Dear Client, The 2017 filing season brings with it some changes, not all are IRS related. Jim and Jennifer sadly and unexpectedly had to say goodbye to their awesome office wiener dog, Charlie, due to health issues. On a happy note, they will be celebrating the wedding of their middle son the beginning of April. Please have your tax information to our office by March 20, 2017, to allow us to prepare, review and deliver the return for timely filing. Tax information not received by this date will not be guaranteed to have a completed return by April 18, 2017. This year the IRS will require you to verify your direct deposit bank account by signing separate form to verify the correct account. This was implemented by the IRS to assist in cutting down on fraudulent returns and identity theft. The ACA penalty amount for 2016 for those not having health insurance coverage is the Higher of these: 2.5% of household income, OR $695 per adult. We will still need your 1095(A)(B) or (C) forms to report health insurance correctly on your returns. We will email our individual tax organizers out to all clients January 12, 2017. If you do not receive an email with a PDF of your organizer, or need a paper copy, please contact our office immediately and we will expedite your request. Password to open the PDF is the primary taxpayer s SSN no dashes or spaces. When you have completed the organizer and/or assembled all your documentation, you have the options of scheduling an appointment, dropping off, email, or mailing your information to us. Please visit our website at www.learycpa.com providing many resources such as; Breaking Tax News, Engagement Letters, Organizers, Consent to Disclose, 2016 CRP Forms and more. We will continue to provide you secure online delivery and access to your tax returns through your portal that is linked through our website. Please login now and check your login credentials if you have any issues logging in please call our office and we will get you all set for the upcoming season. Quick refresher, log on to www.learycpa.com and click on the client center and log in using your full email address as the login and your password. Again, any issues call the office and we can get you fixed up asap. We are looking forward to seeing you all as these visits are our favorite time of the year. Thank you for the opportunity to serve as your advisors again this year! Sincerely, The Leary Group www.learycpa.com 651.450.9373 PH 651.450.9214 FAX 66 Thompson Ave E Suite 120 West Saint Paul, MN 55118
2016 Individual Income Tax Engagement Letter Thank you for the opportunity to prepare your income tax returns this year. As you know, the IRS and other taxing authorities impose severe penalties on taxpayers and tax preparers for failure to observe due care in reporting on income tax returns. We will prepare your 2016 federal and state individual income tax returns from information that you furnish to us. It is your responsibility to provide all the information required for the preparation of complete and accurate returns. Since it may be necessary at some point to prove the accuracy and completeness of the returns to a taxing authority, you should retain all of the documents, cancelled checks and other data relating to income and deductions. The final responsibility for the income tax returns is yours, so be sure to review them carefully before you sign. Our work in preparing your income tax returns does not include procedures designed to detect improper entries or other irregularities, should any exist. However, we will render such accounting assistance as we find necessary to prepare your income taxes properly. We will use our best judgment in resolving questions where the tax law is unclear, or where there may be conflicts between the taxing authority's interpretation of the law and other supportable positions. Unless you tell us otherwise, we will resolve such questions in your favor, whenever possible. It is important that you understand that the law imposes various penalties when taxpayers understate their tax liability. They may also audit more years than normal if the understatement is significant, up to 6 years. You also should know that taxing authority audit procedures will likely include questions on bartering transactions and on deductions that require strict documentation. In preparing your returns, we rely on your representations that we have been informed of all bartering transactions and that you understand and have complied with the documentation requirements for your expenses and deductions. We are not responsible for taxing authority disallowance of doubtful deductions or deductions unsupported by adequate