MARCUS HILTON CPA. Relevant 2017 Tax Changes And Income Tax Questionnaire

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MARCUS HILTON CPA 4226A WHITE PLAINS ROAD 2 ND Floor BRONX, NEW YORK 10466 Tel (718) 554-0640 Fax (718) 554-0642 E-mail: info@marcushiltoncpa.com Web: www.marcushiltoncpa.com Relevant 2017 Tax Changes And Income Tax Questionnaire 1

MARCUS HILTON CERTIFIED PUBLIC ACCOUNTANT 4226A WHITE PLAINS ROAD 2 ND Floor BRONX, NEW YORK 10466 Tel (718) 554-0640 Fax (718) 554-0642 E-mail: info@marcushiltoncpa.com Web: www.marcushiltoncpa.com December 13, 2017 Dear Taxpayer: Welcome to another tax season. I want to thank you for your loyalty and patronage during the past years. For those of you who are first time clients we want to extend a special welcome to you and we do hope that you are satisfied with our tax preparation service. We are always trying to improve our service and we are pleased with the many suggestions that we received from several of you. Please check to see if the name you are using matches your Social Security Card. Help us make this tax preparation season error free. Please note that our main office is at the same address: 4226A White Plains Road, 2 nd Floor Bronx, New York 10466 (corner of 234 th Street) Please review the 2017 relevant tax changes and questionnaire. Kindly take your time and fill in as much information as you can. However, should you have a problem doing so, do not get discouraged, we will do the rest for you. 2

Our hours of operations are as follows: Mondays Fridays Saturdays Sundays 8am to 8pm 8 am to 6pm CLOSED All tax returns prepared by our office for the year 2017 must be e-filed. You can also e-file 2016, 2015 and 2014. Due Date on Return The due date for filing 2017 return is Tuesday, April 17, 2018. This is because April 15 th, 2018 is a Sunday and Emancipation Day is observed in Washington DC on Monday, April 16, 2018. As of this date The Internal Revenue Service has not announced when returns which include an Earned Income Tax Credit and/or an additional Child Tax Credit (Form 8812) will be accepted. We would appreciate if you file early in order to avoid the April 17 th rush. Please take note that the recently passed tax legislation will not substantially affect this year s (2017) tax filing. These provisions will take effect when you file your 2018 tax return. Hope to see you soon. Cordially, 3

Table of Contents Relevant 2017 Tax changes Page # Phase out of Exemptions 2017... 5 Unemployment Compensation 5 Standard Deductions Increased 5 Personal Energy Credit 6 Standard Mileage Rates for 2017 6 Earned Income Credit.. 6-7 Self-Employment. 7 Identity Theft... 7 Individual Health Insurance Requirement... 8 2016 Income Tax Questionnaire Page # Dependents... 10 Proof of Identity.. 10 Unemployment Insurance. 11 Disability Payments.. 11 Interest Income. 11-12 Dividend Income.. 12 Adjustment to Gross Income 12 Self Employed Plans (SEP).. 13 Educator Expense. 13 Disability Pay Exclusion.. 13 Alimony 13 Itemized Deduction.. 14 Taxes Paid in 2017... 15 Interest Expense for 2017. 15 Charitable Contributions (Cash) Made and Paid in 2017... 15 Charitable Contributions (Non-Cash) Made in 2017.. 16 Casualty Losses.. 16 Miscellaneous Expenses. 16-17 Credits. 17-20 Schedule C. 22-24 Schedule E - Rental Income 25-27 4

