INCOME TAX GUIDE AND CLIENT ORGANIZER Provided By: Gail Miller Anderson Tax & Financial Services 9326 Swinton Avenue rth Hills, CA 91343 Phone: (818) 891-8194 Fax: (818) 894-3234 E-Mail: gandtanderson@yahoo.com Web-site: www.gmataxes.com This questionnaire is provided to assist you in compiling the necessary information to prepare your tax return accurately and to assume that all income, credits and allowable deductions are properly taken into account. While every attempt has been taken to cover all cases, you may have information that requires review. If so please note your questions and return them with this form. Please include your last year s return (only if you are a new client), all W-2, 1099 forms and K-1 forms Upon completing this Tax Organizer, please read and sign below. I have gathered and submitted the information contained in this questionnaire and to the best of my knowledge it is true, correct, and complete. Signature:
Personal Information Taxpayer And Spouse TAXPAYER Last SPOUSE Last First First Occupation Occupation Home Phone Home Phone Work Phone Work Phone Date of Birth Date of Birth Mailing Address Mailing Address City, State, & Zip City, State, & Zip County County Check if address is new Check here if there are no changes from last year Married during year Divorced during year Spouse died during year Moved during year date: date: date: date: Lost a dependent Gained a dependent Legally blind? You: Spouse: Disabled? You: Spouse:
DEPENDENTS Check here if there are no changes from last year CHILDREN LIVING AT HOME First, Initial, Last Soc. Sec Num D.O.B Soc. Sec Num D.O.B Soc. Sec Num D.O.B Soc. Sec Num D.O.B OTHER DEPENDENTS D.O.B D.O.B Months in Home Months in Home % of Support By You % of Support By You D.O.B D.O.B Months in Home Months in Home % of Support By You % of Support By You Social Security Numbers are required for all dependents If filing Head of House and qualifying per is your child but not your dependent above. Enter child s name here:
Income Of Employer Of Employer Gross Earnings Gross Earnings WITHELD TAXES WITHELD TAXES Of Employer Of Employer Gross Earnings Gross Earnings WITHELD TAXES WITHELD TAXES INTEREST INCOME Of Payer Interest Of Payer Interest Except Except Of Payer Of Payer Interest Interest Except Except
DIVIDEND INCOME Of Payer Of Payer Total Ordinary Dividends Total Ordinary Dividends Oualified Dividends Oualified Dividends Capital Gains n Tax Capital Gains n Tax Of Payer Of Payer Total Ordinary Dividends Total Ordinary Dividends Oualified Dividends Oualified Dividends Capital Gains n Tax Capital Gains n Tax CAPITAL GAINS AND LOSSES Description Description Date Acquired Date Acquired Date Sold Date Sold Sale Price Cost of Baisis Sale Price Cost of Baisis Description Description Date Acquired Date Acquired Date Sold Date Sold Sale Price Cost of Baisis Sale Price Cost of Baisis MISCELLANEOUS INCOME Child Support payments/assistance Jury duty (or other public services) Tips/gratuities (not reported to IRS) Prizes/awards/lottery winnings (explain) Commissions/bonuses (not reported on W-2) Pensions/annuities (furnish Form 1099-R or details) IRA/Keogh/SEP/SIMPLE Distribution Veteran s benefits/disability income Business/self employment/farm/rental (furnish a schedule) Unemployment compensation Barter and exchanges Scholarship and fellowships Workers compensation/loss of time payments Other (explain)
SALE OF PERSONAL RESIDENCE Date Old Residence Cost or Basis Improvements (Additions, Landscaping, Driveway, New Roof, etc) Date Old Residence Sold Expenses of Sale (commission, legal fees, points etc.) Was any part of the residence rented/used for business: Did you own & use the home as your principal residence for at least 2 of the last 5 years You: Spouse: Have you rolled over a gain from the sale of a prior residence into the home sold? If so please provide Form 2119 from tax return for prior home sale Date New Residence Acquired or Construction Began Date of Occupancy Cost of New Residence If married do you and your spouse have the same proportionate interest in the new residence as the old? Attach copy of Real Estate Closing papers for both sale and purchase