documentation, and the resulting taxes, penalties, and interest. It is possible that your returns may be selected for review by the taxing authorities. Any proposed adjustments by the agent are subject to certain rights of appeal. In the event of such an examination, we will be available upon request to represent you and will render additional invoices for the time and expenses incurred. Our fees will be due and payable upon the completion and prior to the e-filing of the returns. We reserve the right to hold the completed returns until your account is paid in full. Should your return be released without full payment, a finance charge at an annual rate of 18% could be assessed on any amount not paid by the 30th of the month following the billing date. Collection costs may also be assessed in certain circumstances. Having read and fully understood the engagement letter, I (we) agree to engage The Leary Group in accordance with the terms indicated. The information we have provided is complete and correct to the best of my (our) knowledge. Signature () / Printed Name Date Signature () / Printed Name Date
Individual Income Tax Checklist of Important Items Signed Engagement Letter Completed Questions pages from organizer Review and update personal information section from organizer Bank Account Authorization form required for direct deposit of refunds Medical Insurance form 1095 A, B, or C or Signed statement of Coverage New dependents birthdates and social security cards W-2 Forms and final paystubs Interest and dividend income/1099-int/1099-div (Brokerage Statements) Statements on the sales of stocks or bonds/1099-b Pension, retirement, Social Security income/1099-r/ssa-1099 HUD statement from purchase, sale or refinance of real estate in 2014 Other Income: Unemployment income/1099-g, Gambling Winnings/W2-G Canceled Debt Amount/1099-C College expenses: Statement of Account showing payments &1098-T (Req d) Student Loan Interest Paid Medical and dental expenses Real estate and personal property taxes Mortgage or home equity loan interest paid/1098 Cash and non-cash charitable donations Unreimbursed job related expenses Estimated taxes and dates paid, both Federal and State Self-employment business income and expenses/1099-misc Rental income & expenses (HUD statement if sold or bought new) Child Care Expenses and provider information IRA Contributions / Educator Expenses / H.S.A Contributions / Distributions Forms K-1 for Corporations, Partnerships, LLC s, Estates and Trusts www.learycpa.com 651.450.9373 PH 651.450.9214 FAX 66 Thompson Ave E Suite 120 West Saint Paul, MN 55118
Questions Please check the appropriate box and include all necessary details and documentation. Personal Information Did your marital status change during the year?... If yes, explain: Did your address change from last year?... Can you be claimed as a dependent by another taxpayer?... Did you change any bank accounts, or did routing transit numbers (RTN) and/or bank account number change for existing bank accounts that have been used to direct deposit (or direct debit) funds from (or to) the IRS or other taxing authority during the tax year?... Dependent Information Were there any changes in dependents from the prior year?... If yes, explain: Do you have any children under age 19 or a full-time student under age 24 with unearned income in excess of $2,100?... Do you have dependents who must file a tax return?... Did you provide over half the support for any other person(s) other than your dependent children during the year?... Did you pay for child care while you worked or looked for work?... Did you pay any expenses related to the adoption of a child during the year?... If you are divorced or separated with child(ren), do you have a divorce decree or other form of separation agreement which establishes custodial responsibilities?... Yes No Purchases, Sales and Debt Information Did you start a new business or purchase rental property during the year?... Did you acquire a new or additional interest in a partnership or S corporation?... Did you sell an existing business or rental property this year?... Did you acquire or dispose of any stock during the year?... Did you sell, exchange, or purchase any real estate during the year?... Did you purchase or sell a principal residence during the year?... Did you foreclose or abandon a principal residence or real property during the year?... Did you take out a home equity loan this year?... Did you refinance a principle residence or second home this year?... Did you lend money with the understanding of repayment and this year it became totally uncollectable?... Did you have any debts canceled or forgiven this year, such as a home mortgage or student loan(s)?... Did you purchase a qualified plug-in electric drive vehicle or qualified fuel cell vehicle this year?... Income Information Did you receive any income from property sold prior to this year?... Did you receive any unemployment benefits during the year?... Did you receive any disability income during the year?... Did you receive tip income not reported to your employer this year?... Did any of your life insurance policies mature, or did you surrender any policies?... Did you receive any awards, prizes, hobby income, gambling or lottery winnings?... Do you expect a large fluctuation in income, deductions, or withholding next year?... Page 1 of 3
