FELDMAN, HOLTZMAN & COMPANY, LLC CERTIFIED PUBLIC ACCOUNTANTS DAVID L. FELDMAN, CPA 760 HAMBURG TURNPIKE ALAN L. FELDMAN, CPA POMPTON LAKES, NJ 07442 MELVIN S. HOLTZMAN, CPA (Retired) ---- (973) 835-9200 ALICE R. BROSER, CPA FAX (973) 835-8327 JUDITH FELDMAN, CPA LINDA GRIMALDI, EA www.fhccpa.com BARRY KLAPPER, PA info@fhccpa.com January 2018 Dear Client: The time for filing your 2017 Income Tax Return has arrived. In order to ensure that we can give each return the time and attention necessary to do a thorough and accurate job, please send your information no later than March 31, 2018. Information not received at our office by April 1 will result in your 2017 Income Tax Return being put on extension and not completed until after April 17, 2018. The enclosed organizer serves as a reminder of the information we will need to complete your return. A copy of the organizer is also available for you to download on our website. We have also included a summary of the recent tax law changes on our website. If you wish to discuss your tax return in person, please call for an appointment as soon as you have gathered all of your information. The appointment can be made with any staff member that answers the telephone. No appointments will be made after March 31, 2018. Several states require driver s license information be included with your tax return. Please include a photocopy of your driver s license with your tax information (front and back if a New York Resident). New Jersey has a new exemption for honorably discharged Veterans. Please forward your discharge papers (Form DD-214) to us as soon as possible. We will forward the paperwork to New Jersey on your behalf. New Jersey will not accept any returns that claim the additional exemption without the DD-214 being on file. Yours truly, Feldman, Holtzman & Company, LLC FELDMAN, HOLTZMAN & COMPANY, LLC Certified Public Accountants FH&C/cb Enc. P.S. We would like to thank those of you who have referred new clients to our office. Clients recommendations are our most effective, and most gratifying, source of growth.
FELDMAN, HOLTZMAN & COMPANY, LLC - CLIENT ORGANIZER PERSONAL INFORMATION Please include a copy of and 's Driver's Licenses (Most States now require it) Social Security Number Name Occupation Date of Birth Telephone Day/Evening Email Were you and your family all covered for health insurance for all of 2017? Yes No (Please provide Form 1095-A or Exemption Certificate if covered through exchange) Are you an honorably discharged veteran residing in New Jersey? Yes No (Please provide Form DD-214) DEPENDENT INFORMATION First Name Last Name Date of Birth SS # Relationship Student (Y/N) 2017 College College Tuition Provide Form 1098-T Provider information: Name SS# or EIN # Amount Paid in 2017 Bank Name Account Number CHILD AND DEPENDENT CARE EXPENSES Provider #1 Provider #2 DIRECT DEPOSIT (IF YOU WOULD LIKE REFUND DIRECT DEPOSITED) Routing Number Type of Account (Checking-Savings) ESTIMATED TAX PAYMENTS PAID Federal State #1 State #2 Quarter(Due Date) Date Amount Date Amount Date Amount 4th 2016 (1/17/17) 1st(4/18/17) 2nd(6/15/17) 3rd(9/15/17) 4th(1/16/18) Please provide all copies of Forms W-2 that you receive. SALARY AND WAGES
SCHEDULES K-1 Please provide all copies of Schedules K-1 that you receive from Partnerships, S-Corps, Estates and Trusts. GAMBLING INCOME Please provide all copies of Forms W-2G that you receive. INTEREST INCOME Please provide all copies of Forms 1099-INT that you receive. DIVIDEND INCOME Please provide all copies of Forms 1099-DIV that you receive. See schedules attached. BUSINESS INCOME/RENTAL INCOME SALES OF STOCKS, SECURITIES AND OTHER INVESTMENT PROPERTY Please provide all copies of Forms 1099-B, 1099-S and HUD Settlement Statements (sales & purchases). Please