RELEVANT 2017 TAX CHANGES PHASEOUT OF EXEMPTIONS The benefits of personal and dependency exemptions are phased out for individuals by a 2- percent reduction for each $ 2,500 increment ($1,250 on a married filing separately return) by which adjusted gross income exceeds the amounts shown below. It phases out completely at $384,000 ($436,300 for married couples filing jointly). Filing Status PEP Threshold Starts PEP Threshold Ends Single $261,500 $384,000 Married Filing Jointly $313,800 $436,300 Married Filing Separately $156,900 $218,150 Head of Household $287,650 $410,150 UNEMPLOYMENT COMPENSATION Unemployment Compensation is fully taxable. This amount applies to both you and your spouse if you are married. AMT EXEMPTION FOR THE YEAR 2016 For 2017 the Alternative minimum tax (AMT) exemption is set at $84,500 for married taxpayers filing a joint return and on a return filed by a surviving spouse (qualifying widow(er)), $54,300 on a return with the filing status as single or head of household, and $42,250 for a married taxpayer filing a separate return. The exemption begins to phase out at $120,700 for single and head of household and $160,900 for couples filing jointly. STANDARD DEDUCTION INCREASED Married filing jointly $12,700 Head of household 9,350 Single 6,350 Qualifying widower 12,700 Married filing separately 6,350 5

PERSONAL ENERGY CREDIT Energy credit is a non-refundable credit, that means it reduces your taxes dollar for dollar. Any excess over your tax liability is carried forward to 2018. The popular residential energy tax credit equals 10 percent of cost up to a maximum of $500 or a specific amount from $50-$300. Examples: stoves, roofs, insulation, water heaters, windows, furnaces, central air conditioners, HAC air circulations fans, biomass stoves, doors and skylights. There is a 30 percent credit on the items mentioned below. Examples 1. Geothermal heat pumps 2. Solar water heater 3. Small wind turbines There is also a credit by New York State for the same items. These provisions have expired and have not yet been extended by congress as of this date. STANDARD MILEAGE RATES FOR 2016 Business use of automobile: 53.5 cents per mile Medical use or Moving: 17 cents per mile Charity use: 14 cents per mile EARNED INCOME CREDIT This credit has increased for the year 2017. No children $ 510 One child 3,400 Two children 5,616 Three or more children 6,318 The credit can be claimed if you earned less than $48,340 if you are single and $53,930 if married. Three children or more if you earned less than $48,340 (53,930 if married) Two children if you earn less than $45,007 ($50,597 if married) One child if you earn less than $39,617 ($45,207 if married) No children and you earned less than $15,000 ($20,600 if you are married) Maximum Investment income you can earn and get the credit is $3,450 6

Qualifying Child definition is as follows: A child must be younger than you unless the child is permanently and totally disabled. A child is not a qualifying child if the child filed a joint tax return unless the return was filed only as a claim for refund. If the parent of a child can claim a child as a qualifying child but no parent claim the child, no one else can claim the child as a qualifying child unless that person s AGI is higher than the highest AGI of any parent of the child. SELF-EMPLOYMENT Maximum income subject to social security tax The maximum amount of self-employment income subject to social security has not been increased in 2017. It remains at $127,200. SE tax rate For 2017, the Old Age, Survivors, and Disability Insurance (OASDI) portion of the SE remains at 12.4%. The Medicare (HI) portion of the SE tax remains 2.9%. As a result, the SE tax remains at 15.3% and SE tax deduction is one-half of the total self-employment tax. No change this year. IDENTITY THEFT The Internal Revenue Service requires additional information this filing season in an effort to combat stolen-identity tax fraud. Examples of proof of identity verification are as follows: Driver s License, state issued ID or passport Financial or utility account number such as checking account, saving account, loan, credit card, or utility bill which requires a government ID to obtain. Other nongovernmental documentation. MEDICARE TAXES An additional 0.9 percent Medicare tax on wages above $200,000 for individual and $250,000 for married filing jointly remains the same for 2017. The 3.8 percent rate applies to investment (Unearned) income with modified adjusted gross income of $200,000 and $250,000 for single and married filing jointly taxpayer. 7

