Hemminger & Associates, Inc. Income Tax Service Please Read!

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Dear Client; Hemminger & Associates, Inc. Income Tax Service Please Read! We ve moved to 6915 Lakewood Dr. W Suite A3 Tacoma, WA 98467 Referrals! We would like you to pass our name to someone you think may benefit from our services. This organizer is for the tax year 2017. Please use it as a guide in gathering together your 2017 tax information. Bring it with you to your interview or include it when you drop off or mail in the information. If you need more room than this organizer offers, feel free to use your own worksheets. In compiling the information for your 2017 tax preparation, please review your return from 2016. Please make sure that all of the social security numbers, name spellings, addresses and birthdates are correct. This year s filing date is April 17 th. If you need to make an extension to file your return please remember, the extension only gives you extra time to file the return, not to pay any extra tax you may owe. Please do not assume that we will put you or your business on extension. We NEED your permission. Contact us at 565-8333. Personal extensions are valid through October 15 th 2018. Corporate and Partnership extensions are valid until September 17 th 2018. For those of you that are responsible for a corporate or partnership tax return, call our office due dates have changed! If you have brokerage accounts, please bring in your 1099-DIV, 1099-INT and 1099-B forms. The Internal Revenue Service is very good at matching income reported to them with income you report to us. In the past few years we have seen a dramatic increase in letters from them with income that has slipped through the cracks. Please make sure you report all security sales to Internal Revenue Service. In addition to reporting the sale it is very important to report your purchase price. Please bring with you the cost of the securities you sold as well as the date you bought them. Being well organized is one way to help keep your fee lower. Bringing your W-2 s, 1099 s, mortgage interest statements, making sure your expenses are sorted and totaled, these are all time savers for us which ultimately saves you money, not only in your fee but on your tax return. Please use our tax organizer. The Affordable Care Act (ACA) is still in effect for this year. We need to know, were you and your family covered by medical insurance? Please give us copies of the forms that the insurance company or employer sent you to show your health insurance coverage. We would all like to thank you for your trust in our services and for your continued patronage. We hope that this New Year will be good to you and your loved ones. Yours truly, Gordon, Cathy, Steve, Jim, Patricia, Michelle Phone 253-565-8333

Hemminger & Associates, Inc. 253.565.8333 Fax 253.565.6128 online at www.hemtax.com New Address: 6915 Lakewood Dr W Ste A3 Tacoma, WA 98467 Tax Year 2017 Organizer Appointment Date: Time: With: Have you moved? Yes No Taxpayer's Date of Birth New Street: Spouse's Date of Birth - - City, State: Zip If your spouse passed away in 2017 what was the date? - - Home Phone # Work Phone # Cell # Email Address Your filing status for 2017: (Check One) Married filing jointly Single Head of Household (you must qualify) Married filing separate This year, the Government is requiring that you Efile. Ask us if you wish to opt out. Efiling or Opting Out requires signatures. We will need the signed forms BEFORE we can process your tax return this year. Estimated Tax Payments to IRS IRA Information Did you or will you and /or your spouse make an 1st Payment ( April ) $ Date Paid: IRA contribution for 2017? Yes No 2nd Payment ( June ) $ Date Paid: Your contribution $ 3rd Payment ( Sept.) $ Date Paid: Spouse's contribution $ 4th Payment (Jan/18) $ Date Paid: What Type of IRA? Regular Roth Dependent Information (This must match Social Security Card ) Name ( First, MI, Last ) Birthdate Social Security # Relationship Mo. In home Childcare Costs Child Care Provider's Information Providers Name Address Provider SS# or EIN Amount Paid $ Education Credits and Deductions Interest that you paid for yourself, spouse or dependent on student loans. We need to have the 1098-T sent to you or your child before we can calculate the credit. Tuition and related fees paid for higher (post K-12) education for you, spouse, or dependent. Qualified tuition and related expenses has been expanded to include expenditures for course materials. Student name Qualified Expenses $ Which Year of School? DIRECT DEPOSIT INFORMATION If you are anticipating a refund and would like to have it deposited directly into your bank account. FINANCIAL INSTITUTION ROUTING NUMBER YOUR BANK ACCOUNT NUMBER Must be " 9 " numbers (Check One) Checking Savings

Income For 2017 If you have any questions as to the taxability of income or rights to income, please ask us. Generally gifts and insurance proceeds are not taxable but please ask us. W-2 Wages Interest Income Please provide all W-2's Employer Earnings Source Amount Pension and IRA Distribution Please bring in all 1099-R's Company, Bank, CU Amount Dividend Income This year, please provide the 1099 forms. Source Ordinary Div Qualified Social Security Benefits Please bring in the SSA form. You $ Other Income Unemployment Tips Prizes/ Awards Spouse $ Alimony Gambling: Winnings $ Losses $ Installment Sales Contract Description Principal Interest SALE OF STOCK, MUTUAL FUNDS, AND / OR PROPERTY Please Note: It is very important for us to have your COST BASIS and ACQUISITION DATE for all items listed below. If we have to do research, there will be additional fees. PLEASE BRING IN YOUR 1099 BROKERAGE STATEMENT Description of stock, Mutual Fund, or Property Date Bought Date Sold Sale Price Cost