Retirement Information Yes No Are you an active participant in a pension or retirement plan?... Did you receive any Social Security benefits during the year?... Did you make any withdrawals from an IRA, Roth, Keogh, SIMPLE, SEP, 401(k), or other qualified retirement plan?... Did you receive any lump-sum payments from a pension, profit sharing or 401(k) plan?... Did you make any contributions to an IRA, Roth, myra, Keogh, SIMPLE, SEP, 401(k), or other qualified retirement plan?... Education Information Did you, your spouse, or your dependents attend a post-secondary school during the year, or plan to attend one in the coming year?... Did you have any college expenses during the year on behalf of yourself, your spouse, or a dependent?... Did anyone in your family receive a scholarship of any kind during the year?... Did you make any withdrawals from an education savings or 529 Plan account?... Did you pay any student loan interest this year?... Did you cash any Series EE or I U.S. Savings bonds issued after 1989?... Did you make any contributions to an education savings or 529 Plan account?... Health Care Coverage Information Did you have qualifying health care coverage, such as employer-sponsored coverage or government-sponsored coverage (i.e. Medicare/Medicaid) for your family? "Your family" for health care coverage refers to you, your spouse if filing jointly, and anyone you can claim as a dependent. If yes, attach any Form(s) 1095-B and/or 1095-C you received... If you had qualifying health care coverage for your family, was everyone covered for every month of 2015?... Did anyone in your family qualify for an exemption from the health care coverage mandate? If yes, attach the Exemption Certificate Number or type of exemption... Did you enroll for lower cost Marketplace Coverage through healthcare.gov under the Affordable Care Act? If yes, attach any Form(s) 1095-A you received... If yes, did you share a policy with anyone who is not included in your family?... Other Health Care Information Did you make any contributions to a Health savings account (HSA) or Archer MSA?.. Did you receive any distributions from a Health savings account (HSA), Archer MSA, or Medicare Advantage MSA this year?... If yes, were all distributions used for qualifying medical expenses?... Did you pay long-term care premiums for yourself or your family?... Did you make any contributions to an ABLE (Achieving a Better Life Experience) account? If yes, attach any Form(s) 1099-QA you received... Did you receive any withdrawals from an ABLE account? If yes, attach any Form(s) 1099-QA you received... If you are a business owner, did you pay health insurance premiums for your employees this year?... Did you pay out-of-pocket medical expenses (Co-pays, prescription drugs, etc.)?... Page 2 of 3
Itemized Deduction Information Yes No Did you incur a casualty or theft loss or any condemnation awards during the year?... Did you make any cash or noncash charitable contributions (clothes, furniture, etc.)?... Did you donate a vehicle or boat during the year?... Did you have an expense account or allowance during the year?... Did you use your car on the job, for other than commuting?... Did you work out of town for part of the year?... Did you have any expenses related to seeking a new job during the year?... Did you make any major purchases during the year (cars, boats, etc.)?... Did you make any out-of-state purchases (by telephone, internet, mail, or in person) for which the seller did not collect state sales or use tax?... Miscellaneous Information Did you make gifts of more than $14,000 to any individual?... Did you utilize an area of your home for business purposes?... Did you engage in any bartering transactions?... Did you retire or change jobs this year?... Did you incur moving costs because of a job change?... Did you pay any individual as a household employee during the year?... Did you make energy efficient improvements to your main home this year?... Foreign Reporting Information Did you have a financial interest in or signature authority over a financial account such as a bank account, securities account, or brokerage account, located in a foreign country?... Do you have any foreign financial accounts, foreign financial assets, or hold interest in a foreign entity?... Did you have any foreign income or pay any foreign taxes during the year, directly or indirectly, such as from investment accounts, partnerships or a foreign employer?.. Did you receive a distribution from, or were you a grantor or transferor for a foreign trust?... Government Information Did you receive correspondence from the State or the IRS?... If yes, explain: Do you have previous years of tax returns that are either unfiled or filed with unpaid balances due?... Do you want to designate $3 to the Presidential Election Campaign Fund? If you check yes, it will not change your tax or reduce your refund... Did you or a dependent receive an Identity Protection PIN (IP PIN) from the IRS or have you been a victim of identity theft? If yes, attach the IRS letter... Minnesota Information Did you pay any K-12 Education Expenses? Qualifying expenses include such things as private school tuition, academic supplies, dance classes, and academic camps... Would you like to donate to the MN Nongame Wildlife fund?... If yes, How much? Please bring in your 2016 property tax statement or 2015 CRP for us to check eligibility for MN Property Tax Refund. Page 3 of 3
BLANK 01/07/2016 2:26 PM General: 1040 Personal Information GENERAL INFORMATION Filing (Marital) status code (1 = Single, 2 = Married filing joint, 3 = Married filing separate, 4 = Head of household, 5 = Qualifying widow(er)) Mark if you were married but living apart all year Mark if your nonresident alien spouse does not have an ITIN Social security number First name Last name Occupation Designate $3.00 to the presidential election campaign fund? (1 = Yes, 2 = No, 3=Blank) Mark if legally blind Mark if dependent of another taxpayer between 19 and 23, full time student, with income less than 1/2 support? (Y, N) Date of birth Date of death Work/daytime telephone number/ext number Do you authorize us to discuss your return with the IRS (Y, N) 2 General: 1040, Contact Present Mailing Address Address Apartment number City/State postal code/zip code Foreign country name Home/evening telephone number email address email address General: 1040 Dependent Information Care Months expenses in paid for First Name Last Name Date of Birth Social Security No. Relationship home dependent Credits: 2441 Provider information: Business name First and Last name Street address City, state, and zip code Social security number OR Employer identification number Tax Exempt or Living Abroad Foreign Care Provider (1 = TE, 2 = LAFCP) Amount paid to care provider in 2015 Employer provided dependent care benefits that were forfeited Child and Dependent Care Expenses General: Info Direct Deposit/Electronic Funds Withdrawal Information If you would like to have a refund deposited directly or a balance due debited directly into/from your bank account, please enter the following information: Financial institution: Routing transit number Name Your account number Type of account (1 = Savings, 2 = Checking, 3 = IRA*) If you would like to use a refund to purchase U.S. Series I Savings bonds (in increments of $50), enter a maximum amount (up to $5,000).** *Refunds may only be direct deposited to established traditional, Roth or SEP IRA accounts. Make sure direct deposits will be accepted by the bank or financial institution. **To purchase U.S. Series I Savings bonds in someone else's name, please contact our office. Lite 1 GENERAL INFORMATION
BLANK 01/07/2016 2:26 PM Income: W2 Salary and Wages W 2/1099 R/K 1/W 2G/1099 Q Please provide all copies of Form W 2 that you receive. Below is a list of the Form(s) W 2 as reported in last year's tax return. If a particular W 2 no longer applies, mark the not applicable box. Prior Year Mark if no longer T/S Description Information applicable Income: 1099R Pension, IRA, and Annuity Distributions Please provide all copies of Form 1099 R that you receive. Below is a list of the Form(s) 1099 R as reported in last year's tax return. If a particular 1099 R no longer applies, mark the not applicable box. Prior Year Mark if no longer T/S Description Information applicable Income: K1, K1T Schedules K 1 Please provide all copies of Schedule K 1 that you receive. Below is a list of the Schedule(s) K 1 as reported in last year's tax return. If a particular K 1 no longer applies, mark the not applicable box. Mark if no longer T/S/J Description Form applicable Income: W2G Gambling Income Please provide all copies of Form W 2G that you receive. Below is a list of the Form(s) W 2G as reported in last year's tax return. If a particular W 2G no longer applies, mark the not applicable box. Prior Year Mark if no longer T/S Description Information applicable Educate: 1099Q Qualified Education Plan Distributions Please provide all copies of Form 1099 Q that you receive. Below is a list of the Form(s) 1099 Q as reported in last year's tax return. If a particular 1099 Q no longer applies, mark the not applicable box. Prior Year Mark if no longer T/S Description Information applicable Lite 2 W 2/1099 R/K 1/W 2G/1099 Q
