INCOME TAX CHECKLIST All last names must match the name listed on the Social Security Card. TAXPAYER SSN NAME BIRTHDATE OCCUPATION SPOUSE SSN NAME BIRTHDATE OCCUPATION ADDRESS CITY STATE ZIP CODE TELEPHONE HOME HIS CELL HER CELL E-MAIL ADDRESS CHILDREN and DEPENDENTS FULL NAME SOCIAL SECURITY # BIRTHDATE RELATIONSHIP 1. 2. 3. 4. 5. 6. PLEASE PROVIDE THE FOLLOWING DOCUMENTS: W-2 from ALL jobs worked during the tax year. 1099-Misc and/or Self Employment information including ALL deductions 1099-R's (Retirement statements) 1099-INT (Bank Interest) 1099-DIV (Dividends from Stocks and Bonds) 1099-B (Sale of Stocks and Bonds) Dates of Purchase/Sale and the original purchase price 1099-G Unemployment Statements (has State Refund that is taxable if Schedule A was filed last year) Social Security Statements Education: Form 1098-T, School Transcripts, Receipts W-2G (Gambling Winnings) and any losses up to the amount of reported winnings. Any and All other types of income such as sale of home, Cancellation of Debt, etc.
ITEMIZED DEDUCTIONS You should itemize deductions if your allowable itemized deductions are greater than your standard deduction or if you must itemize deductions because you can't use the standard deduction. MEDICAL AND DENTAL Health Insurance Premiums Long-Term Care Premiums Number Medical miles driven Expenses for Dr, Dentist, Eye Pharmacy Expenses Taxes you Paid in Tax Year State Income Taxes (Balance due from prior year or from estimated taxes) Real Estate Taxes Personal Property Tax Interest You Paid Home Mortgage Interest Form 1098 Home Mortgage Interest not reported on Form 1098: Name of Mortgage Holder EIN or SSN of Mort. Holder Address of Same Amount of Interest Paid Points NOT reported on 1098 (Must double check with Bank) Qualified Mortgage Insurance Investment Interest Gifts to Charity Gifts by Check or Cash with Receipts Volunteer Miles Driven Non-Cash Donations (If over $500 must show where, what and how much) Non-Reimbursed Employee Business Expenses You can deduct unreimbursed employee expenses that are required in your trade or business of being an employee, and that ordinary and necessary such as; Uniforms Union Dues Personal Tool and supplies Travel expenses (hotels, airlines, miles etc) Subscriptions to professional journals Medical exams required by employee Meals and Entertainment The list goes on so ask the question if your not sure (there are no dumb questions where your money is concerned). Other Misc. Expenses Tax Prep Fees Safety Deposit Box Gambling Losses (up to reported winnings) $
SCHEDULE C - SELF EMPLOYMENT Use this schedule to report income or loss from a business you operated or a profession you practiced as a sole proprietor. An activity qualifies as a business if your primary purpose for engaging in the activity is for income or profit, and you are involved in the activity with continuity and regularity. Business Type: Name of Business (if different from owner) Employer Identification Number (EIN) Address Total INCOME from 1099s _ How Many 1099s BUSINESS INCOME from ALL other INVENTORY: Beginning of the Year End of Year Goods Purchased Materials & Supplies $ EXPENSES: Advertising Car & Truck Expenses (Use Checklist) Commissions & Fees Contract Labor (1099's) Depletion Depreciation Employee Benefits Insurance Mortgage Interest Other Int. (Cr. Cards etc.) Legal & Professional Services Office Expenses Pensions/profit share Vehicle & Machinery Rental Other Rents Repairs/Maintenance Supplies Taxes and Licenses Travel (hotels, airfare, taxi) Meals and Entertainment Utilities _ Wages (W-2s) _(Less Employment Credits) Other Expenses Might Include: Cell Phone Fuel for Semis Employment Taxes Office Supplies Did you have a Home Office? Refer to Business Use of Home Checklist. ASSETS ACQUIRED (for depreciation) (Equipment, Appliances, Buildings and Improvements) Type of Asset Date Acquired Amount _Sold Date Amount $ Type of Asset Date Acquired Amount _Sold Date Amount $ Type of Asset Date Acquired Amount _Sold Date Amount $ Type of Asset Date Acquired Amount _Sold Date Amount $
SCHEDULE E RENTAL PROPERTY & OIL ROYALTIES Use Schedule E to report income or loss from rental real estate, royalties, partnerships, S corporations, estates, trusts, and residual interests in a Real Estate Mortgage Investment Conduit (REMIC). Address Rental A Type of property* Rent Income Is this property a Qualified Joint Venture (owned by husband and wife)?: Yes/No Address Rental B Type of property* Rent Income Is this property a Qualified Joint Venture (owned by husband and wife)?: Yes/No Address Rental C Type of property* Rent Income Is this property a Qualified Joint Venture (owned by husband and wife)?: Yes/No *Single Family, Multi Family, Vacation/Short-Term Rental, Commercial, Land, Royalties, Self-Rental, Other Royalties from Oil, Gas, Mineral, Copyright or Patent EXPENSES Rental A Rental B Rental C Advertising Auto & Travel Cleaning & Maintenance Commissions Insurance Legal & Professional Fees Management Fees Mortgage Interest Paid Other Interest Repairs Supplies Taxes Utilities Others (list) ASSETS ACQUIRED (for depreciation) (Equipment, Appliances, Buildings and Improvements) Type of Asset Date Acquired Amount _Sold Date Amount $ Type of Asset Date Acquired Amount _Sold Date Amount $ Type of Asset Date Acquired Amount _Sold Date Amount $ Type of Asset Date Acquired Amount _Sold Date Amount $