ESTATES AND GIFT TAXES For an estate of any decedent during 2017, the basic exclusion is $5,490,000 and the maximum rate is 40%. The annual exclusion for gifts is $14,000. INDIVIDUAL HEALTH INSURANCE REQUIREMENT The Affordable Care Act mandates that most individuals have minimum essential coverage (Health Insurance). All individuals must maintain minimum essential coverage for themselves and any dependents that are also applicable individuals. Nonexempt individuals who do not maintain required health coverage for themselves and any nonexempt dependents are subject to a shared responsibility penalty. Exempt individuals are not subject to the shared responsibility penalty for any month they qualify for one or more exemptions on any day during the month. Minimum Essentials Coverage Generally, coverage obtained through government-sponsored programs, an eligible employersponsored plan, or purchased through a state insurance marketplace will meet the minimum essential coverage requirement. Form 1095-A, Health Insurance Marketplace Statement, will be issued by the state marketplace for individuals receiving coverage through a state marketplace. Besides listing individuals covered, this form includes the insurance premiums paid, the benchmark premium, and any premium advance. This information is needed to calculate and reconcile the premium tax credit. If you are covered by the Affordable Care Act (ACA) (Obama Care), please provide a copy of form 1095A and 8962 where applicable. Failure to do so may give rise to delay in processing your tax return. Also, you must provide proof of insurance coverage by submitting a copy of form 1095B or 1095C with your documents. 8

MARCUS HILTON CERTIFIED PUBLIC ACCOUNTANT 4226A WHITE PLAINS ROAD 2 ND Floor BRONX, NEW YORK 10466 Tel (718) 554-0640 Fax (718) 554-0642 E-mail: info@marcushiltoncpa.com Web: www.marcushiltoncpa.com 2017 INCOME TAX QUESTIONNAIRE PERSONAL INFORMATION Last Names: (Taxpayer) (Spouse) First Names:(Taxpayer) (Spouse) Occupation: (Taxpayer) (Spouse) Address: (Street) City and Zip Code: Email address Telephone Numbers: (Home) (Business) Date of Birth: (Taxpayer) _ (Spouse) Social Security Numbers: (Taxpayer) (Spouse) 2. Do you wish to have $3.00 of your tax applied to the Presidential Election Campaign Fund? Please indicate yes or no below: You: Yes No Spouse: Yes No 3. Is someone (such as your parents) claiming you on their tax returns? Yes No Check filing status on this return: Single Married Filing Joint Return Head of Household qualifying widow(er) with dependent child (Indicate year spouse died) Married Filing Separately Enter spouse Social Security Number 9

Note: Married filing separately in most cases give rise to higher taxes being paid. DEPENDENTS: First and Last Names as Shown on Social Security Card Date of Birth Social Security Number Relationship No. of months in your home Please place an asterisk (*) next to the dependent s name if he or she has education expenses. If dependent has an identity protection PIN furnished by the IRS, please write it down or provide IRS letter with number. PIN: (if applicable) Note: It is mandatory to have a Social Security number for each dependent no matter what age. PROOF OF IDENTITY VERIFICATION: Was taxpayer physically present in your office or was return prepared remotely? In Office Remote Which of the following did the taxpayer provide to confirm identity, address, and/or nationality? Driver s License, state issued ID or passport. Financial or utility account number such as checking account, savings account, loan, credit card, or utility bill which requires a government ID to obtain. Other nongovernmental documentation. ID type ID number ID issuing state ID issue date ID Expiration date Bank Information Bank Name: Name on Account: Address: Routing Number: 10

Account Number: Type of Account: Checking Savings Did you claim any child as a dependent who did not live with you during the year due to divorce or separation? Yes No. If your answer is yes, do you have a pre 1985 agreement? Yes No. For dependents other than your children, the following questions must be answered. A. Did you provide more than half of dependent s support? Yes No. If yes, how much is your support in monetary terms? $. Did your dependent have more than $4,050 in income? Yes No. Enclosed copies of your W-2 and 1099 Forms. W-2 FORMS PENSION AND ANNUITIES Yes No N/A Yes No N/A UNEMPLOYMENT INSURANCE Yes No N/A DISABILITY PAYMENTS Yes No N/A * Unemployment compensation is fully taxable. However, you may deduct any sum you repaid from the total benefits receive. Please indicate which Form you filed last year 2016. 1040 1040A 1040EZ How much refund did you receive from New York State income tax for 2016? $ Please indicate the amount on line 29 of Schedule A for 2016 $. INTEREST INCOME Payer Name Amount 11