BLANK 01/07/2016 2:26 PM Income: B1 T/S/J Interest Income INTEREST/DIVIDENDS/CAPITAL GAINS/OTHER INCOME Please provide all copies of Form 1099 INT or other statements reporting interest income. Interest Prior Year Payer Name Income Information Income: B3 Seller Financed Mortgage Interest T, S, J Payer's name Payer's social security number Payer's address, city, state, zip code Amount received in 2015 Amount received in 2014 Income: B2 Dividend Income Please provide copies of all Form 1099 DIV or other statements reporting dividend income. Ordinary Qualified Prior Year T/S/J Payer Name Dividends Dividends Information Income: D Sales of Stocks, Securities, and Other Investment Property Please provide copies of all Forms 1099 B and 1099 S. Gross Sales Price Cost or T/S/J Description of Property Date Acquired Date Sold (Less expenses of sale) Other Basis Income: Income State and local income tax refunds Alimony received Unemployment compensation Unemployment compensation repaid Social security benefits Medicare premiums to be reported on Schedule A Railroad retirement benefits Other Income Please provide copies of all supporting documentation. 2015 Information Prior Year Information Prior Year Information Other Income: Lite 3 INTEREST/DIVIDENDS/CAPITAL GAINS/OTHER INCOME
BLANK 01/07/2016 2:26 PM 1040 Adj: IRA Adjustments to Income IRA Contributions Higher Education Deductions and/or Credits ADJUSTMENTS/EDUCATE Please provide year end statements for each account and any Form 8606 not prepared by this office. Traditional IRA Contributions for 2015 If you want to contribute the maximum allowable traditional IRA contribution amount, enter the applicable code: (1 = Deductible only, 2 = Both deductible and nondeductible) Enter the total traditional IRA contributions made for use in 2015 Roth IRA Contributions for 2015 Mark if you want to contribute the maximum Roth IRA contribution Enter the total Roth IRA contributions made for use in 2015 Educate: Educate2 Complete this section if you paid interest on a qualified student loan in 2015 for qualified higher education expenses for you, your spouse, or a person who was your dependent when you took out the loan. T/S Qualified student loan interest paid 2015 Information Prior Year Information Complete this section if you paid qualified education expenses for higher education costs in 2015. Qualified education expenses include tuition and fees required for enrollment or attendance at an eligible educational institution. Please provide all copies of Form 1098 T. Ed Exp Prior Year T/S Code* Student's SSN Student's First Name Student's Last Name Qualified Expenses Information *Education Expense Code: 1 = American opportunity credit; 2 = Lifetime learning credit; 3 = Tuition and fees deduction The student qualifies for the American opportunity credit when enrolled at least half time in a program leading to a degree, certificate, or recognized credential; has not completed the first 4 years of post secondary education; has no felony drug convictions on student's record. 1040 Adj: 3903 Job Related Moving Expenses Complete this section if you moved to a new home because of a new principal work place. Description of move //Joint (T, S, J) Mark if the move was due to service in the armed forces Number of miles from old home to new workplace Number of miles from old home to old workplace Mark if move is outside United States or its possessions Transportation and storage expenses Travel and lodging (not including meals) Total amount reimbursed for moving expenses 1040 Adj: OtherAdj Other Adjustments to Income Alimony Paid: T/S Recipient name Recipient SSN 2015 Information Prior Year Information Street address City, State and Zip code Educator expenses: Prior Year Information Other adjustments: Lite 4 ADJUSTMENTS/EDUCATE
