, 2) Passport(s) or other ID, 3) retainer of USD200 (by cash or US check, if paying in pesos use the x-rates.com rate on date of payment), 4) most recent filed return, and 5) a signed Engagement Agreement, if you wish me to begin working on your return promptly. Returning clients: After completing this questionnaire and gathering relevant documents for your "yes" answers, please deliver to my office by appointment or to my La Conexion box 558 at Monet Café. After reviewing the information, I may determine that an appointment is needed and will contact you. Foreign information: While you may be familiar with the many tax-related documents issued within the US by employers and banks, such as W-2's and Forms 1099, foreign institutions do not issue these. You will need to gather similar information yourself. For example, to obtain bank interest, you will need to request a Constancia (or Resumen) Fiscal from a Mexican bank or brokerage, which will report the total interest earned and the Mexican tax withheld on it. Section 1: Basic Information: Taxpayer name: Date of Birth: Tax ID number (SSN/ITIN): Citizenship(s): Taxpayer's address: Blind? (Y/N) Occupation: Cell phone number:

2 Spouse's name: Date of Birth: Tax ID number (SSN/ITIN): Citizenship(s): Spouse's address: Blind? (Y/N) Occupation: Cell phone number: Residence Address: Mailing Address: Wish to file jointly, if of benefit? Y N Is the taxpayer or spouse eligible to be claimed as a dependent on another's return? Y N Assumptions: I will make the following assumptions unless you state otherwise here: 1) you wish to contribute to the Presidential Campaign Fund and 2) you wish tax agencies to contact me as a third party designee with any questions regarding your return. If not your wishes, please note here: Section 2: Dependents: To claim someone as a dependent, you must pay at least 50% of their living expenses and the dependent's income (excluding Social Security) must be less than their exemption amount. Remember: A dependent doesn't have to be a family member, if the person lives with you. A family member may be a dependent, even if not living with you. Section 3 - Estimated Tax Payments Already Made Please provide amounts and dates of any estimated tax payments you sent to the IRS. Do NOT include federal tax withheld which is already reported on a Form 1099, W-2, etc. Payment Date Payment Amount To Apply to Which Tax Year? Section 4 - Payments, Refunds, Automatic Withdrawals & Deposits It is more secure to handle tax payments and refunds by automatic withdrawals and deposits from a bank account, than by paper checks. I can set up such transactions when e-filing the return. To do so, please provide your bank information:

3 Bank Name: Routing Number (9 digits): Account number: Do you wish me to set up estimated tax payments for the current tax year? Y N If yes, please complete the bank information above. If you do not wish me to set up such payments, but you expect to owe taxes, how will you make the payment? IRS Direct Pay; an On-line Payment Service, such as OfficialPayments.com or PayUSATax.com; EFTPS (via IRS); or Snail-mailed check Section 5 - Tax Home & State Returns Tax Home: Your tax home is your "regular place of business" and may or may not be the same as your residence. Your tax home includes the city/area in which your business or work is located. If you have more than one regular place ofo business, your tax home is your main place of business. To determine your tax home consider: 1) the total time you ordinarily spend in each place and 2) how much business you have in each place. Where is your tax home? and on what date did you establish it? State-source Income: If you resided in a state, then you may need to file a state return. Also, if you may have income which is tied to a specific state, such as a rental property, you may need to file a tax return to report such income to the state where the rental is located. Note that pension income is not considered tied to the state where you earned the original income. So, if you have pension income and no longer live in the state where you earned that pension, then please 1) contact the pension issuer to stop state tax withholdings immediately and 2) file a return to get a refund of any taxes you paid after moving from that state. Section 6 - Carryovers There are many reasons why information from one year's tax return may carryover to another year's: capital losses, depreciation expenses, foreign tax credits, net operating losses (NOL's), and unused charitable donations or home office expenses. If I prepared your return for a previous tax year, then I already have this information. As a new client, however, this information may not be included on a prior year's tax return, but would have been recorded by your previous tax preparer in separate documentation. Please obtain this information to ensure your lowest tax obligation. What carryovers do you believe you may have? Section 7 - Foreign Financial Accounts, Gifts, Bequests If you are a signatory authority on any non-usa account, whether it is your own or belongs to some one else, then you may have a disclosure requirement, which the US takes seriously (USD 10,000 minimum penalty for any failure in reporting). The rules determining whether a disclosure is necessary and what needs to be disclosed are complex. In the past I have tried to assess this through questions here, but this year I am simplifying my questions and directing you to fill out the Foreign Financial Accounts Information Sheet from the taxesabroad.com website, if you have ANY foreign account for any "yes" answer here.

4 a. Did you have a signatory authority over any foreign (non-usa) financial account during the tax year? Y N "Signatory authority" means that if you sign a document or go to the financial institution, they will act on what you request. b. Did you earn any income from any of your foreign accounts, such as interest, dividends, or have capital gains/losses during the tax year? Y N Please provide a Constancia (or Resumen) Fiscal for every Mexican account you have, even if you think you do not earn interest (or provide a document that confirms you do not earn interest). The Constancia Fiscal report will provide the total interest and/or dividends and the Mexican tan withheld on that income. For capital gains and losses, you will need to provide original purchase information and subsequent sales information so that the gain or loss can be calculated (dates, shares, share price at time of purchase and sale). Did you receive any significant gift or bequest from a foreigner (non-us person) during the tax year? Y N Section 8 - Affordable Care Act and other Healthcare Insurance If you resided in the USA during the tax year for more than 30 days, did you have ACA-compliant healthcare insurance? Y N If yes, then please provide the Form 1095 for it. What dates did you reside in the USA? FYI, Foreign health insurance is not ACA compliant, but it can qualify as self-employment insurance if you are self-employed. Memberships like SkyMed do not qualify as health insurance. If you resided in a foreign country, did you incur healthcare insurance costs? Y N If yes, then please provide the amount you paid for such insurance during the tax year, but do not include amounts already provided on your SSA-1099 from Social Security and/or Forms 1095 (to avoid double counting this insurance cost). If I have prepared your return in the past, and nothing has changed with your sources of income, deductions, or filing status, you can stop here. However, if you have had changed from the prior year's return, please complete the following sections to help ensure your return is complete and accurate. Thank you. If you are a new client, please complete the rest of this questionnaire. Thank you. Section 9 - Sources of Income a. Wages, salaries, and other employment compensation (not self-employment): Y N While in the USA? Y N While abroad? Y N b. Self-employment/contractor income: Y N While in the USA? Y N While abroad? Y N EIN (if any): Business description: Please complete the Business Worksheet (taxesabroad.com). c. State government income (like a state tax refund or unemployment compensation)? Y N

5 d. Social Security? Y N If you have not received your SSA-1099, you may be able to download from ssa.gov. e. Retirement plan lump-sum payment? Y N f. Pension and/or IRA distribution? Y N g. Disability payments? Y N h. Alimony? Y N i. Farm operation income? Y N Tenant farm? Y N j. Property rental income? Y N Real property (eg. house)? Y N Personal property (eg. car)? Y N Please complete the Rental Worksheet (taxesabroad.com) k. Passive income such as interest or dividends? Y N Do you have a Form 1099? Y N Interest received from a personal loan? Y N If you have such income from a foreign source, please let me know. l. Schedule K-1 income from a partnership, S Corp, Estate or Trust? Y N m. Any foreign income from a foreign partnership, corporation, or other foreign entity? Y N n. Royalties? Y N Were they for creative work? Y N Or from oil/gas/minerals? Y N o. Gambling winnings? Y N Did you track your losses? Y N p. Forgiven debts? Y N Please provide Form 1099-A or 1099-C, if received. Section 10 - Capital Gains or Losses a. Did you sell or otherwise dispose (eg. donated, trashed) of items previously depreciating? Y N b. Did you sell passive investments (eg. Stocks, mutual funds)? Y N c. Did you sell real property? Y N Was property a rental or farm at any time you owned it? Y N Were the sale proceeds received in more than two calendar years? Y N Was it your residence for at least 2 of the last 5 years before the sale? Y N Please provide information as specified under "Special Circumstances." d. Did you sell a business? Y N e. Was any sale part of a bartering agreement? Y N f. Did you sell any business equipment/property? Y N Section 11 - Itemized Deductions a. Property taxes (foreign property tax counts)? Y N b. Mortgage interest? Y N c. Employment/Job-related expenses not reimbursed by employer? Y N d. Educator expenses (eg. Books or classroom supplies) not reimbursed by school? Y N e. Personal vehicle mileage not reimbursed by employer (commuting miles don't count)? Y N f. Job search expenses (only for same job-related education, not a new job)? Y N g. Moving expenses when moving to new job site? Y N Please provide mileage between original location and new location, as well as the moving costs and travel expenses. h. Significant unreimbursed medical costs? Y N Please break down by doctor, hospital, meds, lab work, equipment, eyeglasses, etc. Don't forget to include related mileage. i. Long-term health care premiums? Y N j. HSA, FSA, or Archer MSA? Y N Please provide related documents. k. Caregiver costs? Y N In addition to the cost, if the caregiver is a US person, then provide completed Form W-9. l. Healthcare insurance premiums? Y N Please provide any Form 1095's you receive. m. Charitable donations? Y N Please provide donation amounts for each charity. If tangible property was donated, please provide list of items donated with values.

6 n. Investment Expenses (not reported on 1099, such as storage costs)? Y N o. Hobby Income? Y N A hobby is an activity from which you earn income, but you do not expect to make a profit (i.e. not a business). Please provide income and expense information. Section 12 - Education Deductions a. Any qualified post-secondary education tuition and related expenses? Y N b. Did you cash any US EE or I bonds to pay for post-secondary education expenses? Y N c. Education loan interest? Y N Please provide Form d. Withdrawals from a 529 Plan or other education savings account? Y N Section 13 - Other Deductions a. Home office when employed or self-employed? Y N Must be used exclusively for business. May include storage space. Please fill out a business worksheet which includes home office b. Theft loss? Y N For each item stolen, please provide original purchase information, value at time of theft, any insurance claim payment received. If a Ponzi scheme loss, please let me know. c. Casualty loss (from earthquake, flood, etc.)? Y N For each item lost, please provide original purchase information, value at time of loss, any insurance claim payment received. d. Child adoption expenses? Y N e. Pet fostering expenses? Y N When you foster a pet for a charitable organization, but do not have costs reimbursed by that organization, you can deduct costs for which you have receipts. f. Childcare costs to allow you to work (Day camp counts)? Y N Section 14 - Other Reportable Events a. Did your child earn interest or dividend income between $950 - $9500 that you will claim on your return? Y N b. Did you make gifts (in cash or tangible items) that exceeded a value of USD 14,000 to one individual? Y N Please provide the gift receiver's name, SSN, address and cash amount and item(s) with value. c. Did you have any household employees who were US persons to whom you paid more than USD 1000? Y N Please provide each person's Form W-9 and the amount paid. d. Did you suffer any personal bad debts? Y N Please provide the name, SSN, address of the person who failed to pay you and the amount they failed to pay. e. Did you pay foreign taxes on any income? Y N Was the income earned (work) or passive (investments, rental)? IVA/VAT is not deductible as a personal income tax, but may be as a payroll tax or asset/expense cost for a rental or business. f. Any other transaction you believe may be deductible or earn you a credit of some kind? Y N Please explain in space provided below. Questions, notes or other matters not covered:

7 Special Circumstances (if applicable to you, please provide detailed information using a worksheet from taxesabroad.com or on a separate sheet): Sole Proprietorship or Hobby: Please provide details for income and expenses; costs of goods sold; product inventory; vehicle information, expenses, and mileage; assets purchased (item description, date of purchase, date of first service, cost or FMV on date of date). Home office (for business or rental): Please provide square footage of office/storage space(s) and total home. List home costs which relate to this space, such as utilities (including drinking water), property tax, home repairs, cleaning service, gardening service, and other maintenance costs. If a repair included or was exclusive to the office space, please provide further details. Also, provide the date you first began using the home office. If you own your home and wish to depreciate the office portion, please provide original purchase price, any improvement costs prior to the home office, any current year improvements. Foreign-earned income: Please provide the year you last filed form 2555, country of residence and date you began such residence, whether you rent or own your home, if you have a house in the USA (and whether it is occupied), citizenship and/or US green card, type of visa in the foreign country where you live and work, dates you spent in the USA and which of those were workrelated, employer's US and foreign business addresses, whether your employer is a foreign entity or branch of a US company, whether you are self-employed or employed, and any other relevant information. Rental income property: Please provide the address of the property, type of rental (house, condo, self-storage unit, etc.), rental income and expenses, travel costs to monitor the rental, rentalrelated travel dates, purchases of assets and improvements (date and costs), prior depreciation schedule. Some expenses to keep in mind: mortgage interest, property insurance, property taxes, homeowner fees, cleaning & maintenance costs, management fees and commissions. Capital gains and losses: If you do not receive a Form 1099 for the sale of a capital asset, such as when you sell real property, a foreign stock or mutual fund, then to report the sale, please provide date of purchase, number of shares (if relevant), description of share/asset, purchase price including any purchase cost, sales date, sales costs/fees, and sale proceeds. For some assets like a home or business equipment, a sales or depreciation summary could be needed, too. Foreign mutual funds or ETFs (Passive Foreign Investment Companies): The special rules for these type of investments are complex and the taxes can be punitive by taxing unrealized gains at the highest tax rate (currently 39.6%). Fore these investments, please provide the most recent four years of information: purchase dates, number of shares, prices, and sale information, as well as end of the year balances of these type of investments. If the sum at the end of the year was less than USD 25,000 in value, then this PFIC reporting will not be required.

INDIVIDUAL TAX ORGANIZER & ENGAGEMENT LETTER 2017 FORM 1040

INDIVIDUAL TAX ORGANIZER & ENGAGEMENT LETTER 2017 FORM 1040 This organizer is designed to assist you in gathering the information required for preparation of your individual income tax returns. Please