PERSONAL INFORMATION (Returning clients please list any changes from last year)

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Jasper Summers
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PERSONAL INFORMATION (Returning clients please list any changes from last year) Taxpayer (TP) Name SSN Birth Date Phone No. Occupation Spouse (SP) Name SSN Birth Date Phone No.

1 PERSONAL INFORMATION (Returning clients please list any changes from last year) Taxpayer (TP) Name SSN Birth Date Phone No. Occupation Spouse (SP) Name SSN Birth Date Phone No. Occupation Street City State Zip County School District Primary Secondary Name SSN Birth Date No. of Months Lived with You Unearned Income 1 Earned Income Childcare Expenses 2 Dependents 1 Dependents under age 24 with unearned income (e.g. interest or dividends earned, stock sale proceeds) greater than $950 may need to file a return. NOTE: Dependents with unearned income greater than $1,900 are subject to their parent s tax rate. Coordination of returns between parent and child is very important. 2 Please complete Child Care Expenses section on page 3. POST HIGH SCHOOL EDUCATION (Post-High School Expenses) Name Name of Institution Tuition and Fees Paid Room and Board Books and Supplies Grants and Scholarships Students If you incurred expenses for post-hs education as an employee and were NOT reimbursed, see Unreimbursed Job-Related Expenses on Page 2. NOTE: Schools provide documentation showing amount paid for tuition (1098-T). Please provide documentation for school-related purchases (e.g. books). These expenses may be for any family member. If 529 plans (like Edvest) or educational IRAs were used for some of the expenses, please provide documentation including any 1099-Q documents. 1

2 INCOME Income Documents Needed (Please remember to provide these documents) W-2s : Wages/salaries from ALL employers 1099-INT & 1099-DIV : Interest & Dividends for ALL accounts 1099-B : Sales of Securities, Mutual Funds, etc. Year-End : Investment statements, Mutual Fund supplemental information 1099-SSA / 1099-RRB : Social Security and Railroad Retirement benefits 1099-R : Income from Pension, IRAs and Annuities 1099-G : Unemployment Compensation K-1 : Partnerships, Trusts, Estates and S-Corporations Last Paystubs of the year from ALL Employers Other Income Alimony Received Inheritence and Gifts Scholarships, Fellowships and Grants State Income Tax Refunds Tips Received Disability and Sick Pay Jury Duty Gambling Winnings Prizes and Awards Personal Representative Fees Royalties ITEMIZED DEDUCTIONS Medical Expenses 3 Premiums - Taxpayer (TP) (dental, Rx also) Premiums - Spouse (SP) (dental, Rx also) Long-term Care Premiums - TP Long-term Care Premiums - SP Medicare - TP (Part A, B, C, D) Medicare - SP (Part A, B, C, D) Prescriptions (co-pay, out-of-pocket) Doctor, Chiropractor (office visits) Dentists, Orthodontists, Oral Surgeons (office visits) Hospital Nursing Home, Home Health Care, Assisted Living Psychological Counseling Glasses, Hearing Aids & Batteries Medical Equipment, Supplies & Rentals Miles Driven for Medical Reasons Parking, Taxi, Bus or Ambulance Expenses Toll Calls to Doctors, Hospitals 3 Do not include reimbursements or expenses paid by FLEX and HSA accounts. Deduction Documents Needed (Please remember to provide these) Property Tax Bills/Receipts 1098 : For mortgage interest paid HSA Statement : Health savings account Charitable Contributions 4 (documentation required) Total Cash and Check Contributions Endangered Resources, Special License Plates Travel for Charitable Purposes Miles Driven for Charitable Purposes Securities and Stock Non-Cash (In-Kind) Donations 4 All donations must be made to a qualified non-profit organization such as a religious charity, disease research (i.e. cancer research), community outreach, housing, etc. NOTE: Do not include contributions to political organizations or raffle tickets. Taxes Paid in 2013 Real Estate (primary residence) Real Estate (secondary residence) State Income Tax (balance due for prior years) State Income Tax (prepayment for 2013 income) Sales Tax on Large Purchases (e.g. boat, RV, auto) Home Mortgage Interest First Mortgage Second Mortgage Home Equity Line Points Paid Primary Residence Secondary Residence Bring in Form 1098 from your lender. Bring in Form 1098 from your lender. 2 Miscellaneous Deductions 5 Taxpayer Spouse Attorney Fees (to protect taxable income) Gambling Losses Investment Publications and Journals IRA Fees Paid by Check Investment Expenses, Interest 6 Job Search Expenses (within same field) 7 Job-Seeking Mileage Safe Deposit Box (containing tax documents) Tax Preparation and Consulting Fees 5 Self-Employed Individuals: For business-related expenses, please see the Business Organizer. 6 Please provide your year-end statements from your financial planner. 7 Expenses include employment service and resume fees, toll calls, etc.