Kindly submit to us all 1099 Forms issued by your bank or financial institution. DIVIDEND INCOME: Payer Name Amount Kindly submit to us all 1099 Dividend Forms issued by your bank or financial institution. ADJUSTMENTS TO GROSS INCOME Contributions to Retirement Plans: Amount Date of Contribution Keogh (HR-10) Self-Employed Husband Retirement Plan* Wife Individual Retirement Account Husband (Check here if Roth IRA)* Wife Forfeited interest penalty for Husband Premature withdrawal Wife * Include contributions made after December 31, 2017 made with respect to 2017. Regular IRA maximum 2017 wages in order to be eligible is as follow: Single: $72,000 Phase in range $62,000-72,000 Qualifying Widower: $119,000 Phase in range $99,000-119,000 Married: $119,000 Phase in range $99,000-119,000 Married filing separately: $10,000 Phase in range $ 0-10,000 If one spouse is not covered by a pension plan, then the maximum wages for that individual is $196,000 (phase out amount is 186,000 196,000). 12

ROTH IRA maximum contribution is $5,500 per tax payer Phase out for single person is $118,000 133,000 Phase out for married individuals filing jointly is $186,000 196,000 Phase out for married persons filing separately is $0 10,000 The maximum contribution is $5,500 per year, per taxpayer under 50 years old ($6,500 if age 50 or older but under 70 ½ at end of 2017). This applies to both Regular and Roth IRA. Maximum 401(k) is $18,000 with a catch up limit of $6,000 if you are over 50 years old. SELF EMPLOYED PLANS: (SEP) You can contribute a maximum of $54,000 or 25% of the difference between the net business income and one half of self-employment tax. Maximum income is $270,000. EDUCATOR EXPENSE You can deduct up to $250 of qualified expenses and the excess could be claimed as itemized expenses. This provision was modified to include certain expenses related to professional development courses the taxpayer takes related to the curriculum they teach or to their students. DISABILITY PAY EXCLUSION Taxpayers under 65 and who have retired on disability and are permanently and totally disabled may qualify for the exclusion. If you qualify, please furnish me with details. ALIMONY: Amount paid Recipients Name Social Security Number Amount _ Student Loan Interest _ Maximum allowed $2,500. * Phase out for single, head of household or qualifying widower is 65,000 80,000 Phase out for joint filers is 135,000 165,000 Self Employment Health Insurance: (Rate for 2017 is 100% of premium paid) Payer (Insurance Company) Amount Paid 13

ITEMIZED DEDUCTION 1. Medical Expense Paid in 2017 Doctor $ Medical Insurance $ Dentist $ Prescription $ Nurses $ Medical Equipment $ Hospital Bills $ Eye Glasses $ Dentures $ Auto Miles: Total miles @17c Travel to and from Hospital Contact Lenses $ and Doctor s office $ (Actual expenses) Other $ Insulin $ Total Medical Expenses $ Long-term care insurance premiums are treated as qualified medical expenses. The deductible portion of the premiums may not exceed the amounts set forth in the following table for 2017. AGE AT YEAR-END Age 40 or less $ 410 Age 41 through 50 770 Age 51 through 60 1,530 Age 61 through 70 4,090 Age 71 or older 5,110 MAXIMUM DEDUCTIBLE PREMIUM Note: The limit on premiums is for each person. Note: Only the excess of 7.5% of your adjusted gross income is deductible if the taxpayer is over 65 years. However, if the taxpayer is under the age of 65 the excess of 10% of your adjusted gross income is used. 14

