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Income Tax Questionaire 2015

Tax Time

Step 1 of 8

12%

PERSONAL INFORMATION
Name*
Social Security #:*
Driver’s License #:*
Profession/Job Title:
Address
Street Address Address Line 2 City State ZIP Code
Home:
Cell#:
Email:*
Enter Email Confirm Email

SPOUSE INFORMATION
Spouse’s Name:
Spouse’s Date of Birth:
Spouse’s Driver’s License #:
Spouse’s Profession/Job Title:

DIRECT DEPOSIT
Would you like direct deposit?*
- Yes
- No
Name of Bank :
ABA Routing #:
Account #:

DEPENDENTS
Dependant 1
Name : Date of Birth: Social Security #: Relationship
Dependent 2
Name : Date of Birth: Social Security #: Relationship
Dependent 3
Name : Date of Birth: Social Security #: Relationship
Dependent 4
Name : Date of Birth: Social Security #: Relationship:

UPLOAD TAX DOCUMENTS
INCOME (Attach W-2’s or 1099’s)
Drop files here or

Accepted file types: jpg, gif, png, pdf, docx, doc.
Gross Wages
Soc Sec Withheld
Medicare Withheld
Fed Tax Withheld
State Inc Tax Withheld
Interest Income
Dividend Income
Capital Gain & Losses-Investment
Capital Gain & Losses-Date Acquired
Capital Gain & Losses-Cost or Other Basis
Capital Gain & Losses-Date Sold
Capital Gain & Losses-Net Sale Proceeds
Other Gains & Losses-Investment
Other Gains & Losses-Date Acquired
Other Gains & Losses-Date Sold
Other Gains & Losses-Net Sale Proceeds
Pensions, IRA Distributions, Annuities, and Rollovers (attach 1099)
Unemployment Compensation Received
Social Security Benefits Received (attach annual statement)
State/Local Tax Refund(s)
Royalties, Partnerships, S Corporations, Estates, Trusts (Attach K-1’s for all Partnerships/ S-Corporations/Fiduciaries)
Rental Property (Attach separate schedule(s) showing receipts & expenses for each rental property)
ADJUSTMENT TO INCOME
Your IRA deduction
Spouse's IRA deduction
Keogh SEP deduction
Penalty for early withdrawal of savings
Alimony paid - List name and Social Security Number
Self-employed health insurance premiums

ITEMIZED DEDUCTIONS
MEDICAL & DENTAL
Out of pocket costs for prescription medicines, drugs, insulin, doctors, dentists, nurses, and medical and dental insurance premiums (including Medicare B) paid (reduce by any insurance reimbursements)
Transportation and lodging incurred to obtain medical care
Other Medical expenses - hearing aids, eyeglasses, medical devices, etc.
TAXES PAID
State & Local Taxes not listed elsewhere
Real Estate Taxes not listed elsewhere
Personal property taxes (includes owners tax on auto registration)
INTEREST PAID
Home mortgage interest paid to financial institutions
Home mortgage interest paid to individuals (Provide name and address of individual)
Points paid
Investment Interest
CONTRIBUTIONS
Cash (Written documentation is required for all gifts of $250 or more - not just cancelled checks)
Other than cash - Attach details
Casualty and Theft Losses - Attach Details
EMPLOYMENT EXPENSES:
Union/Professional Dues:
Seminars/Continuing Education:
Books/Subscriptions
Parking Tolls:
Uniforms/Protective Equipment:
Job Search Costs:
Equipment/Tools:
Unreimbursed Miles Traveled:

MISCELLANEOUS EXPENSES:
Employee business expenses - attach details for amount Reimbursed, Not Reimbursed and list Job hunting expenses
Business Publications
Tax Preparation Fees:
Union Dues
Business Publications
Professional Dues/Fees
Safety Deposit Box Rental
Small Tools used in your trade or business
Business telephone
Uniforms & Cleaning
IRA Custodial fees
Investment Expenses
Education Expenses (attach details)
Attachments
Drop files here or

Accepted file types: jpg, gif, png, pdf, docx, doc.
Business Entertainment
Other Miscellaneous deductions
Automobile Use (In order to deduct mileage for auto expenses in a tax return, a log must be kept which details mileage driven for business purposes. This log, or something which keeps track of mileage, would be needed to justify the write off for the expense in the event of an audit)
Expenses incurred in connection with adoption
Foreign Tax Credits
Provider Name:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Provider Tax ID #:
Amount Paid:
Tuition (Attach Form 1098T)
Books:
Fees:
Student Loan Interest Paid (Form 1098E):

Click here for PDF version of our “Income Tax Questionaire 2015″

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Phone: (305) 387-5880
Fax: (305) 387-8176

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The information contained within this website is provided for informational purposes only and is not intended to substitute for obtaining accounting, tax, or financial advice from a professional accountant.

TAX QUESTIONAIRE

Income Tax Questionaire 2015

Step 1 of 8

PERSONAL INFORMATION

SPOUSE INFORMATION

DIRECT DEPOSIT

DEPENDENTS

UPLOAD TAX DOCUMENTS

ADJUSTMENT TO INCOME

ITEMIZED DEDUCTIONS

MEDICAL & DENTAL

TAXES PAID

INTEREST PAID

CONTRIBUTIONS

EMPLOYMENT EXPENSES:

MISCELLANEOUS EXPENSES:

BUSINESS USE OF HOME

Provide details for any "Yes" response to the following:

Household Employees: (Nanny Tax)

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Tel: 305-387-5880

TAX QUESTIONAIRE

Income Tax Questionaire 2015

Step 1 of 8

PERSONAL INFORMATION

SPOUSE INFORMATION

DIRECT DEPOSIT

DEPENDENTS

UPLOAD TAX DOCUMENTS

ADJUSTMENT TO INCOME

ITEMIZED DEDUCTIONS

MEDICAL & DENTAL

TAXES PAID

INTEREST PAID

CONTRIBUTIONS

EMPLOYMENT EXPENSES:

MISCELLANEOUS EXPENSES:

BUSINESS USE OF HOME

Provide details for any "Yes" response to the following:

Household Employees: (Nanny Tax)

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Recent Posts

Recent Comments

Address

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