3 JOB-RELATED EXPENSES Unreimbursed Job-Related Expenses 8 Taxpayer Spouse Union and Professional Dues Education and Seminars (tuition & fees) Books and Supplies (not included in above) : E&O, Malpractice Job Tools, Supplies and Equipment Licenses and Fees Publications and Journals Toll Calls Uniforms (purchase, cleaning) 9 8 Self-Employed Individuals: For business-related expenses, please see the Business Organizer. 9 Uniforms must be attire exclusive to your work. Clothing one could wear to dinner does not apply. Unreimbursed Job-Related Mileage Vehicle Vehicle Taxpayer or Vehicle 1 Spouse or Vehicle Trip Distance Detail Taxpayer Spouse For Your Employer mi. mi. To and From Work (commuting) mi. mi. To Professional Meetings mi. mi. Between 1st and 2nd Job mi. mi. From Job to School mi. mi. Investment and Tax Preparation mi. mi. Written Mileage Log? Yes / No Yes / No OTHER INFORMATION Rent Paid for Personal Residence (WI Residents Only) Per Month $ $ Date From Date To Heat Included? Yes / No Yes / No Child or Dependent Care Expenses Name City, State, Zip SSN or EIN Paid $ $ 2013 Retirement Contributions Taxpayer Spouse Traditional IRA ROTH IRA SEP (Simplified Employee Pension) SIMPLE (Savings Match Plan for Employees) Documents Needed (Please remember to provide these documents) 1098-T : For education expenses Questions: From your Landlord, ONLY if Rent Certificate (WI Form I-017i) : your income is below $24,650 Year-End : Retirement account statements (i.e. IRA, SEP) Estimated Taxes Paid Due Date Date Paid Federal State January 15, 2013 $ $ April 15, 2013 $ $ June 17, 2013 $ $ September 16, 2013 $ $ January 15, 2014 $ $ Notes: 3

4 RENTAL PROPERTY Property Type 10 Full (Street, City, State & Zip) Property types include: duplex, 4-plex, 8-unit, cabin, office, house, commercial Did you pay someone over $600 for services performed? YES NO If you marked YES, contact your tax advisor immediately. Property Revenue and Use No. of Days Used Personally Rental Income $ $ $ Reimbursement $ $ $ Related Expenses Advertising Cleaning, Maintenance Commissions Legal, Professional Fees Management, Condo Fees Mortgage Interest Other Interest Repairs 11 Supplies Property Taxes Telephone (for rentals) Utilities: Heat & Electric Water & Sewer Trash Lawn Care/Snow Removal 11 Repair is when you DO NOT make a capital improvement to your property. Example: when you patch existing drywall, it is a repair. When you hang new drywall, it is an improvement. Vehicle Expenses Standard Mileage Rental Miles (2013) Total Miles Driven (2013) Interest Paid on Auto Loan Written Mileage Log? (Yes/No) Rental Miles (2013) Total Miles Driven (2013) Interest Paid on Auto Loan Written Mileage Log? (Yes/No) Taxpayer or Vehicle 1 Spouse or Vehicle 2 STOP HERE IF YOU USE STANDARD MILEAGE Taxpayer or Vehicle 1 Spouse or Vehicle 2 Improvements, Replacements and Equipment Purchases Asset Description Date Cost Sales and Dispositions Asset Description Date Price 4 Actual Expenses Gasoline, Oil, Lubricant Tires, Batteries License, Taxes Interest, Lease Payments Gasoline, Oil, Lubricant Tires, Batteries License, Taxes Interest, Lease Payments Taxpayer or Vehicle 1 Spouse or Vehicle 2