SOCIAL SECURITY Use amount reported in box 5 of Social Security Benefit Statement (SSA-1099) and attach a copy Taxpayer Spouse INCOME TAXES PAID OR REFUNDED If someone else prepared your return last year please provide a copy balance paid on last years tax returns Refunds received from last years return Estimated Taxes Paid (if not paid by due date list actual date paid) 1st Qtr dated 4/15 2nd Qtr dated 6/15 3rd Qtr dated 9/15 4th Qtr dated 1/15 DEDUCTIONS AND CREDITS Check the following deductions and credit lists carefully, and from your cancelled checks, paid invoices, or other records, determine your deductions expenditures during the past year. Enter the amount in the space provided after each deduction item. Also enter items you think are deductible that do not appear on the deduction list so it can be determined whether they are allowable. Keep all paid receipts, contracts, and cancelled checks for these deductions at least three years after the due date for filing. MEDICAL Only the amount of un-reimbursed medical expenses that excess 7.5% of Adjusted Gross Income is allowed. Prescription & Drugs (Doctor Prescribed only) Insulin (General Drugs not allowed) Eye Glasses/Contact Lenses Prizes/awards/lottery winnings (explain) Hearing Aids & Supplies X-Ray/Lab Fees Ambulance/Paramedics Nurses (Board & Fees) Medical Aid Rental Equipment (Prescribed) Nursing Home Medical Care Commissions/bonuses (not reported on W-2) PMedical Part B Service Pmts Smoking Cessation Program Other (explain)
Medical Insurance Code: Pre-Tax=P after Tax=A Insurance-Paid by you Group Health Plan (Deducted by Salary) Medicare Premiums Other Insurances TAXES Description of Tax State Real Estate Taxes (Home) Real Estate (others) Property Tax rebates Personal Property Tax Auto License State or Local Income Taxes Sales Tax Other INTEREST s, names and social security numbers must match Form 1098 issued by Financial institution PRIMARY RESIDENCE Paid to financial institution Home mortgage paid to individuals (list name. address & SS#) Address SECOND RESIDENCE Paid to financial institution Home mortgage paid to individuals (list name. address & SS#) Address
Other Loans Home Improvement Interest on investments Points paid to acquire new mortgage Interest on school loans MOVING EXPENSES If your residence has changed because you transferred to a new place of employment or because you change employers, the cost of the move may be deductible. The information below is necessary to determine amount allowable 1. Distance from former residence to new business location Miles 2. Distance from former residence to former business location 3. Subtract line 2 from 1 Total Miles If line 3 is less than 50 miles stop here, you may not deduct moving expense TRANSPORTATION OF FAMILY Expenses for train, bus, air travel, auto (include mileage) etc Cost of lodging en route Cost of moving furniture & personal effects Date of Move Moving expenses paid by employer CASUALTY / THEFT LOSSES From fire, storm, theft etc. If more than one, provide similar details for each. Kind of Property or item Date Acquired Cost or Basis Insurance reimbursement Describe how or what happen Fair market value-before Fair market value-after
CASUALTY / THEFT LOSSES From fire, storm, theft etc. If more than one, provide similar details for each. Kind of Property or item Date Acquired Cost or Basis Insurance reimbursement Describe how or what happen Fair market value-before Fair market value-after CONTRIBUTIONS te: Charitable contribution of $250.00 or more at one time require written acknowledge from the charitable organization. This information must be obtained prior to filing your tax return. In addition, all cash contributions require substantiation. Church and Religious Oganizations Church: Other Religions Other Charitable Organizations Cancer fund Heart fund Easter Seals United Way Scouts YMCA Blind Education Muscular Dystrophy Schools Veterans Organizations Misc n-cash Contributions Item donated Date Value Item donated Date Value Item donated Date Value Item donated Date Value
Volunteer Work mileage (church, hospital, or non-profit organization) Organization Activity Performed Parking Miles Driven Organization Activity Performed Parking Miles Driven Organization Activity Performed Parking Miles Driven Meals, lodging, and other expenses may also be allowed-list full details MISCELLANEOUS DEDUCTIONS Tax preparation fees Telephone Union Dues Dues/Subscriptions Uniforms Safety deposit box Professional dues Second job mileage X-Ray/Lab Fees Handicapped job expenses Tools/shoes/ glasses Employment agency fees Job hunting expenses Job related education Investment expenses HOUSEHOLD EMPLOYEES : : : Address: ID# $ Paid Address: ID# $ Paid Address: ID# $ Paid