BLANK 01/07/2016 2:26 PM Itemized: A1 Interest Expenses ITEMIZED DEDUCTIONS Medical and dental expenses Medical insurance premiums you paid*** Long term care premiums you paid*** Prescription medicines and drugs Miles driven for medical items Itemized: A1 Tax Expenses State/local income taxes paid 2014 state and local income taxes paid in 2015 Sales tax paid on actual expenses Real estate taxes paid Personal property taxes Other taxes Itemized: A2 Medical and Dental Expenses ***Do not include pre tax amounts paid by an employer sponsored plan, amounts paid for your self employed business, or Medicare premiums entered on Form Lite 3 Home mortgage interest From Form 1098 Other home mortgage interest paid to individuals: T/S/J Payee's Name SSN or EIN 2015 Information Prior Year Information Address City State Zip Code Investment interest expense, other than on Sch K 1s: Refinancing Information: T/S/J Recipient/Lender name Total points paid at time of refinance Date of refinance Term of new loan (in months) Reported on Form 1098 in 2015 Itemized: A3 Contributions made by cash or check Volunteer miles driven Noncash items, such as: Goodwill, Salvation Army Itemized: A3 Refinance #1 Refinance #2 Charitable Contributions Miscellaneous Deductions Unreimbursed expenses Union dues Tax preparation fees Other expenses, subject to 2% AGI limitation: Safe deposit box rental Investment expenses, other than on Schedule(s) K 1 or Form(s) 1099 DIV/INT Other expenses, not subject to the 2% AGI limitation: Gambling losses (enter only if you have gambling income) Lite 5 ITEMIZED DEDUCTIONS
BLANK 01/07/2016 2:26 PM Form ID: Coverage Health Care Coverage and Exemptions 67 Social Security No. Your family for health care coverage refers to you, your spouse if filing jointly, and anyone you can claim as a dependent. Please provide all copies of Form(s) 1095 B and/or 1095 C Was your entire family covered for the full year with minimum essential health care coverage? (Y, N) If your entire family was not covered for the full year with minimum essential health care coverage, enter information for all family members who are covered, or are exempt from the requirement to maintain minimum essential health coverage. Enter either the Exemption Certificate Number issued by the Marketplace, or the Other Exemption Type you are claiming. Mark Full Year if the coverage or exemption is for the entire year, otherwise indicate the Start Month and End Month. First Name Last Name 2015 Information Prior Year Information Exemption Certificate Number Other Exemption Type * Full Year Start Month End Month A = Unaffordable coverage B = Short coverage gap C = Exempt noncitizen D = Health care sharing ministry E = Indian tribe member *Other Exemption Type Codes F = Incarcerated individual G = Hardship (combined coverage unaffordable, initial open enrollment, CHIP) H = Medicaid/TRICARE/Fiscal year employer plan X = Insured with minimum essential coverage (coverage info found on Form(s) 1095 B or 1095 C) Self employed health insurance premiums: (Not entered elsewhere) 2015 Information Prior Year Information Self employed long term care premiums: (Not entered elsewhere) NOTES/QUESTIONS: Control Totals HEALTH CARE Form ID: Coverage
BLANK 02/01/2014 12:48 PM Form ID: MN Minnesota General Information Mark if you or your spouse are disabled Welfare amounts received [1] [2] Contributions Amount of political and charitable contributions you wish to make to: Political Contributions State campaign fund (Enter the appropriate code for the $5 political party contribution on Form M1 or Form M1PR from the list below) [3] [4] 11 = Republican 12 = Democratic Farmer-Labor Political Parties 13 = Independent 14 = Grassroots 16 = Libertarian 99 = General Campaign Fund Nongame Wildlife Fund Charitable Contribution [5] Name of insurance company () Name of insurance company () Policy Number () Policy Number () Credits and Subtractions Long Term Care Insurance Credit [6] [7] [8] [9] K-12 Education Expenses Textbook Transport Hardware Qualified Child's Name Grade Class Fees Indiv Fees Material Costs Software Tuition [10] [11] [12] [13] [14] [15] [16] [17] [18] [19] [20] [21] [22] [23] [24] [25] [26] [27] [28] [29] [30] [31] [32] [33] Class name Class type Ind. instr name Ind. instr type Music ins type Musical ins cost Child One Child Two Child Three [34] [35] [36] [37] [38] [39] [40] [41] [42] [43] [44] [45] [46] [47] [48] [49] [50] [51] Type of school attended [52] [53] [54] Transp provider [55] [56] [57] M1PR Property Tax Credit Note: Please attach copies of your tax year CRP's and/or current year Property Tax Statements Part-year Resident and Nonresident Information If you were a part-year resident during the tax year, enter the dates you lived in Minnesota Part-year residency dates: From [58] To [59] Other state of residence (State/Foreign country required for other nonresidents) [62] [60] [61] [63] NOTES/QUESTIONS: Form ID: MN