Income Tax Package Cover Sheet This package has been put together to help with the preparation of your income tax returns for year ending 2011. Please read and review documents carefully. Make sure that you complete, sign and date all forms that will be applicable to you. Please feel free to call if you have any questions. As always, your business is greatly appreciated. We look forward to working with you this upcoming tax season! Enclosures/Attachments: Client Information Sheet Income Tax Engagement Letter Dependent Information Worksheet Client Banking Information Credit Card/Debit Card Payment Authorization Form Fee Schedule Terri A. Simmons CPA, PLLC 6350 Rogers Road Rolesville, NC 27571 Ph (919)453-2275 Fax (866)763-1569 Visit our website at www.tsimmonscpa.com Providing Quality Accounting, Tax and Business Planning Services To meet your individual and business needs!
Client Information Sheet Tax Payer Name Date of Birth Current Occupation Spouse Name Date of Birth Current Occupation Address City State Zip Code Home Phone Cell Phone Email Address How did you hear about us? Former Client Walk in/drive by Internet/ Website Advertisement Referral (who) Other Are you interested in any of our other services? Accounting & Bookkeeping QuickBooks Training Payroll Services Business Planning Health Insurance Life Insurance Retirement Planning College Savings
Dear Client: Income Tax Engagement Letter Thank you for choosing TERRI A SIMMONS CPA PLLC to assist you with your 2011 taxes. This letter confirms the terms of our engagement with you and outlines the nature and extent of the services that we will provide. We will prepare both your 2011 federal and state income tax returns. We will also prepare your city and school district individual income tax returns for said year if applicable. We will depend on you to provide the information we need to prepare complete and accurate returns. We may ask you to clarify some items but will not audit or otherwise verify the data you submit. An Organizer will be furnished to help collect the data required for your return. We will perform accounting services only as needed to prepare your tax returns. Our work will not include procedures to find defalcations or other irregularities. Accordingly, our engagement should not be relied upon to disclose errors, fraud, or other illegal acts, We will of course, inform you of any material errors, fraud, or other illegal acts we discover. The law imposes penalties when taxpayers underestimate their tax liability. Please call us if you have concerns about such penalties. Should we encounter instances of unclear tax law, or of potential conflicts in the interpretation of the law, we will outline the reasonable courses of action and the risks and consequences of each. We will ultimately adopt, on your behalf, the alternative you select. Fees for services are based on a competitive rate per attached schedule. Acceptable payments for the 2011 tax year will be as follows: (1) Deduct directly from refund check through use of EPS Financial Services (Additional fees will apply. Ask for details) (2) Or Debit Card, Credit Card, Check, Money Order or Cash *All fees are due upon the e-filing and/ or release of tax prepared documents. In cases where the tax preparation fees are suppose to be deducted from a clients refund and refunds are not deposited within two weeks of the scheduled IRS release date, tax prep fees will be deducted from debit or credit card information on file. Any bank fees incurred by our firm due to returned checks will be billed back to the client plus an additional 1.5% inconvenience fee of
total invoiced amount. Invoices over 30 days past due will incur a.5% monthly finance charge. We ask the taxpayer to carefully review all tax returns. Upon your signed authorization, your federal and state, and if applicable, city and school district return will be electronically filed to the appropriate taxing authorities. Should any of your prepared returns require mailing, it is ultimately the taxpayer's responsibility. We will provide pre-addressed envelopes, but no postage is included. Your tax returns will be prepared with extreme care. However, should you receive any correspondence from either agency in regards to these returns, contact this office immediately. We are available to assist you in settling such matters, and are available for representation if you request. Additional invoices will be rendered for these services at the rate of $125.00 per hour. We will return your original records to you at the end of this engagement. You should securely store these records, along with all