TAXES PAID IN 2017: Real Estate Taxes on Residential Property Personal Property Taxes (not sales tax) NYS Estimated Taxes Paid in 2017 NYC Estimated Taxes Paid in 2017 School Taxes Sales Tax $ $ $ $ $ $ INTEREST EXPENSE FOR 2017: A. Mortgage interest paid to financial institutions $ B. Mortgage interest paid to individuals $ Specify: Name: Address: Social Security No. or EIN No. C. Deductible mortgage points $ D. Deductible investment interest $ E. Student loan interest; (maximum allowed $2,500) $ Note: Personal interest is no longer deductible: For example, credit cards, personal bank loans and car loans. CHARITABLE CONTRIBUTIONS MADE AND PAID IN 2017 Cash Contributions must list every organization and amount given. Name Organization Date Amount An official letter is required from an organization for which you gave $250 or more in 2017. A canceled check by itself does not meet the Internal Revenue Service substantiation requirement. 15

If you gave your church $50 per week and the total sum is $2,600 for 2017, treat each $50 as a separate gift. The same rule applies to payroll deduction such as the united way. Gifts from which you benefit: If you made a gift and received a benefit in return, such as food, entertainment, or merchandise, you can generally only deduct the amount that is more than the value of the benefit. But this rule does not apply to certain membership benefits provided in return for an annual payment of $75 or less. Example. You paid $70 to a charitable organization to attend a fund-raising dinner and the value of the dinner was $40. You can deduct only $30. Auto travel: miles @ 0.14c per mile $ Non Cash Organizations Name of Organization Cost Date Acquired FMV Date Donated Note: Please indicate how you determined FMV. Any amount given in excess of $500 requires Form 8283 to be completed. Contributions made of used clothing and household items require that the clothing must be in good condition. CASUALTY LOSSES: Did you report such loss to the police? Yes No Police report Claim No. Date of Loss Cost when purchased Insurance Recovery Fair market value before loss Kind of Property Description of property _ Do you expect to receive insurance recovery? Yes No Miscellaneous Expenses Professional Publication $ Uniforms $ Union Dues $ Uniform maintenance $ Safe Deposit boxes used to keep Nursing Supplies $ Income producing property $ Nursing Journals $ 16

Tax preparation fees $ Work Shoes $ Investment expense $ Small Tools $ Job Hunting fees $ Hose and Support $ Tolls to and from second job $ Malpractice Insurance $ Unreimbursed employee expenses $ Seminars/conferences $ Job education expense: Auto: Books $ Travel rates for automobile is 53.5 per mile Tuition $ Business miles @ 53.5 Travel $ List courses taken Note: Only the excess of 2% of adjusted gross income is deductible. CHILD AND DEPENDENT CARE CREDIT Was service provided in your home? No Yes. Amount paid in each quarter $_. Did you receive employer provided dependent care benefits? No Yes Amount $ Amount must be included in line #7 and the word s DCB written on the dotted line. Did both Husband and Wife work during 2016? Yes No. Was either or both spouse full-time students during 2016? Husband or Wife only? Both Husband and Wife? Care provider s name: Address: Relationship to you Social Security No. if it is an individual 17