CHILD AND DEPENDENT CARE If you or your spouse paid someone to care for your child or other qualifying person so either of you could work or look for work, you may be able to take a credit for child and dependent care expenses. A qualifying person is any dependent child under age 13 or your disabled spouse who is not able to care for himself or herself. Number of qualifying persons Child care provider: Address: ID# $ Paid OFFICE IN HOME Check if justified for business or professional use by: Taxpayer: Spouse: Both: Date acquired Cost of Land Cost of Home Cost of Improvements sq. Footage Living Area sq. Footage Office Area Utilities Interest Taxes Insurance Repair/ Maintenance Other EMPLOYEE BUSINESS EXPENSES Reimbursed by Employer Vehicle Mileage Vehicle 1 Vehicle 2 A. End of year B. Beginning of year 1. Business Miles 2. Commuting Miles 3. Personal Miles 4. Total Miles Driven
VEHICLE EXPENSES If both husband and wife have deductions use vehicle 1 for husband, 2 for wife Vehicle 1 Vehicle 2 Gas and Oil Washing & Lube Repair/maintenance Tires/accessories Insurance Vehicle 1 Vehicle 2 Parking & tolls Licenses Lease payments Tires/accessories Interest Vehicle 1 Make: Year: Model: Date Acq: Cost or Bias Vehicle 2 Make: Year: Model: Date Acq: Cost or Bias TRAVEL EXPENSES Number of nights away from home Husband Wife Transportation Lodging Meals & tips Auto rentals Cabs, bus etc Husband Husband Husband Husband Husband Wife Wife Wife Wife Wife
OTHER BUSINESS EXPENSES Entertainment Tickets/Events Commissions Gifts/cards Phone Postage/freight Office supplies Dues/ subscriptions Required education Furniture/ equipment Did you purchase any other business equipment during the year? If yes, provide list of dates bought, cost, & description and trade-in-details. I have adequate records and sufficient evidence to support use of vehicles and deductions listed above Signature: EARNED INCOME CREDIT If you have more than three qualifying children, only list the three youngest children First, Initial, Last D.O.B Months in Home Full time Student Under 24 First, Initial, Last D.O.B Months in Home Full time Student Under 24 First, Initial, Last D.O.B Months in Home Full time Student Under 24 PARTNERSHIP, S-CORP, ESTATES AND TRUSTS Enclose your copies of Schedules K-1, returns or other documents. Enter name, address, and federal Employer Identification Number from any partnership, joint venture, limited liability company, S corporation, estate or trust, for which you do nor have the Schedule K-1.
QUESTIONS For yes answers, supply details Were you eligible to be claimed as a dependent on another tax return? Were you notified by the IRS, State or City of any changes to any prior year s tax return? Did you make any gifts of over $13,000 in value to any individual? Did you have living expenses in a foreign country as a result of income earned abroad? Do you have any worthless stocks or uncollectible bad debts? Did you receive any reimbursement (medical, insurance) for any expense claimed as a deduction on a prior tax return? Do you expect any significant changes in income or tax liabilities in the coming year? Did you receive any income from a source not listed in this booklet? Do you wish to designate (at no cost to you) $3.00 of your taxes to the Presidential Campaign Fund? OTHER CREDITS Did you pay college tuition for yourself, spouse, or dependent? (If yes attach Form 1098-T and the student account record for each student) Did you make any energy-efficient improvements to your principal residence, such as insulation, windows, doors, furnace etc.? (if yes please provide details on a separate sheet, include receipts) Did you purchase an electric vehicle or electric plug-in-vehicle? (if yes attach manufacturer s certification and purchase statement) CHECK LIST AND CERTIFICATION 1. This completed Client Organizer 2. All W-2 forms 3. Estimated tax forms 4. Partnership, limited liability companies, joint ventures, S corporation estates and trust documents. 5. Forms 1099 indicating dividend and interest income. 6. Buy/sell statements to cover stock sales, real estate transactions, and installment sales. 7. Copies of sales contracts to determine finance charges. 8. If you are a new client, provide copies of last year s tax return. 9. Check if payroll report were filed for household help. 10. Check if you have disability income. 11. Check if you were audited during the past year. Enclose results. OTHER QUESTIONS OR COMMENTS Please note any other questions or comments on a separate piece of paper and keep it with this booklet. I have reviewed the information contained in this booklet and to the best of my knowledge it is true, correct, and complete Signature: WHEN COMPLETE MAIL, DROP OFF OR CALL FOR AN APPOINTMENT.