supporting documents, canceled checks, etc., as these items may later be needed to prove accuracy and completeness of a return. We will retain copies of your records and our work papers for your engagement for seven years, after which these documents will be destroyed. This engagement letter will serve to apply to all future years unless the agreement is terminated or amended in writing by the taxpayer or preparer. Rates are subject to change. Disclosure: All information obtained by client is considered confidential and will be strictly used for the purposes of executing the terms stated in the scope of the engagement and less otherwise agreed to by client and communicated by either fax, email or in writing. To affirm that this letter correctly summarizes your understanding of the arrangements for this work, please sign and date this letter in the space indicated and return it to us via mail, fax or email. Sincerely, Terri A. Simmons TERRI A. SIMMONS CPA PLLC (Both spouses must sign for preparation of joint returns.) Accepted By: [Client: Taxpayer Signature] (Date) [Client: Spouse's Signature] (Date)
Dependent Information Worksheet Please list your entire qualifying dependent s information below (children, parents, grandchildren, etc.) Name Birth Date Social Security #
Client Banking Information Client Name Name of Bank Routing Number Account Number Type: Circle One Checking Savings
Credit Card /Debit Card Payment Authorization Form Instructions: Mail, Fax or Email completed and signed form to the address, fax number or email address listed above. Check one: Visa Master Discover Amer Exp Card Number: Expiration Date (mm/yr): Three (3) digit code on back of card Name as it appears on card: Company name on card (if applicable): Your credit card billing address (if different from home address): City: State: Zip: Telephone Number: I authorize Terri A. Simmons CPA, PLLC to charge my credit/debit card for payment of their products and/or services. If the firm is unable to process my payment I will be responsible for an alternate payment arrangement and any processing fees. By signing this authorization, I acknowledge that I have read and agree to all of the above information and warrant all information given is true. Signature of Card Holder Date
Income Tax Return Preparation Fee Schedule Effective 01/01/2012 Form Type Preparation Fee 1040EZ (Includes one state return) $120.00 1040 A (Includes one state return, schedules for Earned Income Credit, Childcare $175.00 Credit, Education Credit, Retirement Savings Credit, Interest Income, and Additional Child Tax Credit) 1040 (Includes all schedules for the 1040 A plus, Schedule A for itemized $225.00 Deductions) *1040X (Amended Return for Federal, State, and City) $75.00 **1065 (Partnership Return includes up to 3 K-1 s) $800.00 **1020S (S-Corporation Return includes up to 3 K-1 s) $1200.00 **1020C (C-Corporation Return) $1200.00 ** 990-EZ/990 (Return of Organization Exempt from Income Tax) $250.00 minimum *Additional fees will apply to returns not previously prepared by our company. **Additional fees will apply at a rate of $125.00/hour for any bookkeeping and accounting services that need to be rendered in order to complete an accurate return. The following are the additional fees for schedules that may be needed as part of your income tax return: Form/Schedule Type *Schedule C EZ (Profit and Loss for businesses) $50.00 *Schedule C (Profit and Loss for businesses) *Schedule D (Capital Gains and Losses) *Schedule E (Rental Property and Royalties) Form 2106 (Reimbursed Employee Expenses) Form 4562 (Depreciation and Amortization) Form 4868 (Automatic Extension of Time to File) $75.00 Form 8829 (Expenses for Business Use of Your Home) Tax Preparation Fee $85.00 minimum/schedule $50.00 minimum/schedule $35.00 minimum/rental $25.00 /schedule $25.00 /schedule $40.00 /schedule *Additional fees will apply at a rate of $125.00/hour for any bookkeeping and accounting services that need to be rendered in order to complete an accurate return. The following are miscellaneous fees that may apply as part of your income tax return: Miscellaneous Ohio City and/or school district returns $15.00 Additional State Returns $35.00 Additional City and County Returns $10.00 W-2 (only if you have more than five W-2) $ 5.00 K-1 (only if you have more than three K-1 per return) $15.00 EPS Financial Document Prep Fee $5.00 Tax Preparation Fee Disclaimer: This fee schedule is not all-inclusive of all the schedules, forms, and fees that may apply in preparing your income return and should be used as a general guide to you give an approximate idea of cost.