Tax Year Dear Client:

Transcription

1 Tax Year 2016 Dear Client: This letter is to confirm our understanding of the terms and objectives of our tax services engagement and to clarify the nature and limitations of the tax services to be provided. We will prepare the federal and state individual income tax returns. It is your responsiblity to provide us with all the information necessary for the preparation of complete and accurate income tax returns. Your information must be supported by documentation. Estimation of expenses will not meet the requirements. Our fees for the tax services will reflect our standard hourly rates for the time spent, plus outofpocket expenses including computer processing charges. Your returns are subject to examination by the taxing authorities. In the event of an audit, you may be requested to produce documents, records, or other evidence to substantiate the items of income and deduction shown on a tax return. If an examination occurs, we will represent you if you so desire; however, these additional services are not included in our fee for preparation of you returns. We are available to provide you with tax planning advice when you specifically request it. If, during our work we discover information affecting your prior year tax returns, we will make you aware of the facts. However, we cannot be responsible for identifying all items that may affect prior year returns. If you become aware of such information during the year, please contact us to discuss the best resolution of the issue. Sincerely, Kelly, Noland + Ducote Certified Public Accountants

2 TAYPAYER SPOUSE Please attach a copy of your driver s license. Circle one: Attached Not available License number: Issue date (mmddyyyy): Expiration date (mmddyyyy): Location of issuance: Document number (NY only): Please attach a copy of your driver s license. Circle one: Attached Not available License number: Issue date (mmddyyyy): Expiration date (mmddyyyy): Location of issuance: Document number (NY only): TAX DATA SHEET 2016 Fill in NAME & CHANGES from prior year. Taxpayer Name Spouse Name SSN SSN Date of Birth Date of Birth Occupation or Retirement Date Occupation or Retirement Date Address Preferred Phone City, State & Zip Cell Parish Home Dependents: Relationship Number of Months lived with you Name SSN and Date of Birth If you have a refund, do you want to use "Direct Deposit?" If Yes: Routing # Yes No Circle Checking or Savings Account # _ *Louisiana will issue a debit card for refunds not marked to direct deposit. (PLEASE ATTACH VOIDED CHECK) INCOMEAttach Support Documents Please Check Items Attached W2'S Rental Income & Expenses Interest 1099 INT Stock Sales Dividend 1099 DIV Retirement 1099 R (You must provide Date of Purchase & Purchase Price) Oil & Gas 1099 MISC Alimony Paid and Received Rental 1099 MISC Unemployment K1 Partnerships Director Fees K1 S Corporations SelfEmployment Income K1 TrustEstates Gambling Winnings Gross Social Security: Medicare Deducted: Husband $ Wife $ Husband $ Wife $

3 HEALTH INSURANCE COVERAGE * Beginning with tax year 2014, individuals are required to maintain health insurance coverage. * The IRS assumes individuals do not have proper coverage. You are required to provide your coverage status on your income tax return. * Completion of this form is essential for completing your return. If your insurance company provided you with Form 1095B, you may skip this chart and attach a copy. * Visit our website for more information Name of Covered Individual(s) SSN Covered All 12 Months Months of Coverage Jan Feb Mar Apr May Jun Jul RETIREMENT CONTRIBUTIONS Did you make retirement contributions for tax year 2016 or do you intend to? TAXPAYER SPOUSE IRA Traditional IRA Roth Date Paid Date to be Paid Attach any Forms Aug Sep Oct Nov Dec

4 Charitable Contributions ADJUSTMENTS AND DEDUCTIONS Medical Out of Pocket 1 Hospital Ins. Premiums 2 Miles Traveled for Medical 3 Prescription Drugs 4 Doctors, Dentists, Etc Miles Driven for charity Eyeglasses & Dentures NonCash Gifts Attach Receipts Hospitals & Clinics You must have a receipt from the charity for all individual gifts in excess of $250. Noncash gifts in excess of $500 require a valuation statement from the charity. Interest Other: Total: Mortgage1st Mortgage2nd Miscellaneous Home Equity Union & Prof Dues Student Loan Tax Prep Fees Work Tools Property Tax Uniforms Primary Residence Employee Auto Expenses 2nd Home Employee Business Exp. Investment Fees College TuitionAttach Form 1098T Gambling Losses Do you have adequate substantiation? Yes No Did you buy or sell your home this year? If yes, attach HUD statement. (Attach a list, indicate any employer reimbursement) Child Care Expenses All info is required If you paid child care to enable your spouse to work: Name(s) of Dependent for each dependent Care Provider Provider Tax ID or SSN:

5 ESTIMATED TAX PAYMENTS MADE 2016 Schedule of Estimates Federal Payment State Payment Date Paid 1st 2nd 3rd 4th Extra Extra We are no longer able to verify your estimated tax payments through the IRS website. You must provide this information to us. Attach cleared checks if possible. Did you receive a cash or Visa Debit refund last year? Federal State

6 PRIVATE SCHOOL TUITION IN LA 2016 Grades K12 Dependent School Private Y or N Tuition & Fees Uniforms Textbooks Insurance Declaration Page Attach for each property owned to get credit Policy must be dated in Make sure the surcharge appears on the page. Example: Supplies Total