Itemized Deductions for 2017 When you are filling out this worksheet, you are also stating for us that you have receipts and proof of payment or donation as evidence of the number listed. You must be able to prove your deduction if asked by us or an auditor. ( Round all figures to the nearest dollar. Do not total any columns.) MEDICAL EXPENSES OTHER MORTGAGE INTEREST PAID Hospitalization & Health Insurance Premiums Long Term Care Insurance Premiums Dental Insurance Prescribed Drugs & Insulin Doctors & Clinics Dentists & Orthodontists Glasses, Contact Lenses, Eye examinations Hospitals, Nurses, Alcoholism Treatment Lab Tests, Therapy, X-Ray, Anesthesiologist Prescribed Medical Equipment Corrective Devices, Thermometers, Vaporizers Hearing Aids & Batteries Nursing Home ( Medical Care Only ) Schooling for Handicapped Name: Address: Social Security Number: Mortgage Interest You Paid to Them: Goodwill, Salvation Army, ETC. Charitable / Volunteer Miles: If you have a Business or Rental, please do not list your expenses here. Medical Transportation ( taxi,ambulance, etc. ) ( Deductible only If total exceeds 2% of Adjusted Gross Income.) Lodging while obtaining Medical Treatment 1st Mortgage Interest - (provide form 1098) 2nd Mortgage Home Equity / Home Improvement Loan Loan points Do NOT include any amounts paid for or reimbursed by medical insurance or any other type of insurance. Also, do NOT include health insurance premiums paid with pre-tax income. Medical Miles: TAXES PAID Real Estate Taxes Other R/E Taxes ( 2nd home, cabin, etc.) not rentals Sales Tax on all purchases (if you kept records) Sales Tax on Vehicles Sales Tax on Building Material RTA Excise Tax on Vehicle License Employee Paid L&I, SDI MORTGAGE INTEREST PAID Primary Residence 2nd Home, Cabin, etc. Payments you made to an individual. (List THEIR) CONTRIBUTIONS Cash, Check, Charge or Payroll Deduction: Churches or Synagogues Other: United Way, food drives, March of Dimes,etc. IRS requires receipts to be kept for all charitable donations. You don't need to bring them in but you do need documentation. NON-Cash (Clothing,Furniture,Etc.): FMV of Items Given To Charities. If over $500 please have documentation. MISCELLANEOUS Unreimbursed Employment Related Expenses: Union Dues and Professional Dues Professional Licenses and Fees Tools / Supplies Purchased for Job Safety Equipment ( Helmets, protective clothing ) Special Uniforms for job and their Cleaning Telephone ( business line / long distance/ toll calls only) Employee Mileage - Include travel for employer; travel to professional meetings; travel between 1st & 2nd job on same business day;job seeking mileage; and educational travel between jobs and school. Total Miles for the Year: Business Miles: Employment Related Schooling or Seminars Travel and Entertainment Expenses Job Seeking expenses in same Field Non-Employment Expenses: Tax Prep, Financial Planning/ Consultation Fees Investment Expenses : Phone / Postage / Supplies for Investment Investment Publications and Journals Safe Deposit Box IRA & Keogh Fees you paid Directly

Address of Rental Rental Property Rental #1 Rental #2 Rental #3 If this isn't enough room, please make your own worksheet. Rental Income Expenses: Advertising Description Cost Date in Service Auto/Travel Cleaning Insurance Management Fees Mortgage Interest Repairs Supplies Property Tax Vehicle Description Vehicle Expense Utilities Other Rental and/or Business Purchases Equipment, Improvements,Major Repairs,Etc. Total Mileage for Vehicle Business (Rental) Mileage Name of your Company: Product or Service Beginning Inventory $ Ending Inventory $ RESALE Goods Purchased $ Business Income $ Self Employment (BUSINESS) Income Expenses: Repairs Payroll Advertising Supplies Payroll Taxes Business Insurance Commissions State & Local Taxes Professional Fees Licenses Telephone / Cell Rent Travel Internet Fees Office Expense Meals & Entertainment Interest Miscellaneous Equipment Rental Utilities Don't see the right category? Please feel free to use your own worksheet. Self Employed Health Insurance: $ Is this your first year in business? Yes No Please let us know if you have stopped using or sold any business assets this year. If you purchased a Vehicle for Business purposes and you are claiming actual expenses, please list the following: Price $ Date in Service / / Gas & Oil $ Repairs $ Insurance $ License $ Business Miles for the year Personal Miles for the year When you are filling out this worksheet, you are also stating for us that you have receipts and proof of payment as evidence of the number listed. You must be able to prove your deduction if asked by us or an auditor.