Employer s identification number if it is another entity Period of Care: from to Dependent s Name Amount Paid in 2017 Please note that it is imperative you obtain the address and Social Security Number of the person taking care of your child. Failure to obtain such information may give rise to the denial of the credit. * Maximum age for childcare is under age 13 by 12/31/2017 unless such child is disabled. Maximum expenses allowed for child and dependent care is as follows A) One child $3,000 (250 per month) B) Two or more children is $6,000 (500 per month) Rates varies on wages from $0 43,000 from 35% to 21% of expenses paid. Wages over $43,000 receive a maximum percentage of 20% of expenses paid. EARNED INCOME CREDIT Maximum credit allowed for 2017 is $3,400, $5,616, and $6,318 on maximum wages of $39,617 for one child, $45,007 for two children, and $48,340 for three or more children if your filing status is head of household or qualifying widower. You may qualify for earned income credit this year even if you do not have a qualifying child. Maximum credit is $510 on wages under $15,000. If a joint return is filed the maximum salaries are $20,600, $45,207, $50,597, and $53,930 for no children, one child, two children, and three or more children respectively. *Maximum investment income allowed for this year 2017 is $ 3,450. CHILD TAX CREDIT This credit is in addition to the child and dependent care credit and the earned income credit that you may be able to claim. Credit begins to phase out for salaries of $ 75,000 and $ 110,000 for 18

single and married couples respectively. For persons filing married filing separately, the amount begins at $55,000. The allowable credit is reduced by $50 for each $1,000 of modified AGI above the phased out thresholds. WHAT IS THE CHILD TAX CREDIT? The child tax credit is a credit for people who have a qualifying child; it reduces taxes that are owed. The credit can be as much as $1,000 for each qualifying child. The child must be under 17 years of age by December 31, 2017. CREDIT FOR ELECTIVE DEFERRALS AND IRA CONTRIBUTIONS This credit is commonly referred to as the retirement savings contribution credit and has also been referred to as the savers credit. The saver s credit can be claimed by: Married couples filing jointly with incomes up to $62,000 in 2017 Heads of Household with incomes up to $46,500 in 2017; and Married individuals filing separately and singles with income up to $31,000 in 2017. The maximum credit is $1,000 and maximum contribution amount is $2,000. EDUCATION CREDIT How much did you pay for? Tuition Fees $ Course Materials $ Health Fees $ Student Fees $ Is this a two-year program? Yes No Is this a four year program? Yes No Is this a graduate program? Yes No What year in college are you? AMERICAN OPPORTUNITY CREDIT Credit is for 100% of the first $2,000 of qualified tuition and related expenses, plus 25% of the next $2,000 of expense. Maximum credit per student is $2,500 and is available for the first four years of the student s post secondary education. Maximum AGI-Single: $80,000-90,000 Married $160,000 - $180,000. Single phase out $10,000 spread where as married have a $20,000 spread. 19

LIFETIME CREDIT Lifetime credit expense is based on tuition paid during the year 2017. How much did you pay during the year 2017? $ (Maximum eligible expense is $10,000; therefore maximum credit is $2,000 based on a 20% maximum rate.) Maximum AGI for unmarried individuals is $55,000 66,000 and for married individuals is $112,000 132,000 ADOPTION CREDIT In general, the credit is available for costs incurred. Credit is permitted for qualified adoption expenses, up to a maximum nonrefundable credit (that means only individuals with tax liability will benefit) of $13,570 per child. This amount applies whether or not the eligible child is a special needs child. Qualified expenses are adoption and attorney s fees, court costs and other reasonable and necessary expenses directly related to the adoption of a qualified child. No credit is allowed for taxpayers with a Modified Adjusted Gross Income (MAGI) in excess of $243,540. How much did you pay for adoption expenses in 2017? $ ENERGY CREDIT Expenses incurred in 2017 Windows $ Qualified Stove (which use bromes fuel) $ Boiler $ _ Insulation $ Residential exterior doors $ _ Heat Pumps $ Furnaces $ _ Central Air Condition $ Water Heaters $ _ Solar Electricity Equipment $ Metal Roof $ _ Other $ RATE REDUCTION CREDIT: STANDARD DEDUCTION FOR 2017: Over 65 Over 65 & Blind Single $ 6,350 $ 7,900 $ 9,450 Married filing jointly 12,700 15,200 17,700 Head of household 9,350 10,900 12,450 Married filing separately 6,350 7,600 8,850 Qualifying Widower 12,700 13,950 15,200 Note: If you are single or head of household and over 65 years of age (born before January 2, 1953) there is an additional $1,550 added to your standard deduction, and an additional $1,550 20