SCHEDULE F - FARM Use this schedule to report farm income and expenses. Principal Product: Sales of Livestock & other items bought for resale _Cost or basis of sold items _ Sales of livestock, produce, grains, etc. you raised _Cooperative distributions Income Other Income (describe) Agricultural Payments Crop Insurance Received _ EXPENSES: Chemicals Pension & Profit Sharing Conservation Expenses Rent/Lease: Vehicles, Machinery, Equip. Custom Hire (machine work) Other (Land, Animals, Etc.) Feed and Hay Repairs & Maintenance Fertilizers and Lime Seeds & Plants Freight & Trucking Storage & Warehousing Gas, Fuel, Oil (Used in Equip) Supplies Insurance (other than health) Taxes Interest: Mortgage Utilities (On Buildings & Separate Meters) Other Vet, Breeding & Medicine Labor Hired Other Expenses (specify) VEHICLE EXPENSES: Vehicle type *Mileage Log or Written Proof Required By IRS to claim. Total Yearly Mileage Business Mileage Date Placed in Service Used for Personal Y N Parking/Tolls Rental Cars/Taxis Actual Expenses: Gas, Oil, Insurance, Etc. Repairs % of Business Use ASSETS ACQUIRED (for depreciation) (Equipment, Livestock, Buildings and Improvements) Type of Asset Date Acquired Amount Sold Date Amount $ Type of Asset Date Acquired Amount Sold Date Amount $ Type of Asset Date Acquired Amount Sold Date Amount $ Type of Asset Date Acquired Amount Sold Date Amount $
BUSINESS USE OF HOME What is the total square foot of your home and the square footage of the space used as the office? Using the Safe Harbor is the simplest method where the IRS allows $5 per sq.ft up to 300 sq ft ($1,500). You do not have to keep home expense records to use the Safe Harbor method. However, you may benefit more if you keep track of the following home expenses; Casualty Losses Repairs & Maintenance Mortgage Interest (1098) Utilities Real Estate Taxes Other Expenses Excess Mortgage Interest Carryover Operating Expenses Insurance Excess casualty losses Rent Carryover Casualty & Depreciation CAR & TRUCK EXPENSES For how many vehicles are you claiming expenses? Please provide the following information for each vehicle claimed. Vehicle Description Date Placed in Service (mm/dd/year) Taxpayer/spouse has another vehicle for personal use? Yes or No Taxpayer has vehicle available for use during off-duty hours? Yes or No Current-Year Mileage: Business miles Commuting miles Other miles Using mileage alone is the simplest method where the IRS allows a certain amount per business mile. A more comprehensive, and possibly more beneficial method is to keep track of the following expenses; Garage Rent $ Interest $ Gas $ Property Tax $ Insurance $ Repairs $ Licenses $ Tires $ Oil $ Tolls $ Parking fees $ Other Exp. $ EDUCATION EXPENSES Student Loan Interest Paid _ *School loans used for Education Expenses are an Out of Pocket Expense. Tuition Paid Out of Pocket College Grade Level Taxpayer $ Spouse Child's Name Child's Name Provide the following information regarding each student; Have you claimed the Hope Scholarship Credit or American Opportunity Credit a total of four times? Yes or No. Total qualified educational expense, including books, supplies, and equipment, that were REQUIRED to be paid directly to the educational institution $. Additional qualified expenses that were NOT required to be paid directly to the education institution $. Tax-Free educational assistance received in the tax year allocable to the academic period $ Tax-Free educational assistance received in current year allocable to the academic period $ Refunds of Qualified educational expenses paid in tax-year refunded before filing that tax-year Educational Institution EIN Educational Institution Name Address
CHILD AND DEPENDENT CARE EXPENSES Amount Paid for 1 st child _ Care Provider Name FEIN or SSN Address: (City, State and Zip Code) Amount Paid for 2 nd child _ Care Provider Name FEIN or SSN Address: (City, State and Zip Code) Amount Paid for 3 rd child _ Care Provider Name FEIN or SSN Address: (City, State and Zip Code)
Long Haul Truckers and Overnight Drivers Out-of-Town Travel Expenses Baggage and Shipping $ Bath and Shower Costs $ Car Rental and Gas $ Laundry/Laundry Supplies $ Locker Fees $ Lodging $ Meals (actual Costs) $ Parking and Tolls $ Telephone $ Tips $ Toiletries $ Transportation- i.e. Airfare/Bus $ Truck Stop Electrification $ Other: Owner/Operator Truck Expenses Description of Truck Date Placed in Service Odometer Beginning of Year Odometer End of Year Vehicle Weight Interest Paid $ Gas, Lube and Oil $ Repairs and Maintenance $ Tires $ Insurance $ License and Registration $ Other: Dues and Fees License $ Permits and Fees $ Security Bond $ Trade Association Dues $ Travel Card Fees $ Union Dues $ Other: Miscellaneous Expenses Business Cards/Stationary $ Delivery Expenses-Postage $ Insurance Business $ Legal and Professional Services $ Office Supplies $ Safety Classes $ Secretarial Services $ Testing-Job Related $ Other: Supplies Back Support $ Batteries $ Cell Phone $ Citizens Band Radio $ Compass/GPS $ Fire Extinguisher $ First Aide Kit $ Flares $ Flashlight $ Glasses-Safety and Sun $ Gloves $ Ice Chest/Thermos $ Map/Map Book $ Radio $ Safety Boots/shoes $ Seat Cushion $ Tools $ Trade Publications $ Uniforms and Maintenance $ Weather Receiver $ Other: