2016 INDIVIDUAL TAX ORGANIZER - FORM 1040

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Annabelle Griffith
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1 2016 INDIVIDUAL TAX ORGANIZER - FORM 1040 If we did not prepare your prior year returns, provide a copy of federal and state returns for t he three previous years. Taxpayer Name Spouse's Name Home Address TAXPAYER SPOUSE SSN: Birth date: Occupation: Home phone: Cell phone: Office phone: Fax: Best contact method/ time: SSN: Birth date: Occupation: Home phone: Cell phone: Office phone: Fax: Best contact method/ time: Blind? Yes No Blind? Yes No ~Dependent Children Who Lived W ith You: FULL NAME SSN RELATIONSHIP BIRTH DATE ~Othe r Dependents: #MONTHS % SUPPORT FULL NAME SSN RELATIONSHIP BIRTH DATE RESIDED IN YOU YOUR HOME PROVIDED

2 2016 INDIVIDUAL TAX ORGANIZER- FORM 1040 ESTIMATED TAX PAYMENTS MADE FEDERAL STATE DESCRIPTION DATE PAID AMOUNT PAID DATE PAID AMOUNT PAID Balance of 2015 tax (paid with your return in 2016) 1st Quarter (due 04/18/16) 2nd Quarter (due 06/ 15/16) 3rd Quarter (due 09/ 15/16) 4th Quarter (due 01/17 /17) SOURCES OF INCOME..,. Salaries & Wages: Enclose all Forms W-2...,. Pension, IRA & Annuity Income: Enclose all Forms 1099-R...,. Social Security Benefits Received: Enclose all 1099 SSA Forms...,. Interest and Dividend Income: Provide all Forms 1099-INT, Forms 1099-DIV and Consolidated 1099s...,. Capital gains/losses: Provide all Forms 1099-B, 1099-S, and closing statements from real property sa les and purchases (HUD-1)...,. Income from partnerships, $-Corporations, estates and/or trusts: Provide all Schedule K-l's...,. Miscellaneous Income: Enclose Forms 1099 or other forms for the following: State and local income tax refunds Alimony received Jury fees Director's fees Prizes Gambling and/or lottery winnings (Form W2-G) Trustee or executor fees Any other..,. Other sources of income: Schedule C (business/self-employment) income: Complete separate 1040 Schedule C Organizer. Rental income: Complete separate Rental Organizer. Sale and/or purchase of personal residence: Provide settlement statements (HUD-1) for each purchase and/or sale. Complete separate questionnaire.

3 2016 INDIVIDUAL TAX ORGANIZER- FORM 1040 ADJUSTMENTS TO INCOME {If applicable, indicate amounts paid/adjustments to which you are entitled for 2016) DESCRIPTION AMOUNT DESCRIPTION AMOUNT School supplies purchased by teachers (grades K-9) IRA contributions-taxpayer IRA contributions - Spouse Sole Proprietor SEP, Simple, or Qualified Plan Contributions Health Savings Account (provide Forms 5498-SA & 1099-SA) College Tuition Expense (provide Forms 1098-T) Archer Savings Account (MSA) Qualifying adoption expenses Alimony paid (provide former spouse's name & SSN) Moving expenses ITEMIZED DEDUCTIONS (If applicable, indicate amounts paid during 2016).,,_ Medical Expenses: Do NOT provide receipts. Oregon residents- provide amount per individual. Doctors, dentists, lab fees, hospital costs, etc. AMOUNT PAID DESCRIPTION TAXPAYER SPOUSE Long-term care costs (assisted living, nursing home, in-home nursing care) Medical insurance premiums you paid (do NOT incl ude Medicare premiums or amounts paid by your employer) Long-term care premiums you paid Prescription medicines & drugs (do NOT include over-thecounter medicines, vitamins or supplements) Miles driven for medical purposes.,,_ Property Taxes Paid: Include only amounts PAID in 2016, regardless of the year to which the payments are applied. DESCRIPTION On your residence On 2 nd home or investment property On investment property AMOUNT Do not include: - RE tax paid on rental property (see Rental Organizer). - RE on home, if you have a home office deduction (see Sch. C Organizer)..,,_ Mortgage Interest: Provide all Forms 1098 you received. If you paid mortgage interest to an individual, provide name, address, and socia l security number.

4 2016 INDIVIDUAL TAX ORGANIZER- FORM ,.. Contributions to IRS approved domestic charities: You must have a receipt in order to claim a charitable contribution deduction. However, do not provide copies of receipts to us unless specifically requested, below. Cash contributions (i.e., contributions by check, debit card, or credit card). Contributions of publicly traded stock. Provide a copy of the receipt from the charity as well as the name of the stock gifted, trading symbol, number of shares, and date of gift. Non-cash charitable contributions to organizations such as Goodwill and Salvation Army. If the total amount for 2016 exceeds $500, provide a detailed list with date of contribution, name & address of charity, and value of your gift...,.. Unreimbursed Employee Business Expenses (W-2 employees only) Expenses were incurred by: Taxpayer D Spouse (Complete separate schedules) AMOUNT TOTAL EMPLOYER EMPLOYER DESCRIPTION EXPENSES REIMBURSEMENT REIMBURSEMENT INCURRED (on your W-2) NOT on W-2 Travel expenses while away from home: Transportation costs Lodging Meals & entertainment Other employee business expenses: Union dues Professional dues/memberships Small tools Uniforms (not suitable for wear outside of work) Business publications Supplies Other (provide detail) ,.. Miscellaneous Deductions DESCRIPTION Income tax preparation fees Legal fees (provide details) Safe deposit box rental Employment agency fees Investment expenses Documented gambling losses AMOUNT INDIVIDUAL TAX ORGANIZER (FORM 1040)

2016 BUSINESS ORGANIZER- FORM 1040, SCHEDULE C Business Owner's Name -------------- Principal business/profession Business Name----------------- Business EIN -------------- Business Address

5 2016 BUSINESS ORGANIZER- FORM 1040, SCHEDULE C Business Owner's Name Principal business/profession Business Name Business EIN Business Address Accounting method: D Cash D Accrual D Other: Inventory valuation method: D N/A D Cost D Lower of cost or market D Other: Were there any changes to inventory valuation method during the year? If yes, attach an explanation. Do you have a home office? A home office must be used regularly and exclusively for business purposes. If yes, please complete the office-in-home worksheet. Did you use a vehicle for this business during the year? If yes, please complete the vehicle expense worksheet. Did yo u pay any health insurance premiums or long-term care premiums during the yea r? Was this business still in operation at t he end of the year? Did you make any payments during the year that would require you to file Form(s) 1099? If you paid any individual $600 or more during the year or if you paid rent, yo u may have a filing requirement. If yes, did you file Form(s) 1099? Did you have employees? If yes, please provide co pies of all payroll repo rts including Forms W-2/W-3, 940, & 941. Did you do business in Multnomah County and/or City of Portland? If yes, please provide gross receipts for both city and county. Yes No INCOME COST OF GOODS SOLD Descript ion Amount Description Amount Gross receipts or sa les Beginning inventory Returns and allowances Other (list): Purchases Cost of labor (do not include yourself) M ateria ls and supplies Other (list ) Ending inventory EXPENSES EXPENSES (CONTINUED) Description Amount Description Amount Advertising Travel, meals, and entertainment: Commissions and fees Travel (airfare, lodging, etc.) Contract labor I Outside services Meals and entertainment Self-employed owner: Utilities (not home office) Health insurance premiums Wages (provide Forms W-3/W-2) Retirement co ntributions Other expenses: Employee: Bank fees Hea lth insurance premiums Continuing ed ucation / training Retirement plan contributions Computer maintenance BUSINESS ORGANIZER (FORM 1040, SCHEDULE C)

6 2016 BUSINESS ORGANIZER- FORM 1040, SCHEDULE C Description Amount Description Amount Insurance, other than health Dues and subscriptions Interest paid to banks Interest - Other Legal and professional fees Office expense Rent or lease: Vehicle, machinery, equipment Other business property Repairs and maintenance Supplies Taxes and licenses: Payroll taxes Personal property tax Multnomah Co./City of Portland Tri-Met tax Business licenses Gifts ($25 per person, max) Internet service Merchant service fees Parking fees Postage and delivery Promotion Telephone and cell phone Workman's comp insurance List other expenses, as needed): If any business assets were sold, retired or converted to personal use during the year, please provide the following: Descri ption Date Date Sold I Original Sales Price Purchased Retired Cost If any business assets were purchased/placed in service during the year provide the following information for each asset : Description Date Purchased Cost New or Used? BUSIN ESS ORGANIZER (FORM 1040, SCHEDULE C)

7 2016 RENTAL PROPERTY ORGANIZER - FORM 1040, SCHEDULE E Taxpayer Name ~ Spouse's Name Prop # Type of Mortgage Balance at Property Description & Location Property 12/ 31/16 (SM V LC)* *S =Single Family M = Multi Family V =Vacation Home L =Vacant Land C =Commercial INCOME # of days available for rent at FMV Rents received (not security deposits) Roya lties received Other: EXPENSES Advertising Auto I Travel (complete vehicle expense section} Association dues Cleaning and maintenance Insurance Lega l and other professional fees Management fees Mortgage interest pa id to bank (provide 1098s) Other interest paid Repairs Supplies Taxes Utilities Licenses and permits Gardening I Lawn ca re Plumbing Electrical Painting Other (p lease list): RENTAL PROPERTY ORGANIZER (FORM 1040, SCHEDU LE E)

8 2016 RENTAL PROPERTY ORGANIZER- FORM 1040, SCHEDULE E General Questions Do you use a management company for this property? Yes I No Yes/ No Yes/ No Yes I No Did you manage this property? Yes/ No Yes/ No Yes/ No Yes I No Were payments made that required filing Forms 1099? Yes/ No Yes I No Yes I No Yes/ No If yes, were all Forms 1099 filed or will they be filed? Yes I No Yes I No Yes I No Yes I No For each property, did you or any family member use the property for personal purposes for more t han the greater of 14 days Yes/ No Yes/ No Yes/ No Yes/ No or 10% of the total days rented? Number of days of personal use. Vacation Home Rental Complete this section for vacation home rentals only. Total days rented #of days used by you and/or your family Is the average rental period less than 7 days? Yes I No Yes/ No Yes I No Yes/ No List below any purchases of equipment, furniture, appliances or property improvements. Prop Date Description # Purchased Cost RENTAL PROPERTY ORGANIZER (FORM 1040, SCHEDU LE E)

9 2016 VEHICLE EXPENSE WORKSHEET Complete this worksheet on ly if you used a vehicle for both business and personal use for yo ur Schedule C business or for un-reimbursed employee expenses. Name~ ~ Principal business/profession Business Name~ ~ Is another vehicle ava ilab le for personal use? Do you have evidence to support your mileage information? Is your evidence written (in a log, spreadsheet or app)? Yes No Auto Make, Model & Year Total miles in 2016 (January 1- December 31, 2016) Business miles in 2016 (January 1 - December 31, 2016) Commut ing miles Dates of use if not for full year Vehicle 1 Vehicle 2 Was this vehicle purchased this tax yea r? Yes/ No Yes I No Date of purchase, if purchased in Provide purchase agreement. Is the vehicle over 6,000 lbs GVW? Yes I No Yes I No Actual Expenses: Gasoline, lube and oil Repairs Tires Insurance Parking fees and tolls Licensing Interest paid on auto loan Other (provide detail}: Lease payments

10 2016 HOME OFFICE WORKSHEET You may qualify for a home office deduction if you: Are self-employed and the office is your principal place of business or you can show that income is actually produced there. In addition, the space must be used exclusively for business purposes. Are an employee and the office space is sued exclusively for business purposes on a regular basis in connection with your employer's business and for your employer's convenience. Name Principal business/profession Business Name Total area of the house (in square feet): Area used exclusively for business (in square feet) Is this the first year you're claiming the home office deduction on this residence? If yes, please provide the settlement statement [HUD-1] for the purchase of the home. Also provide the cost of improvements, if any. Yes I No Indirect expenses (Expenses that benefit both the business and personal part of the home): Mortgage interest* -1st Mortgage interest* - z nd or HELOC Real estate tax Property insurance Rent Utilities (electricity, gas, water/sewer, garbage service) Security monitoring Other (itemize): Direct expenses (Expenses that are incurred or benefit only the business part of the home): Maintenance Improvements specifically to office area Other (itemize): * Provide Form(s) 1098 supporting the mortgage interest deduction. HOME OFFICE WORKSHEET

Personal Legal Plans Client Organizer 2018

Personal Legal Plans Client Organizer 2018 TAXPAYER NAME SOCIAL SECURITY NUMBER OCCUPATION DATE OF BIRTH EMAIL ADDRESS CELL PHONE SPOUSE Address: Home Phone: City: State: Zip: County: DEPENDENT CHILDREN & OTHER DEPENDENTS NAME SOCIAL SECURITY NUMBER