provide selling price, cost, date of purchase, date of sale on each transaction OR provide end of year realized Gains/Loss statement from investment accounts. RETIREMENT & OTHER INCOME Please provide all copies of Form 1099-Misc., Social Security Form SSA, 1099r'S, etc. State and Local Income Tax Refunds - please provide Form 1099-G if received. Alimony Received Unemployment Compensation (provide form) (Available on state website if not received) ADJUSTMENTS TO INCOME - IRA CONTRIBUTIONS Please provide year end statements for each account and any Form 8606 not prepared by this office. 2017 Traditional IRA contribution 2017 Roth IRA contribution HIGHER EDUCATION DEDUCTIONS AND/OR CREDITS Complete this section if you paid interest on a qualified student loan in 2017 for qualified higher education expenses for you, your spouse, or a person who was your dependent when you took out the loan. Qualified student loan interest paid in 2017 Total expenses if job related JOB RELATED MOVING EXPENSES OTHER ADJUSTMENTS TO INCOME Alimony Paid: Recipient Name Recipient SS# 2017 Amount paid Teacher out-of-pocket expenses: Adoption expenses: Energy Efficient Home Improvements (Please provide invoice)
MEDICAL AND DENTAL EXPENSES Dependents Total Medical and dental expenses Medical insurance premiums you paid *** Medicare insurance premiums you paid(part B & D) Long-term care premiums you paid Prescription medicines and drugs Miles driven for medical items *** Do not include Medical Insurance deducted out of your wages TAX EXPENSES Sales tax paid on purchase of new car, boat, airplane - provide invoice Real estate taxes paid - Primary residence Real estate taxes paid - Additional properties Personal property taxes 2017 Rent paid (certain States allow deduction) 2017 Amount paid 2018 paid in 2017 INTEREST EXPENSES 2017 Amount paid Home mortgage interest: Please provide Forms 1098 Other, such as Home mortgage interest paid to individuals Name SSN 2017 Amount paid 2017 Amount paid Investment interest expense (Please provide 1099) Refinancing information (Provide HUD Statement): Bank Total Points Paid Date of refinance Total number of payments to be made Refinance #1 Refinance #2 CHARITABLE CONTRIBUTIONS Contributions made by cash or check. Please provide exact numbers - attach schedule Volunteer miles driven Noncash items, such as: Goodwill, Salvation Army (provide receipts if greater than $500) MISCELLANEOUS DEDUCTIONS Unreimbursed business expenses - attach breakdown Union dues Tax preparation fees Safe deposit box rental Investment expenses, other than on K-1s Gambling losses: (only if you have gambling income) FOREIGN ACCOUNTS Please provide December, 2017 statement for any bank or brokerage accounts held overseas.
2017 SCHEDULE C NAME OF PROPRIETOR BUSINESS NAME (IF APPLICABLE) EMPLOYER ID NUMBER (IF APPLICABLE) BUSINESS ADDRESS (IF DIFFERENT FROM HOME ADDRESS) : INCOME (INCLUDING 1099'S RECEIVED) 2017 TOTALS EXPENSES: HEALTH INSURANCE FOR SOLE PROPRIETOR PURCHASES, MATERIALS (COST OF GOODS SOLD) ADVERTISING COMMISSIONS INSURANCE (OTHER THAN HEALTH) INTEREST MEALS/ENTERTAINMENT OFFICE SUPPLIES REPAIRS TRAVEL BUSINESS MILEAGE: TOTAL MILES DRIVEN IN 2017 BUSINESS MILES DRIVEN IN 2017 MAKE, YEAR AND MODEL OF CAR FIXED ASSETS: PLEASE PROVIDE INVOICES FOR NEW ASSETS PURCHASED IN 2017 OTHER EXPENSES (PLEASE LIST SEPARATELY):
2017 SCHEDULE E - RENTAL PROPERTY PLEASE PROVIDE HUD STATEMENTS FOR RENTAL PROPERTIES PURCHASED OR SOLD IN 2017 PROPERTY ADDRESS: RENT RECEIVED 2017 TOTALS EXPENSES: ADVERTISING CLEANING & MAINT. COMMISSIONS CONDO FEES INSURANCE INTEREST (PLEASE PROVIDE FORM 1098) REAL ESTATE TAXES REPAIRS UTILITIES WATER/SEWER FIXED ASSETS: PLEASE PROVIDE INVOICES FOR NEW ASSETS/MAJOR IMPROVEMENTS PURCHASED IN 2017 OTHER EXPENSES (PLEASE LIST SEPARATELY):