if you are legally blind. The rate for married filing jointly or separately is an additional $1,250 in each instance. Maximum Social Security wages for 2017 is $127,200. Self-employment tax is 15.3%. TAXPAYER S STATEMENT The foregoing, and all accompanying schedules and statements, have been supplied for the purpose of enabling you to prepare my (our) income tax returns for the year 2017 and the information contained above, which I (we) have read and reviewed, is true and complete to the best of my (our) knowledge and belief. I (we) understand fully that you are not in any way undertaking to audit and verify the facts as I (we) have submitted them to you. Upon request of the taxing authorities I (we) will furnish any necessary substantiation. HUSBAND DATE WIFE DATE OTHER DATE 21

2017 SCHEDULE C 1. Name of proprietor 2. Principal Business of Profession including product or service 3. Employer s Identification Number 4. Business Name 5. Business Address 6. Accounting Method Cash Accrual Other 7. Did you materially participate in the preparation of the business in the year 2017 Yes No 8. Did you start or acquire the business in the year 2017 Yes No If yes state date you began If you have a loss, check the box that best describes your investment in this activity. a. all investment is at risk b. some investment is not at risk If you checked box B above, you must attach Form 6198. Your loss maybe limited. Gross Sales (income) Return and allowances $ $ Beginning Inventory Purchases Cost of Labor Materials and Supplies Ending Inventory Gross Profit Other income: 22

EXPENSES Advertising Car & Truck Expenses Commission s Contract Labor Depletion Depreciation $ Employees Benefit Programs Pension Sep Keogh Simple IRA Insurance $ a) Malpractice b) Auto c) General Liability d) Medical Interest: a) Mortgage (paid to banks) b) Other Legal and Professional Fees Office Expense Rent or Lease a) Vehicles machinery and equipment b) Other business property Repairs & Maintenance Supplies Taxes Licenses Travel, Meals & Entertainment a) Travel b) Meals and Entertainment Utilities (Gas and Electric) Wages and Salaries Payroll Taxes: Employer s FICA Employer s Medicare 23

NYS Unemployment Insurance Federal Unemployment Insurance OTHER: A B C D E F G H I J K L M N Note Maximum FICA wages for 2017 is $127,200 24

2017 SCHEDULE E RENTAL INCOME Do you rent part of your entire house? Yes No If you rent part of your house, what percent do you occupy? Number of days rented *Type of Property: 1) Single family residence 5) Land 2) Multi-family residence 6) Royalties 3) Vacation/short term rental 7) Self-Rental 4) Commercial 8) Other (describe) Property A, address: _ Property B, address: _ Property C, address: Property A Property B Property C What percent do you rent? _ *Write the number for property type _ Fair Rental Days _ Rents Received $ _ Expenses: Advertising _ Accounting fees _ Auto and travel _ Cleaning and maintenance _ Commission _ Insurance _ Legal Fees _ Mortgage interest paid to banks _ Other interest _ Repairs _ Supplies _ Real Estate Taxes _ 26

Water _ Utilities: Total _ A) Gas _ B) Fuel _ C) Electric _ Wages and salaries _ Other: Property A Property B Property C Exterminating _ Boiler Contract _ Snow removal _ Plumbing Repairs _ Gardening _ Monthly maintenance fee _ (Co-Ops & Condominiums) _ Rent Stabilization fee _ Inspection Fees _ Security Services (alarm) _ Postage and Mailings _ Boiler permits _ TOTAL EXPENSE $ ============ ============ =========== Rental Property: Capital Improvements paid for 2017. Nature Date Done Cost % to be expensed 27

* Depreciation Expense Prior Years Nature of Date Depreciation Cost Description Taken Expense Method to Date * If we prepared your 2016 tax return, do not complete this section. 28

Notes 29