5 QUESTIONS Yes No DURING 2013, DID YOU OR YOUR SPOUSE... Change bank information for direct deposit? If so, please provide a voided check. Wish to designate $3 of your taxes to the Presidential Campaign Fund? (does not affect your taxes) Adopt, marry, divorce (bring copy of final decree) or have deaths in your IMMEDIATE family? Help support anyone else? Have a foreign bank account valued over $10,000? Receive alimony? $ Recipient s SSN: Sell any assets through an internet-based auction? (i.e. ebay) Buy or sell real estate? Please bring in closing statements. Sell a house for which you received the First Time Homebuyer s Credit? Receive the First Time Homebuyer s Credit for a home purchased before January 1, 2009? Receive non-taxable military disability payments? Retire from being a Public Safety Officer? Convert a Traditional IRA to a Roth IRA? In year 2011, 2012 or 2013? Rollover or transfer any IRAs or retirement accounts during the year? Collect any unemployment compensation? Have any debt forgiven? (i.e. short sale, home foreclosure, credit card balances, bankruptcy) Have anyone owe you money AND you have EXHAUSTED ALL reasonable efforts to collect? Buy classroom supplies? K-12 TEACHERS ONLY. $ Pay interest on student loans? Taxpayer $ Spouse $ Move over 50 miles because of a job change? If so, please provide a list of your moving expenses. Pay for long-term care insurance? (Please enter amount on page 2) Pay additional federal or state taxes as a result of an audit or filing of a late return? Pay sales tax on auto or boat purchase? Purchase an alternative fuel motor vehicle? Pay any interest to buy or hold investments/land/stock/etc.? Have a casualty or theft loss? (Generally, loss must exceed 10% of your income) Pay any fees to an investment advisor? (Please enter amount on page 2) Paid expenses for post HS education classes or seminars? (Please enter amount on page 3) any solar/wind/geothermal energy efficient improvements to your home? Employ anyone to work in your home? Put money into WI Ed Vest? Tomorrow s Scholar? $ Purchase goods from out of state firms where no sales tax was charged? Cost $ Want to receive a copy of your tax return via PDF? (In lieu of paper return - Please provide address on page 1) Do you wish to contribute to any of the following? (Contributions will increase your Wisconsin Tax) Wisconsin Endangered Resources $ Veterans Trust Fund $ Packers Football Stadium $ Multiple Sclerosis $ Red Cross WI Disaster Relief $ Cancer Research $ Feeding America/2nd Harvest $ Special Olympics $ Military Family Relief $ Firefighters Memorial $ SIGNATURE: 5 DATE:

6 BUSINESS ORGANIZER (FOR CLIENTS WHO ARE SELF-EMPLOYED) Business Information Name Product/Service You must have a log and/or other receipts and records to document business expenses. Documentation must show business purpose, date, time, place and the amount of the expense. Did you pay someone over $600 for service performed? YES NO Did you start or dispose of this business in 2013? YES NO Expenses Accounting Advertising, Marketing Bank Charges Commissions Computer Consulting Dues & Subscriptions Education & Training Equipment Rental, Lease Gifts (note: limit $25/client) Independent Contractors : Building, Equip. Janitorial Licenses Liability Workers. Comp Legal, Professional Fees Meals & Entertainment 12 Office Expense (not rent) Salaries and Wages Software Payroll Expenses Parking Fees, Tolls 12 Also document the following concerning the meal and/or event: a. You discussed business during the meal and/or event. b. You had a substantial and bona fide business discussion or activity before or after the meal and/or event. c. You were away from home overnight. Expenses Pension, Profit-Sharing Postage, Shipping Printing Rents Supplies Taxes: Telephone Tools Travel: Uniforms Utilities: Notes: Improvements, Replacements and Equipment Purchases Sales Payroll Airfare Auto Rental Lodging Heat & Electric Water & Sewer Trash Internet Asset Description Date Cost Income Gross Receipts Returns and Refunds 2012 Inventory/Cost of Goods Sold Inventory-Beginning Inventory- Ending Purchases Personal Use Office In Home Deduction To qualify, an office in home must have exclusive and regular use... As your principal OR By patients, clients, customers place of business in meeting or dealing with you in the normal course of business Office Square Ft. Repairs and Maintenance Home Square Ft. Repairs and Maintenance Utilities Condo and MGMT Fees Vehicle Expenses Standard Mileage Rental Miles (2013) Total Miles Driven (2013) Interest Paid on Auto Loan Written Mileage Log? (Yes/No) Vehicle 1 Vehicle 2 STOP HERE IF YOU USE STANDARD MILEAGE Vehicle 1 Vehicle 2 Sales and Dispositions Asset Description Date Price 6 Actual Expenses Gasoline, Oil, Lubricant Tires, Batteries License, Taxes Interest, Lease Payments Vehicle 1 Vehicle 2

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